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

针对智障青少年的家庭减肥干预

• 批准号: 8710297
• 负责人: RICHARD K FLEMING
• 金额: $ 45.87万
• 依托单位: UNIVERSITY OF MASSACHUSETTS BOSTON
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-22 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8710297
• 关键词: Address; Adherence; Adolescence; Adolescent; Adult; Age; Area; Audiotape; Behavior; Behavior Therapy; Behavioral; Body Weight decreased; Body mass index; Child; Clinical; Cognitive; Control Groups; Counseling; Data; Diet; Down Syndrome; Eating; Education; Family; Food; General Population; High Prevalence; Independent Living; Individual; Intellectual functioning disability; Intervention; Investigation; Knowledge; Life; Life Style; Maintenance; Measurement; Nutrient; Obesity; Outcome Study; Overweight; Parents; Participant; Persons; Physical activity; Population; Randomized; Randomized Controlled Trials; Reporting; Research; Sampling; Self Efficacy; Time; Training; United States Dept. of Health and Human Services; Weight; Work; Youth; aged; base; critical period; design; efficacy testing; efficacy trial; experience; follow-up; food consumption; fruits and vegetables; innovation; nutrition; nutrition education; post intervention; primary outcome; programs; secondary outcome; sedentary; skills; theories; therapy design; treatment duration; tv watching; weight loss intervention; weight maintenance; young adult

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.

描述（由申请人提供）：肥胖在智障人士 (ID) 中比在普通人群中更为普遍。这一人群的减肥在青春期尤为重要，在这个关键时期，父母可以传授健康的饮食和身体活动知识和技能，以期孩子过渡到成年并独立生活。以家庭为基础的治疗对于促进正常发育的儿童和青少年减肥是有效的，但据我们所知，尚未报道针对患有智力障碍的儿童或青少年的随机对照试验（RCT），因此迫切需要进行研究。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，其中我们发现令人鼓舞的结果，有利于我们所说的基于家庭的行为干预 (FBBI)，而不是纯粹的教育方法。该 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，其中 48 名 15-22 岁的智力障碍青少年与父母一起参与该计划，随机接受 FBBI 或延迟治疗 (DT)； 2) 制定、实施和评估后续维持干预措施 (FBBI+MI)，旨在通过长期生活方式维持策略维持体重减轻。完成 FBBI 后，参与者将被随机分配接受为期 6 个月的 FBBI-MI 干预或不接受治疗。这项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品的消费；进行中度至剧烈体力活动的时间；屏幕时间；和自我效能感。数据是在基线、6 个月（年底）收集的 FBBI）、12 个月（FBBI+MI 结束）和 18 个月（无干预随访）。分配到 DT 的参与者在最初的 6 个月延迟后开始 FBBI，在此期间他们充当对照，因此接受额外的基线测量。治疗保真度通过 20% 的疗程的直接观察或录音带审查进行评估，涵盖干预专家实施的营养教育、个人营养咨询和家长行为培训等内容。这项研究的结果将有助于青少年减肥研究，并为更大规模的研究和临床干预提供信息。