Comprehensive Approach to Family Weight Management

家庭体重管理的综合方法

• 批准号: 8310056
• 负责人: JUDITH WYLIE-ROSETT
• 金额: $ 72.85万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8310056
• 关键词: 12 year old; Address; Adoption; Adult; Affect; Age; American; Behavior; Behavioral Model; Biological Markers; Body mass index; Child; Childhood; Clinic; Collaborations; Community Health; Computerized Medical Record; Consult; Counseling; Data; Dietary intake; Effectiveness; Enrollment; Environment; Evaluation; Evaluation Studies; Family; Family member; Goals; Health; Health Food; Healthy People 2010; High Prevalence; Hispanics; Hospitals; Individual; Intervention; Life Style; Maintenance; Managed Care; Measures; Medicaid; Medical; Medical Staff; Metabolic; Modeling; Motivation; New York; New York City; Newsletter; Obesity; Overweight; Parents; Participant; Physical activity; Poverty; Prevalence; Prevention strategy; Primary Health Care; Process Measure; Professional Education; Quality Control; Randomized; Randomized Controlled Clinical Trials; Readiness; Role; Schools; Services; Social Marketing; Students; Surveys; Target Populations; Techniques; Testing; Training Support; Weight maintenance regimen; Youth; arm; base; cost; cost effectiveness; follow-up; improved; intervention effect; obesity prevention; post intervention; programs; sedentary; sex; skills; social; staff intervention; theories

Project Summary The purpose of this study is to address the Healthy People 2010 obesity prevention objective. This study will test the effects of a comprehensive family weight management program on the BMI z-score of 7-12 year-old children with a BMI > 85th percentile who receive primary care in a large municipal Bronx hospital. The intervention framework will draw on social marketing theory and the transtheoretical model of behavioral change to incorporate successful obesity prevention strategies. A two-arm randomized controlled clinical trial (RCT), which will enroll (n =506) 7-12 year old children with a > 85th BMI percentile, will compare the Experimental Intensive Intervention to a Standard (Control) Intervention. The Standard Intervention will receive: 1) an initial consult, which includes an overview of lifestyle goals, 2) quarterly follow-up, 3) and a monthly newsletter. The Intensive Intervention will add: 1)12 core group modules for parents (to address roles and skills) and for children (to enhance motivation and skills and to provide physical activity), 3) Tailored support using a ¿toolbox¿ approach from community health workers as extensions of the Family Weight Management professional education staff, and 4) monthly after-core follow-up groups. The study will determine if children randomized to the Experimental Intensive Intervention will have greater improvement in BMI change (z-scores) than those randomized to the Control Standard Intervention. The study will also evaluate the effects on the Experimental Intervention on lifestyle variables and assess intervention costs. The RE-AIM evaluation will address: Reach: How many of the eligible children/ families were referred and how many of those referred actually enrolled? We will use BMI data in the computerized medical records to evaluate the proportion and the appropriateness of the referrals. Efficacy/Effectiveness: How did the Experimental intervention affect BMI (changes in z-score), and key biomarkers when followed as planned? Adoption: How acceptable were the intervention(s) to the primary care medical team and the children/families in the pediatric clinics etc? (from process measures and post intervention surveys) Implementation: How many of the intervention activities were provided as planned? Quality control measures will be used to evaluate the integrity of the intervention(s). Maintenance: How much of the intervention effect is sustainable? Individual effects will be evaluated based on the 24 month follow data. Institutional effects evaluation will include the potential to maintain services using third-party coverage. Project Narrative The purpose of this study is to address the Healthy People 2010 obesity prevention objective and to test a comprehensive family weight management program in 7-12 year- old Bronx children who are overweight. The study will randomize 506 children to the Experimental (Intensive) Intervention or to a Standard (Control) Intervention. The Standard Intervention will receive: 1) an initial consult, which includes an overview of lifestyle goals, 2) quarterly follow-up, 3) and a monthly newsletter. The Intensive Intervention will add: 1)12 core group modules for parents (to address roles and skills) and for children (to enhance motivation and skills and to provide physical activity), 3) tailored support using a ¿toolbox¿ approach from community health workers as extensions of the Family Weight Management professional education staff, and 4) Monthly after-core follow-up groups.

项目摘要 本研究的目的是为了解决健康人2010年肥胖预防 objective.这项研究将测试一个全面的家庭体重管理的效果 BMI >第85百分位数的7-12岁儿童的BMI z评分计划， 在一家大型的布朗克斯市立医院进行初级护理。干预框架将利用社会 营销理论和行为改变的跨理论模型， 肥胖预防策略。一项两组随机对照临床试验（RCT），将 入组（n =506）BMI> 85百分位数的7-12岁儿童，将比较 实验性强化干预与标准（对照）干预。标准 干预将接受：1）初步咨询，其中包括生活方式目标的概述，2） 季度后续行动，3）和每月通讯。强化干预将增加：1）12个核心 为父母（解决角色和技能）和儿童（提高动机）提供的小组模块 和技能，并提供体力活动），3）使用工具箱方法提供量身定制的支持， 社区卫生工作者作为家庭体重管理专业人员的延伸 教育工作人员，以及4）每月核心后随访组。这项研究将确定儿童是否 随机分配到实验性强化干预组的患者， 与随机分配至对照标准干预组的受试者相比，这项研究将 还评估了实验干预对生活方式变量的影响， 干预成本。RE-AIM评估将解决：覆盖范围：有多少符合条件的 儿童/家庭被转介，其中有多少人实际登记？我们将使用 BMI数据在电子病历中所占比例的评价及 转介的适当性。功效/有效性：如何进行实验 干预影响BMI（z评分变化），以及按计划随访时的关键生物标志物？ 采用：初级保健医疗团队和 儿童/家庭在儿科诊所等？(from过程措施和事后干预 执行情况：有多少干预活动是按计划提供的？ 质量控制措施将用于评价干预措施的完整性。 维持：干预效果有多少是可持续的？个体效应将是 根据24个月随访数据进行评价。机构影响评估将包括 使用第三方覆盖来维持服务的可能性。项目叙述 本研究的目的是为了解决健康人2010年肥胖预防 目的：在7-12岁的儿童中测试一个全面的家庭体重管理计划- 超重的布朗克斯老人这项研究将随机抽取506名儿童， 实验（强化）干预或标准（对照）干预。的 标准干预将接受：1）初步咨询，其中包括概述 生活方式目标，2）季度随访，3）和每月通讯。重症 干预措施将增加：1）12个父母核心小组模块（解决角色和技能） 和儿童（以提高动机和技能，并提供体育活动），3） 使用社区卫生工作者的“工具箱”方法提供有针对性的支持， 家庭体重管理专业教育人员的扩展，以及4） 每月一次的核心随访组。