Treatment of children with obesity in primary care

初级保健中肥胖儿童的治疗

• 批准号: 7229805
• 负责人: Ellen Wald
• 金额: $ 22.05万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-11-01 至 2009-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7229805
• 关键词: Treatment; children; obesity; primary; care

Obesity in children and adolescents increasingly is imposing a burden on their physical health and emotional well being. Because effective management of obesity requires ongoing monitoring of and attention to the onset of known co-morbidities, it is most appropriately conceptualized as a chronic medical condition and is best managed in the' pediatric primary care setting. Although it has been recommended that treatment targeting pediatric obesity be offered within primary care practice, and although there is an efficacious treatment that targets this problem, there are no published studies of efforts to determine the effectivenessof this intervention when offered in a pediatric practice. This project (which will begin this translation) will apply concepts from the Chronic Care Model to the problem of pediatric obesity and proposes to: (1) assess the effectiveness of teaching primary care providers (within diverse pediatric practices) to use specific communication strategies with parents of overweight children to help them take steps with their child toward healthy behavior change; and (2) offer core components of an efficacious family-based behavioral weight management program within the pediatric primary care setting to determine if participating children will change behaviors regarding dietary intake and physical activity to achieve clinically meaningful weight loss. The proposed study is a prospective, randomized, controlled clinical trial in which the outcome of children participating in an immediate intervention will be comparedto a control group. The primary project outcomes will include the (1) change in frequency with which providers counsel parents of overweight children and (2) change in children's diet, physical activity, weight and absolute BMIat the end of treatment compared to a control group. The proposed study will take place within 5 of the 22 practices comprising Pediatric PitNet, a practice-based research network servicing 130,000 children and including 142 providers. If this proves to be effective we will disseminate the components of the comprehensive intervention, which includes not only targeting the patients, but also the providers, the practice, the health insurers, and the community.

儿童和青少年的肥胖症越来越多地给他们的身体健康和情绪带来负担。 健康由于有效的肥胖管理需要持续监测和关注 由于已知的合并症发作，因此最适当地将其概念化为慢性疾病， 最好在儿科初级保健环境中进行管理。尽管有人建议治疗 在初级保健实践中提供针对儿童肥胖症的治疗，虽然有一个有效的方法， 针对这个问题的治疗方法，目前还没有发表研究来确定其有效性 在儿科实践中提供这种干预。本项目（将开始这一翻译）将适用 概念从慢性护理模式的问题，儿童肥胖症，并建议：（1）评估 教导初级保健提供者（在不同的儿科实践中）使用特定 与超重儿童的父母沟通策略，帮助他们采取措施， 健康行为改变;（2）提供有效的基于家庭的行为权重的核心组成部分 在儿科初级保健环境中的管理计划，以确定参与儿童是否会 改变有关饮食摄入和体力活动的行为，以达到临床意义上的体重减轻。 这项研究是一项前瞻性、随机、对照的临床试验， 将参与即时干预的人与对照组进行比较。项目主要成果 将包括（1）提供者为超重儿童的父母提供咨询的频率的变化，以及（2） 治疗结束时儿童的饮食、体力活动、体重和绝对BMI的变化， 对照组拟议的研究将在组成儿科PitNet的22个实践中的5个实践中进行， 基于实践的研究网络，为130 000名儿童提供服务，包括142个提供者。如果这被证明是 我们将传播全面干预措施的组成部分，其中不仅包括 目标是病人，但也是提供者，实践，健康保险公司和社区。