Childhood Obesity Treatment: A Maintenance Approach

儿童肥胖治疗：维持方法

• 批准号: 8039038
• 负责人: Denise Ella Wilfley
• 金额: $ 23.83万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-22 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8039038
• 关键词: Address; Adherence; Adult; Ancillary Study; Area; Attention; Award; Behavior; Behavioral; Body Composition; Body Weight decreased; Characteristics; Child; Childhood; Clinical Investigator; Clinical Trials; Communities; Control Groups; Data; Databases; Dietary intake; Dose; Eating; Eating Behavior; Environment; Environmental Risk Factor; Epidemic; Family; Fatty acid glycerol esters; Food; Frequencies; Geographic Information Systems; Goals; Habits; Health; Health Professional; Health education; Home environment; Individual; Intervention; Learning; Life; Life Style; Link; Maintenance; Measures; Mediating; Mediator of activation protein; Modeling; Neighborhoods; Obesity; Outcome; Overweight; Parenting behavior; Parents; Participant; Pattern; Physical activity; Prevalence; Problem Solving; Psychosocial Factor; Public Health; Randomized; Relapse; Research; Research Personnel; Resources; Restaurants; Schedule; Scientist; Social Facilitation; Social Problems; Social support; Solutions; Speed; Subgroup; Supermarket; Technology; Testing; Time; Translations; Treatment outcome; Weight; base; clinical care; density; design; efficacy testing; energy balance; fast food; follow up assessment; improved; interdisciplinary collaboration; obesity in children; obesity treatment; peer; prevent; primary outcome; programs; psychologic; psychosocial; secondary outcome; skills; stem; theories; therapy design; treatment duration; treatment response; urban public health; weight maintenance

DESCRIPTION (provided by applicant): The prevalence of childhood overweight (CO) has tripled in recent decades and there is growing recognition of environmental factors related to the rapid increase of this significant public health problem. Socio-ecological models provide a strong theoretical framework for studying the interplay between an individual's weight-related behaviors and his or her environment. Data linking built environments to eating and physical activity habits underscore the potential importance of carefully assessing neighborhood-level variables in weight loss clinical trials. However, few studies have examined whether neighborhood environmental characteristics differentially impact an individual's attempt to modify physical activity and eating behaviors. Spatial databases and Geographic Information System (GIS) technologies provide a means for objectively assessing environmental factors that may moderate weight loss maintenance treatment response. Our present R01 is designed to test the efficacy of an enhanced social facilitation maintenance treatment (SFM+) for overweight children and their families. SFM+ is informed by learning theory and involves lengthening maintenance treatment contact and enhancing treatment focus by targeting a broad range of socio-environmental levels for intervention (individual/self-regulatory skills, family involvement and the home environment, peer relationships and social support, and identification of neighborhood or community resources and barriers to healthy lifestyle behaviors). The objective of SFM+ is to strengthen newly developed weight-regulating skills across socio-environmental contexts over time in order to decrease relapse. Overweight children (N=240) and their parents will complete four months of a family-based behavioral weight loss program and will then be randomized to one of three 8- month maintenance conditions: (1) low dose SFM+ [LOW; 16 sessions], (2) high dose SFM+ [HIGH; 32 sessions], or (3) a credible health education CONTROL [16 sessions] matched on schedule, duration, and attention of the LOW condition. The LOW and HIGH conditions are matched on content and duration, but differ in treatment dose. We hypothesize that the HIGH condition will produce better weight maintenance and greater improvements in associated outcomes than either the LOW or the CONTROL conditions, and that the LOW condition will produce better weight maintenance than the CONTROL condition. The proposed ancillary study will form a transdisciplinary team of scientists including basic behavioral, public health, and urban design to test the exploratory hypothesis that children's built environment will be a moderator of weight loss maintenance treatment. Because HIGH intensively targets the socio-environmental context, we predict that HIGH will prove more effective than either CONTROL or LOW for the subset of children whose community environments provide limited access to healthful food and opportunities for physical activity. This study promises to not only clarify the most efficacious overall treatment choice for CO, but also to identify subgroups for whom specific treatments are indicated, and to inform public health approaches to the long-term management of CO. PUBLIC HEALTH RELEVANCE: This project seeks to strengthen and expand upon the current R01's aim to identify environmental moderators of pediatric weight loss maintenance. The addition of objective measures of the built environment will provide an important opportunity for transdisciplinary collaboration among public health professionals, urban design investigators, and clinical researchers, as well as add to our understanding of the neighborhood-level characteristics that may influence pediatric obesity treatment response. It is necessary to better understand for whom and under what conditions weight loss is maintained, in order to stem the childhood obesity epidemic and to prevent the tracking of obesity and its negative health and psychosocial consequences into adulthood.

描述（由申请人提供）：近几十年来，儿童超重（CO）的患病率增加了两倍，人们越来越认识到与这一重大公共卫生问题迅速增加有关的环境因素。社会生态模型为研究个体体重相关行为与环境之间的相互作用提供了一个强有力的理论框架。将建筑环境与饮食和体育活动习惯联系起来的数据强调了在减肥临床试验中仔细评估邻里水平变量的潜在重要性。然而，很少有研究探讨是否邻里环境特征差异影响个人的尝试，以修改体力活动和饮食行为。空间数据库和地理信息系统（GIS）技术提供了一种客观评估环境因素的手段，可能会缓和减肥维持治疗反应。我们目前的R 01旨在测试增强型社会促进维持治疗（SFM+）对超重儿童及其家庭的疗效。可持续森林管理+以学习理论为依据，涉及延长维持治疗接触和加强治疗重点，针对广泛的社会环境层面进行干预（个人/自我调节技能、家庭参与和家庭环境、同伴关系和社会支持，以及确定邻里或社区资源和健康生活方式行为的障碍）。可持续森林管理+的目标是，随着时间的推移，在各种社会环境背景下加强新开发的体重调节技能，以减少复发。超重儿童（N=240）和他们的父母将完成4个月的基于家庭的行为减肥计划，然后将被随机分配到三个8个月的维持条件之一：（1）低剂量SFM+ [低; 16次]，（2）高剂量SFM+ [高; 32次会议]，或（3）可信的健康教育对照组[16次会议]，时间表，持续时间和注意力匹配的低条件。LOW和HIGH条件在内容和持续时间上匹配，但治疗剂量不同。我们假设，高条件将产生更好的体重维持和更大的改善相关的结果比低或控制条件，低条件将产生更好的体重维持比控制条件。拟议的辅助研究将形成一个跨学科的科学家团队，包括基本行为，公共卫生和城市设计，以测试探索性假设，即儿童的建筑环境将是减肥维持治疗的调节剂。由于高集中目标的社会环境背景下，我们预测，高将被证明比控制或低的儿童的社区环境提供有限的健康食品和体育活动的机会的子集更有效。这项研究不仅有望阐明CO最有效的总体治疗选择，而且还可以确定特定治疗适用的亚组，并为CO的长期管理提供公共卫生方法。 公共卫生关系：该项目旨在加强和扩大目前的R 01的目标，以确定环境主持人的儿科减肥维护。增加建筑环境的客观测量将为公共卫生专业人员，城市设计调查人员和临床研究人员之间的跨学科合作提供重要机会，并增加我们对可能影响儿童肥胖治疗反应的社区水平特征的理解。有必要更好地了解为谁以及在什么条件下保持体重减轻，以遏制儿童肥胖症的流行，并防止肥胖症及其负面健康和心理社会后果一直延续到成年。

项目成果

Behavioral Interventions and Cardiovascular Risk in Obese Youth: Current Findings and Future Directions.

• DOI: 10.1007/s12170-012-0272-y
• 发表时间: 2012-12-01
• 期刊: CURRENT CARDIOVASCULAR RISK REPORTS
• 影响因子: 1.9
• 作者: Vannucci, Anna;Wilfley, Denise E
• 通讯作者: Wilfley, Denise E

The Promise and Opportunities for Screening and Treating Childhood Obesity: USPSTF Recommendation Statement.

筛查和治疗儿童肥胖的承诺和机会：USPSTF 建议声明。

• DOI: 10.1001/jamapediatrics.2017.1604
• 发表时间: 2017
• 期刊: JAMA pediatrics
• 影响因子: 26.1
• 作者: Quattrin,Teresa;Wilfley,DeniseE
• 通讯作者: Wilfley,DeniseE

Factors associated with depression and anxiety symptoms among children seeking treatment for obesity: A social-ecological approach.

寻求肥胖治疗的儿童中与抑郁和焦虑症状相关的因素：社会生态方法。

• DOI: 10.1111/ijpo.12518
• 发表时间: 2019
• 期刊: Pediatric obesity
• 影响因子: 3.8
• 作者: Sheinbein,DanielH;Stein,RichardI;Hayes,JacquelineF;Brown,MackenzieL;Balantekin,KatherineN;Conlon,RachelPKolko;Saelens,BrianE;Perri,MichaelG;Welch,RRobinson;Schechtman,KennethB;Epstein,LeonardH;Wilfley,DeniseE
• 通讯作者: Wilfley,DeniseE

Psychosocial correlates of shape and weight concerns in overweight pre-adolescents.

• DOI: 10.1007/s10964-011-9686-y
• 发表时间: 2012-01
• 期刊: JOURNAL OF YOUTH AND ADOLESCENCE
• 影响因子: 4.9
• 作者: Sinton, Meghan M.;Goldschmidt, Andrea B.;Aspen, Vandana;Theim, Kelly R.;Stein, Richard I.;Saelens, Brian E.;Epstein, Leonard H.;Wilfley, Denise E.
• 通讯作者: Wilfley, Denise E.

The use of biosimulation in the design of a novel multilevel weight loss maintenance program for overweight children.

• DOI: 10.1038/oby.2009.437
• 发表时间: 2010-02
• 期刊: OBESITY
• 影响因子: 6.9
• 作者: Wilfley, Denise E.;Van Buren, Dorothy J.;Theim, Kelly R.;Stein, Richard I.;Saelens, Brian E.;Ezzet, Farkad;Russian, Angela C.;Perri, Michael G.;Epstein, Leonard H.
• 通讯作者: Epstein, Leonard H.