School nurse-directed secondary obesity prevention for elementary school children

学校护士指导小学生二次肥胖预防

• 批准号: 9376740
• 负责人: Martha Y Kubik
• 金额: $ 30.68万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-03 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9376740
• 关键词: nurse; directed; secondary; obesity; prevention

DESCRIPTION (provided by applicant): Because one in three school-aged children are overweight or obese, there is a need to develop and test school-based programming that aims to prevent progression and support remission of childhood obesity (secondary prevention). The proposed study will test a novel elementary school-based, school nurse- directed weight management program that aims to reduce the prevalence of overweight and obesity among 8 to 11 year old children. The 12-month, multi-component intervention for children who are overweight or at risk for overweight will include parents and will target key modifiable diet and activity factors known to be successful in changing long-term energy balance. The program will be offered as a second step of an established school-based body mass index (BMI) screening and parent notification program, held after school and include: 1) quarterly parent/child coaching sessions, 2) twice monthly child groups; 3) a once monthly parent group, and 4) collaboration with health care providers and community-based organizations. Study aims will be accomplished using a randomized controlled trial design, with random assignment of 175 2nd and 4th grade students plus one parent to intervention or attention-only control conditions. The primary aim of this research is to reduce excessive weight gain among 8 to 11 year old children who are overweight or at risk of overweight by increasing healthy dietary practices and physical activity levels and decreasing sedentary practices. Secondary aims will examine the effect of the intervention on the dietary, physical activity and sedentary practices of children and on family lifestyle practices overseen by parents. Measures for children will include height and weight, dietary intake measured by 24-hour dietary recall, child activity levels measured by accelerometer, health-related quality of life and psychosocial factors. Parent measures will include height and weight, parental dietary and activity practices and psychosocial and environmental mediators at the family level. Process measures will assess program implementation and include measures of fidelity, dose, reach and context. Collaboration with key stakeholders representing school nursing practice, health insurers, health providers and community programming, as well as prospective economic analyses of intervention effectiveness will support translation of this work into sustainable school practice. It is hypothesized that relative to the control condition, children receiving the intervention will have significantly lower body mass index, following implementation of the 12-month intervention, controlling for baseline values.

描述（由申请人提供）：由于三分之一的学龄儿童超重或肥胖，因此有必要制定和测试以学校为基础的计划，旨在防止儿童肥胖的进展并支持缓解（二级预防）。拟议的研究将测试一项以小学为基础、由学校护士指导的新型体重管理计划，旨在降低 8 至 11 岁儿童超重和肥胖的患病率。针对超重或有超重风险的儿童的为期 12 个月的多成分干预将包括父母，并将针对已知可成功改变长期能量平衡的关键可改变饮食和活动因素。该计划将作为已建立的基于学校的体重指数 (BMI) 筛查和家长通知计划的第二步提供，在放学后举行，包括：1) 每季度一次的家长/儿童辅导课程，2) 每月两次的儿童小组； 3) 每月一次的家长小组，以及 4) 与医疗保健提供者和社区组织的合作。研究目标将通过随机对照试验设计来实现，随机分配 175 名二年级和四年级学生以及一名家长接受干预或仅注意控制条件。 这项研究的主要目的是通过增加健康饮食习惯和身体活动水平以及减少久坐习惯，减少超重或有超重风险的 8 至 11 岁儿童体重过度增加。次要目标将检查干预措施对儿童饮食、身体活动和久坐习惯以及父母监督的家庭生活方式的影响。针对儿童的测量包括身高和体重、通过 24 小时饮食回忆测量的饮食摄入量、通过加速度计测量的儿童活动水平、与健康相关的生活质量和心理社会因素。家长的衡量标准将包括身高和体重、家长的饮食和活动习惯以及家庭层面的社会心理和环境调节因素。流程衡量标准将评估计划的实施情况，包括保真度、剂量、范围和背景的衡量标准。与代表学校护理实践、健康保险公司、健康提供者和社区规划的主要利益相关者的合作，以及干预效果的前瞻性经济分析，将支持这项工作转化为可持续的学校实践。 据推测，在实施 12 个月的干预措施（控制基线值）后，相对于对照条件，接受干预的儿童的体重指数将显着降低。