Integrating Parenting Interventions into Pediatric Obesity Care

 描述（由申请人提供）：儿童肥胖症是一个重要的长期公共卫生问题，影响美国近五分之一的儿童，并以不同的方式影响种族和少数民族群体以及低社会经济地位的儿童。为Thao-Ly Tam Phan博士提议的K23职业发展奖是响应美国国立卫生研究院的战略计划，开发创新的肥胖干预措施，解决医疗保健的差异和利用健康信息技术的能力。拟议的职业发展计划提供了Phan博士完成学术培训和实践经验的手段，这些培训和实践经验对于成为儿童肥胖领域的独立研究者至关重要。针对肥胖儿童父母的育儿干预措施在改善儿童行为和体重方面显示出了希望，但往往是资源密集型的，并且并不总是考虑到不同背景的儿童父母的观点，这些儿童父母有显著的需求， 减轻体重。这项拟议的研究将开发一种干预措施，包括简短、量身定制、文化敏感的视频，以指导使用循证育儿技术来管理儿童的肥胖相关行为，并在发展过程中纳入父母的定性反馈（目标1）。4至11岁的肥胖儿童的父母将被随机分配到Nemours体重管理诊所进行首次访问，接受干预，这将与儿童在三个月内访问诊所一起提供。该研究将测试通过与儿童电子健康记录链接的患者门户网站提供干预的可行性，并评估干预对促进诊所访视期间有关育儿主题的讨论的影响（目标2）。此外，该研究还将评估干预对父母自我效能、儿童肥胖相关行为和儿童体重的影响（目标3）。通过与她的导师团队（Kazak博士，Abatemarco博士，Metzler博士和邦内尔博士）的正式教学法和直接指导培训经验相结合，Phan博士将获得以下领域的技能和专业知识：（1）以家庭为基础的干预研究，（2）以媒体为基础的 父母干预，（3）复杂性科学，因为它适用于儿科实践的变化，和（4） 利用保健信息技术提供保健服务。Nemours是儿童肥胖和健康信息学领域的国家领导者，将为Phan博士提供理想的环境，以成功完成拟议的项目，并实现她成为独立研究者的目标，开发和测试创新策略，让家庭参与治疗和预防儿童肥胖。

 DESCRIPTION (provided by applicant): Childhood obesity is a significant long-term public health problem affecting nearly 1 in 5 children in the United States and affecting children of racial and ethnic minority groups and of low socioeconomic status in a disparate manner. The proposed K23 career development award for Thao-Ly Tam Phan, M.D. is responsive to the NIH's strategic plan to develop innovative obesity interventions that address healthcare disparities and leverage the capabilities of health information technology. The proposed career development plan provides the means by which Dr. Phan will complete scholarly training and practical experience important to becoming an independent investigator in the area of pediatric obesity. Parenting interventions for parents of children who are obese have shown promise in improving child behaviors and weight, but are often resource-intensive and do not always consider the perspective of parents of children of diverse backgrounds with significant need for weight reduction. The proposed study will develop an intervention consisting of brief, tailored, culturally sensitive videos to provide guidance on the use of evidence-based parenting techniques for managing a child's obesity-related behaviors, incorporating qualitative feedback from parents during the development process (Aim 1). Parents of obese children between the ages of four and eleven years presenting for an initial visit to the Nemours Weight Management Clinic will be randomly assigned to receive the intervention, which will be delivered in conjunction with a child's visits to the clinic over three months. The study will test the feasibilty of delivering the intervention through a patient portal linked to the child's electronic health recrd and assess the impact of the intervention on facilitating discussion about parenting topics during clinic visits (Aim 2). Additionally, the study will evaluate the impact of the intervention on parental self-efficacy, child obesity-related behaviors, and child weight (Aim 3). Through a combination of formal didactics and direct mentored training experiences with her mentoring team (Drs. Kazak, Abatemarco, Metzler, and Bunnell), Dr. Phan will acquire skills and expertise in the following areas: (1) family-based intervention research, (2) media-based delivery of parenting interventions, (3) complexity science as it applies to pediatric practice change, and (4) use of health information technology for health care delivery. Nemours, a national leader in the fields of pediatric obesity and health informatics, will provide Dr. Phan with the ideal environment to successfully complete the proposed project and to achieve her goals of becoming an independent investigator, developing and testing innovative strategies to engage families in the treatment and prevention of pediatric obesity.