BM12: Brief Motivational Interviewing to Reduce Child BMI

BM12：减少儿童体重指数的简短动机访谈

• 批准号: 7776905
• 负责人: Ken A. Resnicow
• 金额: $ 67.74万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2013-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7776905
• 关键词: Academy; Accident and Emergency department; Address; Age; American; American Dietetic Association; Behavior; Behavior Therapy; Behavioral; Body mass index; Caring; Centers for Disease Control and Prevention (U.S.); Child; Childhood; Collaborations; Consumption; Continuing Education; Counseling; Data; Diet; Dietitian; Educational Intervention; Educational Materials; Educational workshop; Effectiveness of Interventions; Enrollment; Evidence based intervention; Health; Intake; Intervention; Life Style; Mediation; Metric; Modeling; Obesity; Outpatients; Overweight; Parents; Patient Self-Report; Patients; Pediatric Research; Pediatrics; Persons; Physical activity; Pilot Projects; Policies; Primary Health Care; Process; Public Health; Questionnaires; Randomized; Relative (related person); Reporting; SERPINI2 gene; Schedule; Screening procedure; Series; Supervision; System; Target Populations; Telephone; Television; Testing; Training; Videotape; Visit; Weight; Work; Youth; base; cohort; cost; cost effectiveness; design; drinking; efficacy trial; feeding; follow-up; fruits and vegetables; heme oxygenase-1; indexing; instrument; motivational enhancement therapy; nutrition; obesity treatment; pediatrician; primary outcome; programs; response; secondary outcome; sugar; tool; treatment as usual; tv watching

DESCRIPTION (provided by applicant): Working with the PROS (Pediatric Research in Office Settings) Network of the American Academy of Pediatrics (AAP), the American Dietetic Association (ADA), and the Centers for Disease Control (CDC), we will conduct an efficacy trial among 30 PROS practices to test two interventions that address many of the key barriers to obesity counseling in pediatric primary care. The target population will be 600 youth ages 2-8 with a BMI >= 85th and =< 97th percentile. We will employ a cluster-randomized design with PROS practice as the unit of randomization with three experimental groups. Group 1 (Usual Care-UC) will include determination of BMI percentile at baseline, 1 year, and 2 year follow up. UC practitioners will provide parents with a series of educational tip sheets as well as an educational video tape. UC pediatricians (PEDS) will also receive a = day study orientation session that will include a brief CME-type workshop addressing obesity treatment. Group 2 (PED only) will include the same assessments, enrollment criterion and educational materials as UC. In addition, Group 2 PEDs will receive 2.0 days of in-person training in Motivational Interviewing (MI) plus 2 telephone based counseling supervision sessions, and an interactive DVD MI booster training system to be developed during year 1. PEDs in Group 2 will schedule 3 proactive counseling sessions with a parent of the index child in Year 1 and 1 additional visits in year 2. Group 2 PEDS will be reimbursed $50 per visit. Group 3 (PED+RD) will include the same training and intervention components as Group 2, but will add counseling from a trained dietitian (RD). RDs will deliver 6 MI-based counseling sessions over 2 years, frontloaded with 4 contacts in year 1 and 2 in year 2. The RD sessions will be delivered both in-person and by telephone. RDs will receive 2.0 days of in-person MI training jointly with PEDS, plus 2 telephone-based supervision sessions. RDs will be compensated $50 per in-person visit and $35 for telephone sessions. The project is significantly informed by a recently completed pilot study conducted with AAP PROS, along with the team that will conduct the proposed study. The primary outcome for the trial will be child's BMI percentile at 2 year followup. Secondary outcomes include physical activity by accelerometry, diet and activity via 24hr recall and self report questionnaire, and parental feeding practices. Process, mediation, and cost effectiveness analyses will also be conducted. Pediatric obesity remains a major public health problem. There is a paucity of evidenced- based intervention models to assist primary care practitioners to treat their overweight pediatric patients. The results of this study could impact training, policy, and reimbursement of obesity care in pediatric practice.

描述（由申请人提供）：我们将与美国儿科学会（AAP）、美国饮食协会（ADA）和疾病控制中心（CDC）的PROS（儿科办公室研究）网络合作，在30个PROS实践中进行功效试验，以测试两种干预措施，这些干预措施解决了儿科初级保健中肥胖咨询的许多关键障碍。目标人群为600名2-8岁的青少年，BMI指数为85和< 97百分位。我们将采用聚类随机设计，以PROS实践为随机化单位，分为三个实验组。第一组（常规护理- uc）将包括基线时BMI百分位数的测定，1年和2年随访。UC的工作人员将为家长提供一系列的教育小册子和教育录像带。加州大学儿科医生（PEDS）也将接受为期两天的学习指导会议，其中包括一个简短的cme类型的关于肥胖治疗的研讨会。第二组（仅限PED）将包括与UC相同的评估，入学标准和教材。此外，第二组的教师将接受2.0天的动机性访谈（MI）面对面培训，加上2个电话咨询监督课程，以及将在第一年开发的交互式DVD MI强化培训系统。第二组的儿科医生将在一年级安排3次与索引孩子的家长的主动咨询，并在二年级安排1次额外的访问。第2组儿科医生每次就诊可报销$50。第3组（PED+RD）将包括与第2组相同的培训和干预内容，但将增加训练有素的营养师（RD）的咨询。rd将在两年内提供6次基于mi的咨询课程，在第一年和第二年分别有4名联系人和2名联系人。研发课程将以亲身及电话方式进行。研发人员将与PEDS一起接受2.0天的现场MI培训，外加2个电话监督课程。rd每次亲自访问将获得50美元的补偿，电话会议将获得35美元的补偿。该项目最近完成了一项试点研究，该研究由AAP PROS和将进行拟议研究的团队共同进行。试验的主要结果将是儿童2年随访时的BMI百分位数。次要结果包括通过加速度计测量的身体活动、通过24小时回忆和自我报告问卷的饮食和活动以及父母的喂养做法。还将进行程序、调解和成本效益分析。儿童肥胖仍然是一个主要的公共卫生问题。缺乏基于证据的干预模型来帮助初级保健从业者治疗他们的超重儿科患者。本研究的结果可能会影响儿科肥胖护理的培训、政策和报销。