Parks & Pediatrics Fit Together: Translating knowledge into action for child obesity treatment in partnership with Parks and Recreation

公园

• 批准号: 10668416
• 负责人: Sarah C Armstrong
• 金额: $ 61.32万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-19 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10668416
• 关键词: Adult; Body mass index; Cardiovascular Diseases; Caregivers; Caring; Characteristics; Child; Childhood; Chronic Disease; Clinic; Clinical; Communities; Data; Development; Diabetes Mellitus; Disease; Effectiveness; Ensure; Environment; Epidemic; Evidence based treatment; Family; Funding; Future; Generations; Goals; Habits; Hand; Health; Health Benefit; Health Care Reform; Hour; Improve Access; Interruption; Intervention; Knowledge; Lead; Learning; Life; Life Expectancy; Life Style Modification; Location; Low income; Measures; Minority; Mission; Modeling; Morbidity - disease rate; Municipalities; National Institute of Child Health and Human Development; Obesity; Obesity Epidemic; Obesity associated cancer; Online Systems; Outcome; Overweight; Parents; Pediatrics; Physical Fitness; Population; Primary Care; Process; Provider; Public Health; Quality of life; Recommendation; Recording of previous events; Recreation; Reporting; Research; Resource-limited setting; Resources; Risk; Risk Reduction; Rural; Series; Site; Testing; Time; Training Activity; Translating; Translations; United States; United States National Institutes of Health; United States Preventative Services Task Force; Work; adopted child; adult obesity; cardiovascular health; clinical practice; community setting; comorbidity; cost; design; disability; dissemination strategy; effective therapy; evidence based guidelines; implementation evaluation; implementation outcomes; implementation process; implementation strategy; implementation tool; improved; innovation; learning materials; mortality; obesity in children; obesity treatment; payment; pediatrician; prevent; programs; uptake; web platform

PROJECT SUMMARY/ABSTRACT Evidence-based treatment for childhood obesity exists, yet a fundamental knowledge-to-action gap has significantly limited the uptake of recommendations into clinical practice, particularly in low-income settings. Persistence of this gap represents a large-scale public health threat, as the earliest generation of children living through the obesity epidemic now enters adulthood, they are the first in US history to have a shorter life expectancy than their parents, mainly due to rising rates of obesity-related cancers and cardiovascular disease. A central challenge in delivering recommended treatment is the intensity; ≥26 hours of face-to-face contact are necessary to achieve health benefits and risk reduction. The long-term goal is to close the knowledge-to-action gap by disseminating effective implementation tools that will deliver the current child obesity treatment recommendations in diverse community settings. The objective of the proposed project is to develop and test an implementation strategy that pairs primary care pediatric clinics with municipal Parks and Recreation (P&R) centers to deliver the current treatment recommendations with high fidelity, while allowing crucial adaptations for the local and cultural context. The central hypothesis is that effective pediatric obesity treatment is possible to achieve, but only with strong implementation supports to ensure fidelity to evidence- based recommendations and adaptability to local resource constraints and population needs. Guided by strong preliminary data on effectiveness and implementation feasibility, this hypothesis will be tested through three specific aims: 1) Develop a web-based platform that will support the implementation and broad dissemination of the shared clinic-P&R model in low-resource settings; 2) Evaluate the implementation platform using an interrupted time series design anchored in the Process Redesign Framework and reporting qualitative and quantitative measures of provider and organizational characteristics, implementation process and outcomes, child outcomes, and caregiver outcomes; and 3) Design a dissemination and sustainability strategy, using the PCORI Dissemination Framework, that considers relevant factors including community resources, funding stability, organizational capacity, partnership development, program requirements, and sustainability. The approach is innovative because it is a strong example of value-based care, a new horizon for alternative payment models in the current environment of health care reform. The proposed research is significant, because it will deliver implementation tools into the hands of front-line pediatric health care providers and over 33,000 park and recreation centers nationally. If successful, the expected outcomes will dramatically improve access to effective treatment in diverse communities, and deliver on the existing recommendations for millions of children with obesity in the United States.

项目总结/文摘