A Family-Based Weight Loss Intervention for Youth with Intellectual Disability

描述（由申请人提供）：肥胖在智障人士（ID）中比在一般人群中更为普遍。在这一人群中，减肥在青春期尤为重要，在这一关键时期，父母可以向孩子传授健康的饮食和体育活动知识和技能，以预期他们的孩子将过渡到成年并独立生活。以家庭为基础的治疗在促进正常发育的儿童和青少年减肥方面是有效的，但据我们所知，还没有关于儿童或青少年ID的随机对照试验（rct）的报道，因此迫切需要研究。这项R01提案旨在建立在我们最近完成的针对患有唐氏综合症的青少年/年轻人的随机对照试验（N=21）的基础上，在该试验中，我们发现了令人鼓舞的结果，即我们所说的基于家庭的行为干预（FBBI）优于纯粹的教育方法。本R01提案的具体目标是：1)对我们的试点计划（FBBI）进行必要的更大规模的复制，有48名年龄在15-22岁的ID青少年与父母一起参与该计划，随机分配到FBBI或延迟治疗（DT）；2)制定、实施和评估随访维持干预（FBBI+MI），旨在通过长期生活方式维持策略来维持体重减轻。完成FBBI后，参与者将被随机分为FBBI- mi干预组和无干预组，干预期为6个月。本研究的主要结果是青少年参与者体重状况的变化，以体重指数（BMI）报告。次要结果是青少年的变化：水果、蔬菜和高能量密度食物的消费；花在中度到剧烈体育活动上的时间；屏幕时间;和自我效能感。数据收集于基线，6个月（6月底）

DESCRIPTION (provided by applicant): Obesity is more prevalent in persons with intellectual disabilities (ID) than in the general population. Weight loss in this population is particularly important during adolescence, a critical period in which parents can impart healthful dietary and physical activity knowledge and skills in anticipation of their child's transition into adulthood ad independent living. Family-based treatments have been effective in promoting weight loss among typically developing children and adolescents, but to our knowledge no randomized controlled trials (RCTs) have been reported with children or adolescents with ID, and research is sorely needed. This R01 proposal seeks to build upon our recently completed RCT (N=21) with adolescents/young adults with Down syndrome in which we found encouraging results favoring what we refer to as family-based behavioral intervention (FBBI) over a purely educational approach. The specific aims of this R01 proposal are to: 1) conduct a needed larger replication of our pilot program (FBBI) with 48 adolescents with ID aged 15-22 years, participating in the program with a parent, randomized to FBBI or delayed treatment (DT); and 2) develop, implement and evaluate a follow-up maintenance intervention (FBBI+MI) designed to sustain weight loss through longer-term lifestyle maintenance strategies. After completion of the FBBI, participants will be randomized to either a FBBI-MI intervention for 6 months or a no treatment period. The primary outcome of this study is change in adolescent participants' weight status, reported as body mass index (BMI). Secondary outcomes are changes in adolescents': fruit, vegetable and high energy-dense food consumption; time spent in moderate to vigorous physical activity; screen time; and self-efficacy. Data are collected at baseline, 6 months (end of FBBI), 12 months (end of FBBI+MI) and 18 months (no-intervention follow-up). Participants assigned to DT begin FBBI after an initial 6-month delay, during which they serve as controls, and therefore receive an additional baseline measurement. Treatment fidelity is assessed by direct observation or audiotape review for 20% of sessions, covering the interventionists' implementation of nutrition education, individual nutrition counseling and parent behavioral training components. The results of this study will contribute to the research on weight reduction for adolescents and inform larger-scale research and clinical interventions.