Patient-Provider Communication to Promote Health Behavior Change in African Ameri

医患沟通促进非裔美国人健康行为的改变

• 批准号: 8770193
• 负责人: April Marie Idalski Carcone
• 金额: $ 23.68万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8770193
• 关键词: Address; Adherence; Adolescent; Adult; African; African American; Basic Behavioral Science; Behavior Therapy; Behavioral; Body Weight decreased; Body fat; Caregivers; Childhood; Client; Clinical; Clinical Skills; Clinical Trials; Code; Communication; Consensus; Cues; Data; Data Analyses; Development; Diet; Dietary Practices; Eating; Elements; Empathy; Family; Food; Funding; Goals; Grant; Guidelines; Health; Health Communication; Health Personnel; Health behavior; Health behavior change; Intention; Intervention; Investigator-Initiated Research; Life Style; Link; Malignant Neoplasms; Mediator of activation protein; Methods; Minority; Monitor; Motivation; Obesity; Outcome; Outcome Study; Overweight; Parents; Patient-Centered Care; Patients; Pattern; Physical activity; Population; Population Heterogeneity; Problem behavior; Process; Provider; Randomized; Randomized Clinical Trials; Recommendation; Research; Research Project Grants; Scheme; Self Efficacy; Target Populations; Testing; Training; Translating; United States National Institutes of Health; Universities; Weight; Work; Youth; base; behavior change; behavioral health; communication behavior; design; evidence base; fitness; high risk; innovation; motivated behavior; motivational enhancement therapy; obesity prevention; obesity treatment; patient oriented; primary outcome; public health relevance; skills; substance abuser; success; treatment strategy; weight loss intervention

DESCRIPTION (provided by applicant): Rates of overweight and obesity in pediatric populations are reaching crisis levels, with African American adolescents at highest risk. Although effective weight loss strategies (e.g., monitoring of food intake and activity level, environmental control to reduce cues to eat unhealthy foods, goal setting) are well known, attempts to construct effective behavioral weight loss interventions for African American adolescents with obesity (AAAO) have largely failed. A primary barrier to success has been motivation to engage in the weight loss strategies critical for success. Therefore, successful weight loss treatment requires that treatment providers be able to motivate families to make the challenging behavioral changes necessary for sustained weight loss. Patient-provider communication is the primary treatment strategy that treatment providers, in any setting, use with their patients. Although patient-provider communication is recognized as a key clinical skill, there are few guidelines to help treatment providers communicate effectively with patients. Motivational Interviewing (MI) is an evidence-based communication strategy that uses client-centered, directive methods for enhancing intrinsic motivation and self-efficacy. MI provides a framework to study the relationship between provider communication and patient outcomes. Originally developed to treat adult substance abusers, MI has been widely adapted to the treatment of other behavioral health problems including obesity and poor dietary practices and is now included the expert recommendations for pediatric obesity prevention and treatment. In addition, MI has been successfully utilized in diverse populations in the U.S. and around the world. Despite the application of MI to multiple behavioral problems, the mechanisms by which MI elicits behavior change are less clear, particularly in pediatric and minority populations. In other words, it is unclear which components of MI are most important for health care providers working with African American adolescents and caregivers to elicit behavior change. Identifying the key components of MI in eliciting behavioral changes would enable the development of targeted health communication training designed to maximize African American adolescents' and caregivers' motivation for weight loss. The proposed study will use data from a parent clinical trial that is part of an NIH-funded obesity center grant (U01 HL097889) at Wayne State University providing family-based weight loss interventions to AAAOs and their primary caregivers. A newly developed code scheme will be used to conduct a secondary analysis of 184 weight loss treatment sessions from the parent clinical trial. The goals of this research are to (1) identify provider communication behaviors that predict motivation and intention for behavior change among AAAOs and their caregivers and (2) to link provider communication behaviors to changes in the health behavior of AAAOs and their caregivers, such as changes in diet, fitness, body fat composition and weight, through changes in their motivation and intention for behavior change.

描述（由申请人提供）：儿童人群中超重和肥胖的比率正达到危机水平，其中非裔美国青少年的风险最高。虽然有效的减肥策略（例如，监测食物摄入量和活动水平，环境控制以减少吃不健康食品的线索，目标设定）是众所周知的，但为非裔美国青少年肥胖（AAAO）构建有效的行为减肥干预措施的尝试在很大程度上失败了。成功的主要障碍是参与对成功至关重要的减肥策略的动机。因此，成功的减肥治疗需要治疗提供者能够激励家庭做出持续减肥所必需的具有挑战性的行为改变。患者-提供者沟通是治疗提供者在任何情况下对患者使用的主要治疗策略。尽管医患沟通被认为是一项关键的临床技能，