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

项目总结/摘要 儿童肥胖症是一种公共卫生危机，与昂贵的心血管和慢性疾病有关， 生活质量下降。不成比例的儿童肥胖，定义为身体质量指数 (BMI)年龄和性别≥第95百分位数，为少数种族/族裔或社会经济弱势群体。 以家庭为基础的儿童肥胖症治疗已经证明是有效的，但仍存在高风险。 参与者辍学和出勤率不一致，限制了干预效果的机会， 健康成果。照顾者经常退出，由于程序超载无关的信息或没有 满足他们的期望。由于儿童肥胖的复杂性，儿童体重增加的贡献者可以 每个家庭都有很大的不同。个性化定制的以家庭为基础的方案使用严格的评估， 制定个性化治疗计划，解决家庭的独特需求和治疗优先事项。的 家庭体检4健康（FCU 4 Health）是一个评估驱动的个性化定制的家庭为基础的儿科 肥胖计划，目标是育儿技巧和健康行为，参与率很高， 低收入主要是少数民族样本中的保留率。尽管个人的承诺 剪裁，工具，以量化的过程中，个人剪裁研究不足，阻碍了能力，以评估 个人剪裁，并分析剪裁影响项目参与和成果的理论。的 拟议的研究将开发和验证一个观察性评级系统，以衡量 在以家庭为基础的儿童肥胖干预中个体定制。会议录像、文字记录和 来自FCU 4 Health的一项已完成试验的多方法数据，即养育健康儿童（RHC）项目， 用于开发观察评级系统。接下来，FCU 4 Health的第二次试验， 社区4健康学生（HC 4 HS）项目，将用于验证新的评级系统。最后， 新的评分系统的分数将被用来测试个人剪裁，计划 参与和健康行为和人体测量结果的变化，使用RHC和 HC 4 HS样品。本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。新工具将推进儿童肥胖领域 通过提供一个评级系统来指导儿童肥胖的设计、实施和评估 干预与个人定制组件。量化个人剪裁将阐明其关系 通过项目参与和成果，为循证干预措施的调整提供信息。的 加强干预措施将满足参与者的需求，促进健康行为的改变， 预防和管理儿童肥胖症，降低相关疾病的风险。

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.