Analysis of Behavioral Interventions for Pediatric Obesity

儿童肥胖行为干预分析

• 批准号: 9192591
• 负责人: Andrea Kass Graham
• 金额: $ 5.88万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9192591
• 关键词: Address; Adoption; Adult; Affect; Behavior Therapy; Behavioral; Binge Eating; Body Weight decreased; Body mass index; Caring; Chicago; Child; Communities; Cost Effectiveness Analysis; Costs and Benefits; Data; Eating; Eating Behavior; Effectiveness; Ensure; Environment; Evaluation; Family; Foundations; Generations; Goals; Gold; Health; Health Benefit; Health Care Costs; Health Resources; Healthy Eating; Individual; Intervention; Intervention Trial; Investments; Learning; Left; Life; Literature; Maintenance; Medical; Mental Depression; Mentors; Mentorship; Modeling; Morbidity - disease rate; National Institute of Child Health and Human Development; National Research Service Awards; Obesity; Obesity associated disease; Outcome; Overweight; Parents; Policies; Population; Public Health; Publishing; Quality of life; Randomized Controlled Trials; Research; Research Personnel; Research Project Grants; Sanguisorba; Services; Social Facilitation; Testing; Time; Training; Translational Research; United States National Institutes of Health; Universities; Weight; Weight Gain; Work; Youth; base; care delivery; comparative; cost; cost effective; cost effectiveness; depressive symptoms; design; disability; economic evaluation; educational atmosphere; evidence base; follow-up; health economics; healthy weight; innovation; lifestyle intervention; mortality; neglect; next generation; obesity in children; obesity treatment; obesogenic; post-doctoral training; programs; psychosocial; routine practice; skills; standard care; treatment strategy

PROJECT SUMMARY/ABSTRACT Pediatric obesity is a public health crisis that is taking a dramatic toll on our nation's health and resources. Gold-standard treatment for pediatric obesity is family-based behavioral weight loss treatment (FBT). However, weight regain following FBT is common given the abundance of unhealthy prompts in the US obesogenic environment. The NIH has called for designing and testing interventions to achieve and maintain a healthy weight. Toward this end, two weight loss maintenance interventions were evaluated by Wilfley and colleagues in a randomized controlled trial of youth with overweight or obesity and their parents (NICHD R01 HD036904; Wilfley et al., 2007). Results showed that, following FBT, a social facilitation weight loss maintenance intervention (SFM) and a behavioral skills weight loss maintenance intervention (BSM) produced greater weight loss maintenance than a control condition, and SFM was superior to BSM. The critical next question is to examine which intervention strategy offers the greatest value. Thus, the overarching aim of this proposal is to evaluate the comparative cost-effectiveness of SFM, BSM, and the control condition for children and parents on changes in BMI units reduced over two years (Aim 1), depressive symptoms and binge eating behaviors reduced over two years (Aim 2), and on obesity-related health benefits and health care costs over 10 years (Aim 3). The microsimulation cost-effectiveness model will be based on a newly published approach from the largest economic evaluation of pediatric obesity interventions. Evaluation of the cost per changes in depression and binge eating is included because psychosocial changes from treatment have been neglected in prior cost-effectiveness analyses of pediatric obesity intervention, despite the impact of depression and binge eating on weight status, disability, and quality of life in youth with obesity. The proposed study and training plan enhances my program of research (a) evaluating the efficacy of behavioral interventions for obesity and weight-related issues, and (b) investigating factors that impact adoption and implementation of evidence-based behavioral interventions into routine practice. The rich educational environment of The University of Chicago will equip me with a strong theoretical and methodological foundation in cost-effectiveness analysis to conduct this translational research project and will expand my capacity to comprehensively evaluate behavioral interventions. Expertise of the mentorship team ensures this project will be successful. The goal of this work is to inform meaningful decisions regarding adoption of family- based weight loss maintenance strategies for the treatment of obesity, which has the potential to advance sustainable solutions for obesity care. In doing so, we facilitate efforts to ensure all individuals live healthy and productive lives. In summary, this NRSA would afford protected time for mentored postdoctoral training in cost- effectiveness analysis, which is critical for achieving my goal of being an independent investigator focused on testing, implementing, and increasing access to intervention delivery for obesity and weight-related issues.

项目总结/摘要 儿童肥胖是一个公共卫生危机，正在对我们国家的健康和资源造成巨大损失。 儿童肥胖的金标准治疗是以家庭为基础的行为减肥治疗（FBT）。然而，在这方面， FBT后体重反弹是常见的，因为在美国肥胖症患者中存在大量不健康的提示。 环境美国国立卫生研究院呼吁设计和测试干预措施，以实现和维持健康的 重量.为此，Wilfley及其同事评估了两种减肥维持干预措施 在一项对超重或肥胖青年及其父母的随机对照试验中（NICHD R 01 HD 036904; Wilfley等人，2007年）。结果表明，FBT后，社会促进减肥维持 干预（SFM）和行为技能减肥维持干预（BSM）产生更大的 体重减轻维持比对照条件，SFM优于BSM上级。关键的下一个问题是 来研究哪种干预策略提供了最大的价值。因此，本提案的总体目标 评价SFM、BSM的成本-效果比较及儿童控制情况 和父母对BMI单位的变化在两年内减少（目标1），抑郁症状和暴食 饮食行为在两年内减少（目标2），以及与肥胖相关的健康益处和健康 10年以上的护理费用（目标3）。微观模拟成本效益模型将基于一个新的 最大的儿童肥胖干预经济评估的方法。评价 包括抑郁症和暴饮暴食的每次变化成本，因为治疗引起的心理社会变化 在先前的儿童肥胖干预的成本效益分析中被忽视了，尽管 抑郁和暴食对肥胖青年的体重状况、残疾和生活质量的影响。拟议 学习和培训计划增强了我的研究计划（a）评估行为的有效性 肥胖和体重相关问题的干预措施，以及（B）调查影响收养的因素， 将循证行为干预纳入日常实践。的丰富教育 芝加哥大学的环境将使我具备很强的理论和方法论 基金会在成本效益分析进行这一转化研究项目，并将扩大我的 全面评估行为干预的能力。导师团队的专业知识确保了这一点 项目将取得成功。这项工作的目标是为有关家庭收养的有意义的决定提供信息， 基于减肥维持策略的治疗肥胖，这有可能推进 肥胖症护理的可持续解决方案。在这样做的过程中，我们促进努力，以确保所有人都能健康地生活， 富有成效的生活。总之，这个NRSA将提供受保护的时间，指导博士后培训的成本- 有效性分析，这对实现我成为一名独立调查员的目标至关重要， 测试，实施，并增加获得肥胖和体重相关问题的干预交付。