Pediatric Practice-based Obesity Intervention to Support Families: FITLINE

以儿科实践为基础的肥胖干预措施为家庭提供支持：FITLINE

• 批准号: 9335420
• 负责人: LORI PBERT
• 金额: $ 79.32万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-19 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9335420
• 关键词: 12 year old; Academy; Accelerometer; Adult; Age; Agreement; American; Behavior; Body Weight decreased; Body mass index; Calories; Caring; Child; Childhood; Chronic Disease; Counseling; Development; Diet; Eating; Educational Curriculum; Educational Materials; Effectiveness; Family; Family Practice; Feedback; Goals; Guidelines; Habits; Hour; Intake; Intervention; Life Style; Modeling; Morbid Obesity; Nurse Practitioners; Nutritionist; Obesity; Overweight; Pamphlets; Parents; Patients; Pediatrics; Persons; Physical activity; Pilot Projects; Prevalence; Prevention; Primary Health Care; Protocols documentation; Provider; Questionnaires; Randomized; Recommendation; Recruitment Activity; Resources; Risk; Schedule; Services; Structure; System; Telephone; Testing; Time; Training; Transportation; Weight; Weight maintenance regimen; base; behavior change; biomedical referral center; compare effectiveness; cost; cost effective; cost effectiveness; disability; family support; follow-up; fruits and vegetables; improved; innovation; obesity in children; obesity treatment; pediatrician; programs; response; saturated fat; scale up; social cognitive theory; sugar; sweetened beverage

Project Summary/Abstract The American Academy of Pediatrics (AAP) recommends a staged approach to the management of pediatric overweight and obesity, starting with Stage 1, Prevention Plus, which encourages families to improve lifestyle choices related to eating and activity in order to improve BMI status. Most pediatric practices have difficulty implementing these guidelines, however, due to limited time and access to weight loss experts to whom they can refer their patients and families, and burden to families in accessing in-person weight loss services. In response, our team developed the FITLINE pediatric practice-based referral program which provides practices an easily accessible resource to help families make AAP-recommended lifestyle changes. The program includes two components: (1) a pediatric practice-based component based on the Let's Go 5-2-1-0 intervention involving systems to assess and document BMI, a healthy habits screener and brief provider- delivered intervention, referral to the FITLINE counseling program, and feedback from the FITLINE nutritionist; and (2) a parent support component consisting of eight weekly FITLINE telephone counseling calls by centrally located nutritionists to provide parents coaching tailored to their family's unique needs and culture to help them set goals and make targeted lifestyle changes recommended by the AAP for Stage 1, Prevention Plus, accompanied by a parent booklet. The proposed five-year cluster randomized controlled pediatric practice-based trial will compare the effectiveness of two practice-based interventions on improving diet and physical activity and reducing BMI among overweight and obese 8-12 year olds seen in pediatric practice: (1) PP-FITLINE, consisting of the pediatric practice-based component plus FITLINE counseling and booklet, or (2) PP-Materials, consisting of the same practice-based component, but only the parent materials mailed over 8 weeks, with no referral to FITLINE counseling. Sixteen pediatric primary care practices will be randomized to either the PP-FITLINE (N=8) or the PP-Mailings (N=8) condition. Five hundred and twelve parents and their children ages 8-12 with a body mass index (BMI) of > 85th percentile (overweight or obese) will be recruited from the practices to achieve N=400 at 12 month follow-up. Assessments will be completed at baseline and 6- and 12-months post-baseline. The specific aims of this study are to determine the effectiveness of the PP-FITLINE program in reducing BMI in overweight and obese children and improving the child's diet and physical activity behaviors; explore possible mechanisms of the effect of the PP-FITLINE program on BMI, diet and physical activity; and estimate the cost-effectiveness of the PP-FITLINE compared with the PP-Mailing program. If found to be effective and cost-effective, the PP-FITLINE program will provide an innovative model which can be scaled up for widespread implementation of Stage 1, Prevention Plus of the AAP expert committee recommendations through pediatric practices nationwide, contributing significantly to the development of new standards for weight management care in pediatric practice.

项目概要/摘要 美国儿科学会 (AAP) 建议采用分阶段的方法来管理儿科疾病 超重和肥胖，从第一阶段“预防+”开始，鼓励家庭改善生活方式 与饮食和活动相关的选择，以改善体重指数状况。大多数儿科实践都有困难 然而，由于时间和接触减肥专家的机会有限，实施这些指南的难度很大。 可以转介患者和家人，并减轻家人获得面对面减肥服务的负担。在 为此，我们的团队开发了 FITLINE 儿科基于实践的转介计划，该计划提供实践 一个易于获取的资源，可帮助家庭做出 AAP 建议的生活方式改变。该计划 包括两个部分：(1) 基于 Let's Go 5-2-1-0 的儿科实践部分 干预涉及评估和记录 BMI 的系统、健康习惯筛查器和简介提供者 - 提供干预、转介至 FITLINE 咨询计划以及 FITLINE 的反馈 营养师； (2) 家长支持部分，包括每周八次的 FITLINE 电话咨询 位于中心的营养师呼吁为家长提供适合其家庭独特需求的指导， 帮助他们设定目标并做出 AAP 建议的第一阶段有针对性的生活方式改变的文化， 预防加，附有家长手册。拟议的五年整群随机对照 儿科基于实践的试验将比较两种基于实践的干预措施在改善 儿科中超重和肥胖 8-12 岁儿童的饮食和体力活动以及降低 BMI 实践：(1) PP-FITLINE，包括基于儿科实践的部分加上 FITLINE 咨询和 小册子，或 (2) PP 材料，包含相同的基于实践的组件，但仅包含母材料 邮寄超过 8 周，未转介至 FITLINE 咨询。十六种儿科初级保健实践将 随机分配到 PP-FITLINE (N=8) 或 PP-Mailings (N=8) 条件。五百一十二 体重指数 (BMI) > 85%（超重或肥胖）的父母及其 8-12 岁的孩子 将从实践中招募，以在 12 个月的随访中达到 N=400。评估将完成 基线时以及基线后 6 个月和 12 个月。本研究的具体目的是确定 PP-FITLINE 计划在降低超重和肥胖儿童的 BMI 并改善体重方面的有效性 孩子的饮食和身体活动行为；探索 PP-FITLINE 效果的可能机制 BMI、饮食和体力活动计划；并估计 PP-FITLINE 的成本效益比较 使用 PP-Mailing 程序。如果发现有效且具有成本效益，PP-FITLINE 计划将提供 一种创新模式，可以扩大规模以广泛实施第一阶段，预防加 AAP 专家委员会在全国儿科实践中提出的建议，做出了重大贡献 制定儿科实践体重管理护理的新标准。