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

项目摘要 在美国，近五分之一的儿童受到肥胖的影响，种族和民族的儿童中肥胖率更高。 以及社会经济地位低下和生活在农村社区的少数民族群体。肥胖是一个重要的 公共卫生问题，因为它增加了儿童每个器官系统健康状况的风险，包括 糖尿病、心血管疾病和心理健康问题。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， 社区.在临床和社区整合框架的指导下，强调整合 社区和医疗保健系统，以推动家庭参与和赋权治疗肥胖，我们的 工作已经证明了解决心理社会需求和利用技术来改善 照顾肥胖儿童的家庭。我们组建了一个研究团队， 专业领域，完善和测试多组件干预，移动的儿童综合护理 肥胖症（MICCO）。MICCO结合了我们以前开发和测试的基于证据的方法， 研究团队，每个都通过与电子健康记录集成的移动的应用程序平台提供。 其组成部分将包括：（1）协调社区的社会服务，以满足家庭的心理社会需求， (2)整合肥胖专家使用远程医疗的护理，以及（3）提供基于媒体的心理教育 促进生活方式行为改变的自我管理的工具。社区参与和定性研究 将采用各种方法，改进小额信贷组织，使其以社区为中心，对家庭友好（目标1）。成品 将在一项随机对照试验中对184个4-12岁儿童的家庭进行干预测试， 肥胖，从农村初级保健实践招募，以确定干预对儿童肥胖的影响 和家庭参与治疗超过6个月（目标2），以及这些结果的种族，民族， 社会经济地位（目标3）。这项研究将告知R 01应用程序在第二年，以扩大概念， 多地点随机对照试验，以测试MICCO的综合，以社区为中心，技术状态的有效性， 最先进的方法，以提高儿童肥胖症治疗对家庭的影响和相关性， 服务不足的农村社区，增加对肥胖结果和不公平产生积极影响的可能性 儿童健康。

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.