Development and Validation of an Observational Rating System for Individual Tailoring in Family-Based Pediatric Obesity Interventions

基于家庭的儿科肥胖干预措施中个体定制观察评级系统的开发和验证

• 批准号: 10561594
• 负责人: Emily Suzan Fu
• 金额: $ 2.46万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-12-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10561594
• 关键词: Address; Affect; Age; Area; Attenuated; Behavioral; Behavioral Medicine; Body mass index; Cardiovascular Diseases; Caregivers; Child; Child Development; Child Health; Child Rearing; Chronic Disease; Clinical Psychology; Clinical Research; Code; Communities; Community Services; Data; Development; Disease; Dropout; Drops; Effectiveness; Effectiveness of Interventions; Emotional; Enrollment; Epidemic; Equation; Etiology; Evaluation; Evidence based intervention; Failure; Family; Family health status; Future; Gender; Goals; Health; Health Promotion; Health Status; Health and Behavior in Children; Health behavior; Health behavior change; Health education; Individual; Intervention; Intervention Studies; Libraries; Low income; Measures; Methodology; Methods; Modeling; Motivation; National Heart, Lung, and Blood Institute; Obesity; Obesity Epidemic; Outcome; Participant; Process; Process Assessment; Process Measure; Program Development; Psychometrics; Public Health; Quality of life; Recommendation; Research; Research Personnel; Resources; Risk; Risk Reduction; Role; Sampling; Self Determination; Self Efficacy; Standardization; Students; System; Testing; Theoretical model; Training; Transcript; Validation; Video Recording; Weight Gain; Weight maintenance regimen; career; checkup examination; clinical implementation; cost; design; ethnic minority; excessive weight gain; expectation; implementation research; implementation science; improved; individualized medicine; intervention effect; low socioeconomic status; novel; obesity in children; obesity management; obesity risk; obesity treatment; obesogenic; patient engagement; pre-doctoral; prevent; preventable death; primary care services; programs; racial diversity; racial minority; services as usual; skills; social; socioeconomic disadvantage; theories; therapy design; therapy development; tool; tool development; treatment as usual; treatment planning

Project Summary/Abstract Pediatric obesity is a public health crisis associated with costly cardiovascular and chronic diseases and decreased quality of life. A disproportionate number of children with obesity, defined as a body mass index (BMI)≥95th percentile for age and gender, are racial/ethnic minorities or socioeconomically disadvantaged. Family-based treatments for childhood obesity have demonstrated effectiveness but struggle with high participant drop-out and inconsistent attendance, limiting opportunities for intervention effects and improving health outcomes. Caregivers frequently drop out due to a program overloading irrelevant information or not meeting their expectations. Due to the complexity of pediatric obesity, contributors to children's weight gain can greatly vary from family to family. Individually tailored family-based programs use rigorous assessment to develop individualized treatment plans that address a family's unique needs and treatment priorities. The Family Check-Up 4 Health (FCU4Health) is an assessment-driven individually tailored family-based pediatric obesity program that targets parenting skills and health behaviors and has had high rates of participation and retention among a low-income predominantly ethnic minority sample. Despite the promise of individual tailoring, tools to quantify the process of individual tailoring are understudied, hindering the ability to evaluate individual tailoring and analyze the theory that tailoring affects program engagement and outcomes. The proposed study will develop and validate an observational rating system to measure the process and degree of individual tailoring in family-based pediatric obesity interventions. Videorecorded sessions, transcripts and multimethod data from a completed trial of the FCU4Health, the Raising Healthy Children (RHC) project, will be used to develop the observational rating system. Next, a second trial of the FCU4Health, the Healthy Communities 4 Healthy Students (HC4HS) project, will be used to validate the new rating system. Finally, scores from the new rating system will be used to test the relationship between individual tailoring, program engagement and changes in health behaviors and anthropometric outcomes using a combined RHC and HC4HS sample. This novel research will employ video observation coding, psychometrics, structural equation modeling, and implementation science methods. The new tool will advance the field of pediatric obesity research by providing a rating system to guide the design, implementation, and evaluation of pediatric obesity interventions with an individual tailoring component. Quantifying individual tailoring will elucidate its relationship with program engagement and outcomes to inform adaptations for evidence-based interventions. The enhanced interventions will accommodate participants' needs, facilitate health behavior change and ultimately prevent and manage pediatric obesity and reduce risk for associated diseases.

项目概要/摘要 儿童肥胖是一场公共卫生危机，与昂贵的心血管疾病和慢性疾病以及 生活质量下降。肥胖儿童的数量不成比例（定义为体重指数） (BMI)≥年龄和性别第 95 个百分位数，属于少数种族/族裔或社会经济弱势群体。 以家庭为基础的儿童肥胖治疗已被证明有效，但仍面临高风险 参与者退出和出勤不一致，限制了干预效果和改善的机会 健康结果。护理人员经常因程序超载不相关信息而退出 满足他们的期望。由于儿童肥胖的复杂性，导致儿童体重增加的因素可以 每个家庭的情况差异很大。个性化定制的基于家庭的计划采用严格的评估 制定个性化的治疗计划，以满足家庭的独特需求和治疗重点。这 Family Check-Up 4 Health (FCU4Health) 是一项以评估为导向、个性化定制的家庭儿科服务 针对育儿技能和健康行为的肥胖计划，参与率很高， 保留在以低收入为主的少数族裔样本中。尽管个人的承诺 裁缝方面，量化个性化裁缝过程的工具尚未得到充分研究，阻碍了评估能力 个性化定制并分析定制影响项目参与和结果的理论。这 拟议的研究将开发和验证一个观察评级系统来衡量 基于家庭的儿童肥胖干预措施的个体化定制。录像会议、文字记录和 来自 FCU4Health（养育健康儿童 (RHC) 项目）已完成试验的多方法数据将被 用于开发观察评级系统。接下来是 FCU4Health 的第二次试验，即 Healthy 社区 4 健康学生 (HC4HS) 项目将用于验证新的评级系统。最后， 新评级系统的分数将用于测试个人剪裁、节目之间的关系 使用 RHC 和人体测量相结合的方法来了解健康行为和人体测量结果的参与度和变化 HC4HS 样品。这项新颖的研究将采用视频观察编码、心理测量学、结构方程 建模和实施科学方法。新工具将推动儿童肥胖领域的发展 通过提供评级系统来指导儿童肥胖的设计、实施和评估进行研究 通过个性化定制组件进行干预。量化个体剪裁将阐明其关系 计划参与和成果为基于证据的干预措施的调整提供信息。这 加强干预措施将满足参与者的需求，促进健康行为的改变，并最终 预防和管理儿童肥胖并降低相关疾病的风险。