BM12: Brief Motivational Interviewing to Reduce Child BMI

BM12：减少儿童体重指数的简短动机访谈

• 批准号: 7599068
• 负责人: Ken A. Resnicow
• 金额: $ 69.98万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2013-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7599068
• 关键词: Academy; Accident and Emergency department; Address; Age; American; American Dietetic Association; Behavior; Behavior Therapy; Behavioral; Body mass index; Caring; Centers for Disease Control and Prevention (U.S.); Child; Childhood; Collaborations; Consumption; Continuing Education; Counseling; Data; Diet; Dietitian; Educational Intervention; Educational Materials; Educational workshop; Effectiveness of Interventions; Enrollment; Evidence based intervention; Health; Intake; Intervention; Life Style; Mediation; Metric; Modeling; Obesity; Outpatients; Overweight; Parents; Patient Self-Report; Patients; Pediatric Research; Pediatrics; Persons; Physical activity; Pilot Projects; Policies; Primary Health Care; Process; Public Health; Questionnaires; Randomized; Relative (related person); Reporting; SERPINI2 gene; Schedule; Screening procedure; Series; Supervision; System; Target Populations; Telephone; Television; Testing; Training; Videotape; Visit; Weight; Work; Youth; base; cohort; cost; cost effectiveness; design; drinking; efficacy trial; feeding; follow-up; fruits and vegetables; heme oxygenase-1; indexing; instrument; motivational enhancement therapy; nutrition; obesity treatment; pediatrician; primary outcome; programs; response; secondary outcome; sugar; tool; treatment as usual; tv watching

DESCRIPTION (provided by applicant): Working with the PROS (Pediatric Research in Office Settings) Network of the American Academy of Pediatrics (AAP), the American Dietetic Association (ADA), and the Centers for Disease Control (CDC), we will conduct an efficacy trial among 30 PROS practices to test two interventions that address many of the key barriers to obesity counseling in pediatric primary care. The target population will be 600 youth ages 2-8 with a BMI >= 85th and =< 97th percentile. We will employ a cluster-randomized design with PROS practice as the unit of randomization with three experimental groups. Group 1 (Usual Care-UC) will include determination of BMI percentile at baseline, 1 year, and 2 year follow up. UC practitioners will provide parents with a series of educational tip sheets as well as an educational video tape. UC pediatricians (PEDS) will also receive a = day study orientation session that will include a brief CME-type workshop addressing obesity treatment. Group 2 (PED only) will include the same assessments, enrollment criterion and educational materials as UC. In addition, Group 2 PEDs will receive 2.0 days of in-person training in Motivational Interviewing (MI) plus 2 telephone based counseling supervision sessions, and an interactive DVD MI booster training system to be developed during year 1. PEDs in Group 2 will schedule 3 proactive counseling sessions with a parent of the index child in Year 1 and 1 additional visits in year 2. Group 2 PEDS will be reimbursed $50 per visit. Group 3 (PED+RD) will include the same training and intervention components as Group 2, but will add counseling from a trained dietitian (RD). RDs will deliver 6 MI-based counseling sessions over 2 years, frontloaded with 4 contacts in year 1 and 2 in year 2. The RD sessions will be delivered both in-person and by telephone. RDs will receive 2.0 days of in-person MI training jointly with PEDS, plus 2 telephone-based supervision sessions. RDs will be compensated $50 per in-person visit and $35 for telephone sessions. The project is significantly informed by a recently completed pilot study conducted with AAP PROS, along with the team that will conduct the proposed study. The primary outcome for the trial will be child's BMI percentile at 2 year followup. Secondary outcomes include physical activity by accelerometry, diet and activity via 24hr recall and self report questionnaire, and parental feeding practices. Process, mediation, and cost effectiveness analyses will also be conducted. Pediatric obesity remains a major public health problem. There is a paucity of evidenced- based intervention models to assist primary care practitioners to treat their overweight pediatric patients. The results of this study could impact training, policy, and reimbursement of obesity care in pediatric practice.

描述（由申请人提供）：与美国儿科学会（AAP），美国饮食协会（ADA）和疾病控制中心（CDC）的PROS（办公室环境中的儿科研究）网络合作，我们将在30个PROS实践中进行疗效试验，以测试两种干预措施，解决儿科初级保健中肥胖咨询的许多关键障碍。目标人群将是600名年龄在2-8岁、BMI >= 85且<= 97百分位数的青年。我们将采用分组随机化设计，以PROS实践作为随机化单元，分为三个实验组。第1组（家庭护理-UC）将包括基线、1年和2年随访时BMI百分位数的测定。UC从业人员将为家长提供一系列的教育提示以及教育录像带。加州大学儿科医生（PEDS）也将接受为期=天的研究方向会议，将包括一个简短的CME型研讨会解决肥胖治疗。第2组（仅PED）将包括与UC相同的评估、入组标准和教育材料。此外，第2组PED将接受为期2.0天的动机访谈（MI）面对面培训，外加2次电话咨询监督会议，以及将在第1年开发的交互式DVD MI助推器培训系统。第2组的PED将在第1年安排3次主动咨询会议，与索引儿童的父母一起，并在第2年安排1次额外的访问。第2组PEDS每次访视将报销50美元。第3组（PED+RD）将包括与第2组相同的培训和干预成分，但将增加训练有素的营养师（RD）的咨询。RD将在2年内提供6次基于MI的咨询课程，第1年有4次接触，第2年有2次接触。研发会议将通过面对面和电话进行。RD将与PEDS一起接受2.0天的面对面MI培训，外加2次电话监督会议。RD将获得每次亲自访问50美元和电话会议35美元的补偿。该项目是显着通知最近完成的试点研究进行的AAP PROS，沿着的团队，将进行拟议的研究。试验的主要结局是2年随访时儿童的BMI百分位数。次要结局包括通过加速度计进行的体力活动、通过24小时回忆和自我报告问卷进行的饮食和活动以及父母喂养实践。还将进行流程、调解和成本效益分析。儿童肥胖症仍然是一个主要的公共卫生问题。有一个证据为基础的干预模式，以协助初级保健医生治疗他们的超重儿科患者的匮乏。这项研究的结果可能会影响儿科实践中肥胖护理的培训，政策和报销。