MICCO - Mobile Integrated Care for Childhood Obesity: A technology-enhanced comprehensive approach to integrating obesity care in rural communities

MICCO - 儿童肥胖移动综合护理：一种技术增强的综合方法，将肥胖护理纳入农村社区

• 批准号: 10580770
• 负责人: Thao-Ly Tam Phan-Vo
• 金额: $ 25.28万
• 依托单位: ALFRED I. DU PONT HOSP FOR CHILDREN
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10580770
• 关键词: 12 year old; Academy; Address; Affect; American; Area; Behavior; Behavior Therapy; Cardiovascular Diseases; Caring; Child; Child Health; Childhood; Clinical; Color; Communities; Community Healthcare; Community Integration; Complex; Counseling; Diabetes Mellitus; Disparity; Electronic Health Record; Enhancement Technology; Ensure; Ethnic Origin; Face; Family; Feedback; Food; Foundations; Friends; Health; Healthcare; Healthcare Systems; Home environment; Inequity; Intervention; Life Style; Low income; Measures; Mental Health; Modeling; National Institute of Child Health and Human Development; National Institute of Diabetes and Digestive and Kidney Diseases; Nutritional; Obesity; Outcome; Parents; Pediatrics; Physical activity; Public Health; Qualitative Research; Quality of Care; Race; Randomized; Randomized, Controlled Trials; Recommendation; Research; Research Methodology; Resources; Risk; Role; Rural; Rural Community; Self Management; Site; Social Work; Socioeconomic Status; Specialist; Technology; Testing; Transportation; Treatment outcome; United States; Work; behavior change; body system; community center; community organizations; community-level factor; disparity reduction; effectiveness testing; efficacy evaluation; empowerment; ethnic minority population; evidence base; family management; health care quality; improved; innovative technologies; integrated care; intervention refinement; low socioeconomic status; member; mobile application; multi-component intervention; obesity in children; obesity treatment; patient centered medical home; primary care practice; primary care provider; primary care setting; primary care visit; psychoeducation; psychoeducational; psychosocial; racial minority population; recruit; rural underserved; standard care; success; telehealth; tool; usability

PROJECT SUMMARY Nearly 1 in 5 children in the United States are affected by obesity, with even higher rates among children of racial and ethnic minority groups, of low socioeconomic status, and living in rural communities. Obesity is a significant public health concern because it increases a child’s risk for health conditions within every organ system, including diabetes, cardiovascular disease, and mental health problems. Traditional lifestyle behavior interventions have not been as effective when implemented in communities of color, low-income communities, and rural communities. Guided by the Clinical and Community Integration Framework, which emphasizes the integration of community and healthcare systems to drive family engagement and empowerment in treating obesity, our work has demonstrated the importance of addressing psychosocial needs and leveraging technology to improve care for families of children with obesity. We have assembled a research team, with complimentary and relevant areas of expertise, to refine and test a multi-component intervention, Mobile Integrated Care for Childhood Obesity (MICCO). MICCO combines evidence-based approaches previously developed and tested by our research team, each delivered through a mobile app platform integrated with the electronic health record. Components will include: (1) coordinating social services in the community to meet families’ psychosocial needs, (2) integrating care from obesity specialists using telehealth, and (3) providing media-based psychoeducational tools to promote self-management of lifestyle behavior change. Community-engaged and qualitative research methods will be employed to refine MICCO to be community-centered and family-friendly (Aim 1). The refined intervention will be tested in a randomized controlled trial with 184 families of children 4-12 years of age with obesity, recruited from rural primary care practices, to determine the impact of the intervention on child adiposity and family engagement in treatment over six months (Aim 2) and disparities in these outcomes by race, ethnicity, and socioeconomic status (Aim 3). This study will inform a R01 application in Year 2 to expand the concept to a multi-site RCT to test the effectiveness of MICCO’s integrated, community-centered, and technologically state- of-the-art approach in improving the reach and relevance of childhood obesity treatments to families in underserved rural communities, increasing the likelihood of a positive impact on obesity outcomes and inequities in child health.

项目总结 在美国，近五分之一的儿童受到肥胖的影响，种族儿童的肥胖率更高 和少数民族群体，社会经济地位较低，生活在农村社区。肥胖是一种重要的 公共卫生问题，因为它增加了儿童在每个器官系统内健康状况的风险，包括 糖尿病、心血管疾病和精神健康问题。传统的生活方式行为干预 在有色人种社区、低收入社区和农村地区实施时效果不佳 社区。以强调整合的临床和社区整合框架为指导 社区和医疗保健系统以推动家庭参与和赋权治疗肥胖症，我们的 工作证明了满足心理社会需求和利用技术改进的重要性 关心肥胖儿童的家庭。我们已经组建了一个研究团队，提供免费的和相关的 专业领域，以完善和测试多组件干预，儿童流动综合护理 肥胖(Micco)。Micco结合了我们之前开发和测试的基于证据的方法 研究团队，每个都通过一个与电子健康记录集成的移动应用平台提供。 内容包括：(1)协调社区的社会服务，以满足家庭的心理社会需求； (2)使用远程保健整合肥胖专家的护理，以及(3)提供基于媒体的心理教育 促进自我管理改变生活方式行为的工具。社区参与和定性研究 将采用各种方法将MICCO改进为以社区为中心和对家庭友好(目标1)。精致的 干预措施将在184个4-12岁儿童家庭的随机对照试验中进行测试 从农村初级保健机构招募的肥胖，以确定干预对儿童肥胖症的影响 和六个月以上的家庭参与治疗(目标2)，以及这些结果中的种族、民族、 和社会经济地位(目标3)。这项研究将在第二年通知R01申请，将这一概念扩展到 多站点RCT，以测试Micco的集成、以社区为中心和技术状态的有效性- 改善儿童肥胖症治疗的覆盖面和家庭相关性的最先进方法 服务不足的农村社区，增加了对肥胖结果和不平等产生积极影响的可能性 在儿童健康方面。