Value and mechanisms of home visitation in obesity interventions for low-income children
家访在低收入儿童肥胖干预中的价值及机制
基本信息
- 批准号:9204202
- 负责人:
- 金额:$ 71.05万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2017
- 资助国家:美国
- 起止时间:2017-02-01 至 2022-01-31
- 项目状态:已结题
- 来源:
- 关键词:Academic Medical CentersAccountabilityAccountingAddressAdultAffectAgeBehavior TherapyBeveragesBody Weight decreasedBody mass indexCaloriesCaregiversCaringCharacteristicsChildChildhoodChronic DiseaseCommunitiesControl GroupsCosts and BenefitsDataEatingEating BehaviorEnvironmentEquipmentFamilyFoodFutureGoalsHealth Services AccessibilityHealth educationHealthcareHome environmentHome visitationHouseholdIncomeInsurance CarriersInterventionLearningLocationLongevityLow Income PopulationLow incomeMediatingMedicalMedical centerModalityMonitorObesityOutcomeOverweightPersonsPhysical activityPositioning AttributePriceProviderPublic HealthRandomizedRandomized Controlled TrialsRecommendationResearchResourcesRiskRisk FactorsScheduleSchoolsSleepSportsTestingThird-Party PayerTransportationTreatment outcomeUniversitiesWaiting Listsarmbasecostcost effectivenessdesigndosageimprovedindividualized medicinelower income familiesnext generationobesity in childrenobesity riskobesity treatmentprogramsrandomized trialsexskillsstaff interventiontreatment effecttv watchingvirtual
项目摘要
PROJECT SUMMARY/ABSTRACT
Children from low-income families are more than twice as likely to become obese than those from higher-
income households, which places them at increased risk for obesity-related chronic diseases throughout their
adult lives. Family-based pediatric obesity interventions, particularly those designed for low-income
populations, are increasingly delivered in children’s homes. Home visitation has a number of potential
advantages that could enhance weight loss outcomes relative to delivering treatment in traditional medical and
academic settings. By eliminating the need for transportation and childcare, home visitation may make
treatment more accessible for low-income families, resulting in a higher dosage of intervention received. Home
visitation allows intervention staff to directly observe and address risk factors in the home environment,
potentially enabling them to provide more tailored and potent treatment recommendations. Caregivers may
also be more likely to apply healthy changes in their household when they learn and rehearse new skills in the
environment where they are to be implemented. Research to date has consistently found that home-based
interventions are more effective than low-intensity comparison conditions such as wait-list controls, health
education, and usual medical care. Yet, as the home visitation treatment modality has been confounded with
intervention dosage, intensity, and content in prior studies, there is a lack of empirical evidence to support its
use. The goal of this project is to systematically evaluate the incremental weight loss benefit and cost-
effectiveness of delivering standard family-based treatment for pediatric overweight/obesity in the home setting
vs. traditional medical settings. In a randomized controlled trial involving low-income households, 266 children
ages 6-11 years will be allocated to 12 months of family-based treatment delivered either in their home or at an
urban academic medical center. Both arms will receive the same intervention content and dosage, and differ
only in the location of in-person treatment sessions. Aim 1 is to test the hypothesis that home-based treatment
produces a greater reduction in child adiposity, reflected in 12-month change in BMI z-score. Aim 2 is to
compare the cost-effectiveness of home-based treatment to medical center-based treatment, and calculate the
added cost of the incremental weight loss benefit associated with home visitation. These data will inform efforts
to disseminate home-based interventions for low-income populations by public health agencies and third-party
payers. Aim 3 is to explore specific mechanisms through which home visitation may improve weight loss
outcomes. The results of this trial will have a strong impact on the design of future pediatric overweight/obesity
interventions, as virtually any program could be adapted for delivery in the home setting.
项目概要/摘要
低收入家庭的儿童肥胖的可能性是高收入家庭的儿童的两倍多
收入家庭,这使他们在一生中患肥胖相关慢性病的风险增加
成人生活。以家庭为基础的儿童肥胖干预措施,特别是针对低收入人群的干预措施
越来越多的人在儿童之家分娩。家访有很多潜力
相对于传统医学治疗而言,可以增强减肥效果的优势
学术设置。通过消除交通和儿童保育的需要,家访可以使
低收入家庭更容易获得治疗,从而获得更高剂量的干预措施。家
探视使干预人员能够直接观察和解决家庭环境中的风险因素,
可能使他们能够提供更有针对性和更有效的治疗建议。照顾者可能会
当他们学习和练习新技能时,他们也更有可能在家庭中进行健康的改变。
实施这些措施的环境。迄今为止的研究一致发现,以家庭为基础的
干预措施比低强度比较条件(例如等候名单控制、健康状况)更有效
教育和常规医疗保健。然而,由于家访治疗方式与
既往研究中干预剂量、强度和内容缺乏经验证据支持其
使用。该项目的目标是系统地评估增量减肥效益和成本
在家庭环境中为儿童超重/肥胖提供标准家庭治疗的有效性
与传统医疗环境相比。在一项涉及低收入家庭的随机对照试验中,266 名儿童
6-11 岁的儿童将被分配到 12 个月的家庭治疗,在家中或在诊所进行
城市学术医疗中心。双臂将接受相同的干预内容和剂量,并且不同
仅在现场治疗地点进行。目标 1 是检验家庭治疗的假设
可以更大程度地减少儿童肥胖,这反映在 BMI z 分数的 12 个月变化中。目标 2 是
比较家庭治疗与医疗中心治疗的成本效益,并计算
与家访相关的增量减肥效益的额外成本。这些数据将为努力提供信息
传播公共卫生机构和第三方针对低收入人群的家庭干预措施
付款人。目标 3 是探索家访可以改善减肥的具体机制
结果。该试验的结果将对未来儿科超重/肥胖的设计产生重大影响
干预措施,因为几乎任何计划都可以调整为在家庭环境中实施。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Bradley M. Appelhans其他文献
Neighborhood physical environments and change in cardiometabolic risk factors over 14 years in the study of Women's health across the nation
- DOI:
10.1016/j.healthplace.2024.103257 - 发表时间:
2024-05-01 - 期刊:
- 影响因子:
- 作者:
Bradley M. Appelhans;Brittney S. Lange-Maia;Chen Yeh;Elizabeth A. Jackson;Mary D. Schiff;Emma Barinas-Mitchell;Carol A. Derby;Carrie A. Karvonen-Gutierrez;Imke Janssen - 通讯作者:
Imke Janssen
Considerations for Interpreting Childhood Obesity Treatment Trials from the COVID-19 Pandemic Era.
解释 COVID-19 大流行时代儿童肥胖治疗试验的注意事项。
- DOI:
- 发表时间:
2024 - 期刊:
- 影响因子:2.5
- 作者:
Bethany Forseth;Bradley M. Appelhans;Ann M. Davis - 通讯作者:
Ann M. Davis
A point-of-purchase intervention featuring in-person supermarket education impacts healthy food purchases
以现场超市教育为特色的购买点干预措施会影响健康食品的购买
- DOI:
- 发表时间:
2012 - 期刊:
- 影响因子:0
- 作者:
B. Milliron;K. Woolf;Bradley M. Appelhans - 通讯作者:
Bradley M. Appelhans
Psychological Co-morbidities of Cardiovascular Disease
心血管疾病的心理共病
- DOI:
- 发表时间:
2011 - 期刊:
- 影响因子:0
- 作者:
M. Whited;Amanda L. Wheat;Bradley M. Appelhans;S. Pagoto - 通讯作者:
S. Pagoto
Attention Deficit/Hyperactivity Disorder and the Clinical Management of Obesity
注意力缺陷/多动障碍和肥胖的临床管理
- DOI:
- 发表时间:
2012 - 期刊:
- 影响因子:8.8
- 作者:
S. Pagoto;C. Curtin;Bradley M. Appelhans;M. Alonso - 通讯作者:
M. Alonso
Bradley M. Appelhans的其他文献
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{{ truncateString('Bradley M. Appelhans', 18)}}的其他基金
Stress, race, and cognitive mediators of SES-related disparities in behavioral obesity treatment outcomes
行为性肥胖治疗结果中与 SES 相关的差异的压力、种族和认知调节因素
- 批准号:
10514449 - 财政年份:2022
- 资助金额:
$ 71.05万 - 项目类别:
Stress, race, and cognitive mediators of SES-related disparities in behavioral obesity treatment outcomes
行为性肥胖治疗结果中 SES 相关差异的压力、种族和认知调节因素
- 批准号:
10632130 - 财政年份:2022
- 资助金额:
$ 71.05万 - 项目类别:
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