Parks & Pediatrics Fit Together: Translating knowledge into action for child obesity treatment in partnership with Parks and Recreation

公园

• 批准号: 10242013
• 负责人: Sarah C Armstrong
• 金额: $ 66.5万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-19 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10242013
• 关键词: Adult; Advisory Committees; Body mass index; Cardiovascular Diseases; Caregivers; Caring; Characteristics; Child; Childhood; Chronic Disease; Clinic; Clinical; Communities; Data; Development; Diabetes Mellitus; Disease; Effectiveness; Ensure; Environment; Epidemic; Evidence based treatment; Family; Funding; Future; Generations; Goals; Habits; Hand; Health; Health Benefit; Health Care Reform; Health Personnel; Hour; Improve Access; Interruption; Intervention; Knowledge; Lead; Life; Life Expectancy; Life Style Modification; Location; Low income; Measures; Minority; Mission; Modeling; Morbidity - disease rate; Municipalities; National Institute of Child Health and Human Development; Obesity; Obesity Epidemic; Obesity associated cancer; Online Systems; Outcome; Overweight; Parents; Pediatrics; Physical Fitness; Population; Preventive service; Primary Health Care; Process; Provider; Public Health; Quality of life; Recommendation; Recording of previous events; Recreation; Reporting; Research; Resources; Risk; Risk Reduction; Rural; Series; Site; Testing; Time; Training Activity; Translating; Translations; United States; United States National Institutes of Health; Work; adopted child; adult obesity; base; cardiovascular health; clinical practice; community setting; comorbidity; cost; design; disability; dissemination strategy; effective therapy; evidence based guidelines; implementation outcomes; implementation process; implementation strategy; implementation tool; improved; innovation; learning materials; mortality; obesity in children; obesity treatment; payment; prevent; programs; uptake

PROJECT SUMMARY/ABSTRACT Evidence-based treatment for childhood obesity exists, yet a fundamental knowledge-to-action gap has significantly limited the uptake of recommendations into clinical practice, particularly in low-income settings. Persistence of this gap represents a large-scale public health threat, as the earliest generation of children living through the obesity epidemic now enters adulthood, they are the first in US history to have a shorter life expectancy than their parents, mainly due to rising rates of obesity-related cancers and cardiovascular disease. A central challenge in delivering recommended treatment is the intensity; ≥26 hours of face-to-face contact are necessary to achieve health benefits and risk reduction. The long-term goal is to close the knowledge-to-action gap by disseminating effective implementation tools that will deliver the current child obesity treatment recommendations in diverse community settings. The objective of the proposed project is to develop and test an implementation strategy that pairs primary care pediatric clinics with municipal Parks and Recreation (P&R) centers to deliver the current treatment recommendations with high fidelity, while allowing crucial adaptations for the local and cultural context. The central hypothesis is that effective pediatric obesity treatment is possible to achieve, but only with strong implementation supports to ensure fidelity to evidence- based recommendations and adaptability to local resource constraints and population needs. Guided by strong preliminary data on effectiveness and implementation feasibility, this hypothesis will be tested through three specific aims: 1) Develop a web-based platform that will support the implementation and broad dissemination of the shared clinic-P&R model in low-resource settings; 2) Evaluate the implementation platform using an interrupted time series design anchored in the Process Redesign Framework and reporting qualitative and quantitative measures of provider and organizational characteristics, implementation process and outcomes, child outcomes, and caregiver outcomes; and 3) Design a dissemination and sustainability strategy, using the PCORI Dissemination Framework, that considers relevant factors including community resources, funding stability, organizational capacity, partnership development, program requirements, and sustainability. The approach is innovative because it is a strong example of value-based care, a new horizon for alternative payment models in the current environment of health care reform. The proposed research is significant, because it will deliver implementation tools into the hands of front-line pediatric health care providers and over 33,000 park and recreation centers nationally. If successful, the expected outcomes will dramatically improve access to effective treatment in diverse communities, and deliver on the existing recommendations for millions of children with obesity in the United States.

项目总结/摘要 儿童肥胖症的循证治疗是存在的，但一个基本的知识到行动的差距， 严重限制了临床实践对建议的采纳，特别是在低收入环境中。 这一差距的持续存在是一个大规模的公共卫生威胁，因为生活在非洲的最早一代儿童， 他们是美国历史上第一个寿命较短的人， 他们的期望值比父母高，主要是由于肥胖相关癌症和心血管疾病的发病率上升。 疾病提供推荐治疗的主要挑战是强度; ≥26小时的面对面治疗 接触是必要的，以实现健康效益和减少风险。长期目标是关闭 通过传播有效的执行工具， 在不同社区环境中的肥胖治疗建议。拟议项目的目标是 制定并测试一项实施战略，将初级保健儿科诊所与市政公园配对， 娱乐（P&R）中心提供高保真的当前治疗建议，同时允许 对当地和文化背景的重要适应。中心假设是有效的儿童肥胖 治疗是有可能实现的，但只有在强有力的实施支持下，才能确保对证据的忠实性- 根据当地资源限制和人口需求提出建议和进行调整。以强为导 关于有效性和实施可行性的初步数据，将通过三个方面来检验这一假设。 具体目标：1）建立一个网络平台，支持执行和广泛传播 共享诊所P &R模式在低资源环境中的应用; 2）使用 中断的时间序列设计以流程重新设计框架为基础， 提供者和组织特征、实施过程和结果的量化措施， 儿童成果和照顾者成果; 3）设计传播和可持续性战略， PCORI传播框架，考虑相关因素，包括社区资源、资金 稳定性、组织能力、伙伴关系发展、计划要求和可持续性。的 方法是创新的，因为它是一个强有力的例子，以价值为基础的照顾，一个新的视野， 在当前医疗保健改革环境下的支付模式。拟议的研究意义重大， 因为它将为一线儿科医疗保健提供者提供实施工具， 全国有33,000个公园和娱乐中心。如果成功，预期结果将大大改善 在不同社区获得有效治疗，并为数百万人提供现有建议 肥胖儿童的比例。