Parents as peer interventionists in treatment for pediatric weight management

 描述(申请人提供)：美国儿童超重和肥胖的高流行率要求开发有效但成本效益高且易于传播的干预措施，以改善并维持更好的儿科体重结果。积累的证据发现，对小学学龄儿童进行中到高强度(&gt；25个接触小时)的家庭治疗(FBT)具有初步和长期疗效，但这种治疗费用高得令人望而却步，因为人员成本高(由行为健康专业人员提供)，因此在可获得性、覆盖范围和影响方面有限。很少有超重/肥胖儿童接受循证治疗，以改善他们的体重状况或健康。我们的试点数据表明，一种新的模式，即基于同伴的FBT，由接受FBT治疗的父母接受培训，然后将FBT交付给其他家庭，是可行的，并展示了初步的效果。这种交付模式可以极大地降低FBT成本并提高FBT可用性。初步数据还表明，担任同伴干预者也可能对同龄人自己和他们的孩子有利，使他们更好地维持自己的体重结果。本研究旨在对同伴与专业人员提供的FBT对儿童体重结果的短期和长期效果提供更明确的测试。在这种比较中，包括对基于同伴的FBT交付的可行性的研究，调查担任同伴干预者对同龄人自己及其孩子长期体重状况的影响，以及更全面地检查基于专业的FBT交付与基于同行的FBT交付的差异成本。本研究还将通过检查同行提供的FBT在同行干预者中的有效性来测试潜在的传播和可持续性，这些同行干预者本身也从其他同行而不是专业干预者那里接受FBT。治疗结果的适度性也被审查，重点是同伴干预者和儿童的特征。这项多阶段试验将在我们地区的多个地点招募304个有7-11岁超重/肥胖儿童的家庭，包括短期(治疗后)和长期(停止治疗后1年)评估。这项对一种创新方法的研究可以显著降低FBT的交付成本，同时还可以改善治疗效果的维持，这对于改善许多已经超重、面临慢性病风险的儿童的健康至关重要。

 DESCRIPTION (provided by applicant): The high prevalence of pediatric overweight and obesity in the U.S. necessitates the development of efficacious, but cost-effective and easily disseminable interventions that improve and sustain better pediatric weight outcomes. Accumulated evidence finds initial and long-term efficacy of moderate-to-high intensity (>25 contact hours) family-based treatment (FBT) for elementary school-aged children, but such treatment is prohibitively expensive because of high personnel costs (delivery by behavioral health professionals) and therefore limited in availability, reach, and impact. Very few overweight/obese children receive evidence-based treatment to improve their weight status or health. Our pilot data suggest a new model, peer-based delivery FBT with FBT-treated parents trained and subsequently delivering FBT to other families, is feasible and demonstrates initial efficacy. This delivery model could dramatically reduce FBT costs and increase FBT availability. Preliminary data also suggest that serving as a peer interventionist may also benefit the peers themselves and their children in better sustaining their own weight outcomes. The present study aims to provide a more definitive test of the short- and long-term efficacy of peer- versus professionally-delivered FBT on child weight outcomes. Embedded in this comparison is an examination of the feasibility of peer-based FBT delivery, investigating the impact of serving as a peer interventionist on the peers' own and their child's long- term weight status, and a more comprehensive examination of differential costs of professional- versus peer- based FBT delivery. The present study will also test potential dissemination and sustainability by examining the efficacy of peer-delivered FBT among peer interventionists who themselves received FBT from other peers and not from professional interventionists. Moderation of treatment outcome is also examined, focusing on peer interventionist and child characteristics. This multi-phase trial will enroll 304 families with 7-11 year old overweight/obese children in multiple sites throughout our region, and include short-term (post-treatment) and long-term (up through 1 year after treatment cessation) assessments. This investigation of an innovative approach that could significantly reduce FBT delivery costs, while also improving the maintenance of treatment effects, is critical to improving the health of the many already overweight children at risk for chronic disease.