MA Childhood Obesity Research

描述（由申请人提供）：项目摘要拟议的运动质量：减少儿童肥胖的社区-临床合作伙伴关系将使用肥胖慢性护理模型来实施和评估一项全面，系统的干预措施，以减少服务不足儿童的儿童肥胖。马萨诸塞州公共卫生部（MDPH）与哈佛医学院人口医学系、哈佛公共卫生学院和国家儿童保健质量倡议合作，寻求通过全州群众运动健康倡议，在社区建立有希望的社区经验和相关的临床肥胖预防工作，在两个城市开展干预，菲奇堡和新贝德福德，这可以复制整个国家。该研究提出了一个多部门和多层次的综合办法。它纳入了初级卫生保健（儿童高五）、儿童保育（我在移动，我在学习; NAP SACC）和学校/课后计划（食品与乐趣、吃好并保持运动和地球健康）的循证干预措施，以及政策变革和全社区的社会营销活动，以预防或减少主要是低收入2-12岁儿童的肥胖。使用前后时间序列和准实验设计相结合，我们将检查我们的干预对个人水平的生活方式行为，身体质量指数（BMI）的变化，对医疗保健服务的满意度和生活质量的有效性。具体目标是：（1）在干预与比较社区中，检查基于儿科初级保健、早期教育和儿童护理计划、小学和中学、课后计划以及社区范围内的社会营销活动的多层次、多部门儿童干预在多大程度上改善了致肥胖行为。(2)在干预与对照社区中，实现较小的年龄相关BMI增加。(3)在干预社区的健康中心，证明了以下方面的增加：对所有2-12岁儿童的BMI筛查和5种目标肥胖相关行为的咨询;多学科临床团队和社区卫生工作者对年龄和性别特定BMI为第85百分位数的儿童的协调护理;父母对服务和儿童肥胖相关生活质量的满意度。(4)收集有关干预活动成本的数据，为成本效益分析做准备。(5)为MDPH制定详细的实施和传播指南，用于支持全州其他社区的收养。

DESCRIPTION (provided by applicant): Project abstract The proposed Mass in Motion: Community-Clinical Partnerships to Reduce Childhood Obesity will use the Obesity Chronic Care Model to implement and evaluate a comprehensive, systematic intervention to reduce childhood obesity among underserved children. The Massachusetts Department of Public Health (MDPH), in partnership with the Department of Population Medicine at Harvard Medical School, the Harvard School of Public Health, and the National Initiative for Children's Healthcare Quality, seeks to build on promising community-level experience and related clinical obesity prevention work in communities through the statewide Mass in Motion wellness initiative to develop an intervention in two cities, Fitchburg and New Bedford, that could be replicated throughout the state. The study proposes an integrated multi-sector and multi-level approach. It incorporates evidence-based interventions in primary health care (High Five for Kids), child care (I Am Moving, I am Learning; NAP SACC) and schools/after-school programs (Food & Fun, Eat Well and Keep Moving, and Planet Health), as well as policy change and a community-wide social marketing campaign to prevent or reduce obesity among predominantly low-income 2-12-year- old children. Using a combination of pre- post time series and quasi-experimental designs, we will examine the effectiveness of our intervention on individual-level lifestyle behaviors, change in body mass index (BMI), satisfaction with health care services, and quality of life. The Specific Aims are: (1) In intervention v. comparison communities, examine the extent to which a multi-level, multi-sector intervention for children, based in pediatric primary care, early educatin and child care programs, elementary and middle schools, after school programs, and a community-wide social marketing campaign results in improvements in obesogenic behaviors. (2) In intervention v. comparison communities, achieve smaller age associated increases in BMI. (3) In health centers in the intervention communities, demonstrate increases in: BMI screening and counseling on the 5 targeted obesity-related behaviors for all children ages 2-12 years; Coordinated care by a multi-disciplinary clinical team and community health workers for children with an age- and sex-specific BMI e 85th percentile; Parental satisfaction with services and child obesity-related quality of life. (4) Collect data on the costs of the intervention activiies in preparation for cost-effectiveness analyses. (5) Develop a detailed implementation and dissemination guide for MDPH to use to support adoption in other communities across the state.