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TEEN JOIN: A Scalable Weight Control Intervention for Adolescents

TEEN JOIN：针对青少年的可扩展体重控制干预措施

基本信息

批准号：
8878252
负责人：
ELISSA JELALIAN
金额：
$ 21.3万
依托单位：
MIRIAM HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-07-01 至 2017-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8878252
关键词：
Academic Medical Centers Address Adolescent Adult Advisory Committees Age Area Behavior Behavioral Benchmarking Beverages Body Weight decreased Child Childhood Clinical Collaborations Communities Consumption Controlled Clinical Trials Data Development Diet Dietary intake Drops Educational Curriculum Effectiveness Effectiveness of Interventions Epidemic Evaluation Family Food Goals Health Health behavior change Height Intervention Interview Maintenance Measures Monitor Nutrient Obesity Outcome Overweight Parents Patient Triage Physical activity Pilot Projects Policies Prevalence Preventive Procedures Public Health Randomized Recommendation Research School-Age Population Self Concept Self Efficacy Series Services Site Teenagers Testing United States Weight Weight maintenance regimen Youth base cohesion community setting cost cost effectiveness dissemination trial effective intervention evidence base improved innovation lifestyle intervention meetings obesity in children obesity prevention obesity treatment parental involvement programs psychosocial public health priorities sedentary tertiary care theories treatment trial

项目摘要

DESCRIPTION (provided by applicant): The prevalence of overweight/obesity among children and adolescents remains a public health priority. Interventions to treat children and adolescents currently struggling with excess weight are critical for prevention of obesity into adulthood. There is increasing evidence to support the efficacy of comprehensive lifestyle interventions for adolescents. Despite the emergence of such treatments, few adolescents benefit because these interventions are available primarily through carefully controlled clinical trials or delivered in specialized/tertiary clinical settings affiliated with academic medical centers. In 2010, the U.S. Preventive Services Task Force (USPSTF) provided a Grade recommendation B (i.e. the service is recommended with moderate/high certainty of benefit) for clinicians to screen children ages 6-17 years for obesity and refer identified youth to comprehensive behavioral programs. The challenge in meeting this objective is the lack of community-based obesity treatments to which to refer, particularly for adolescents. The JOIN program, developed as a collaboration between United HealthGroup and Y-USA is a pediatric weight control intervention targeted toward a broad age range of youth from 6-17 years that is: 1) based on well established and evidence based principles; 2) delivered by YMCA facilitators within a community setting: and 3) potentially scalable nationally. Findings from a 6-month pilot study examining the effectiveness of JOIN demonstrated impressive changes in weight status for school age children, but more modest results for adolescents. The goal of the proposed study is to modify the JOIN program to increase its effectiveness with adolescents while retaining its potential for scalability A tota of {120} adolescents (ages 13-17) with BMI > 85th% and < {50} will be randomly assigned to a 16-week enhanced JOIN program (TEEN JOIN), or the traditional JOIN intervention, followed by 6 monthly maintenance sessions. Evaluation of adolescent height, weight, group cohesion, objective physical activity, {dietary intake} and psychosocial outcomes will be obtained at baseline, 4 months, and 10 months. Additional outcomes will include treatment feasibility, including attendance, completion of diet and physical activity monitoring logs, and exit interviews with adolescents and parents regarding the intervention. We will also obtain preliminary indicators of cost effectiveness. It is hypothesized that adolescents who are randomized to TEEN JOIN will demonstrate greater decrease in BMI at 4 and 10 months than those randomized to JOIN. It is further hypothesized that adolescents randomized to TEEN JOIN will demonstrate greater increases in participation in moderate-vigorous physical activity and greater improvements in self-concept, self-efficacy related to physical activity, and group cohesion than adolescents who receive the standard JOIN condition. The next objective in this line of research is to conduct a large scale dissemination trial (R18) to evaluate the effectiveness of TEEN JOIN for adolescent weight control.

描述（由申请人提供）：儿童和青少年超重/肥胖的患病率仍然是公共卫生优先事项。对目前体重超重的儿童和青少年进行干预治疗对于预防成年后肥胖至关重要。越来越多的证据支持青少年综合生活方式干预的有效性。尽管出现了此类治疗方法，但很少有青少年受益，因为这些干预措施主要是通过仔细控制的临床试验或在附属于学术医疗中心的专业/三级临床机构中提供的。 2010 年，美国预防服务工作组 (USPSTF) 为临床医生提供了 B 级推荐（即以中等/高度肯定的益处推荐该服务），以筛查 6-17 岁儿童的肥胖情况，并将确定的青少年转介至综合行为计划。实现这一目标的挑战是缺乏可供参考的基于社区的肥胖治疗方法，特别是针对青少年。 JOIN 计划是 United HealthGroup 和 Y-USA 合作开发的一项儿科体重控制干预措施，针对 6 至 17 岁的广大青少年，该计划是： 1) 基于既定且基于证据的原则； 2) 由 YMCA 协调员在社区环境中提供：以及 3) 可能在全国范围内推广。一项为期 6 个月的试点研究检查了 JOIN 的有效性，结果表明，学龄儿童的体重状况发生了令人印象深刻的变化，但青少年的结果则较为温和。拟议研究的目标是修改 JOIN 计划，以提高其对青少年的有效性，同时保留其可扩展性的潜力。总共 {120} 名 BMI > 85% 且 < {50} 的青少年（13-17 岁）将被随机分配到为期 16 周的增强型 JOIN 计划 (TEEN JOIN) 或传统的 JOIN 干预，然后进行 6 个月的维护课程。将在基线、4 个月和 10 个月时获得对青少年身高、体重、群体凝聚力、客观身体活动、{饮食摄入}和心理社会结果的评估。其他结果将包括治疗的可行性，包括出勤率、饮食和身体活动监测日志的完成情况，以及与青少年和家长就干预措施进行的离职面谈。我们还将获得成本效益的初步指标。据推测，被随机分配到 TEEN JOIN 的青少年在 4 个月和 10 个月时的 BMI 会比随机分配到 JOIN 的青少年表现出更大的下降。进一步假设，与接受标准 JOIN 条件的青少年相比，随机接受 TEEN JOIN 的青少年将表现出更多地参与中等强度的体育活动，并且在自我概念、与体育活动相关的自我效能和群体凝聚力方面有更大的改善。该研究的下一个目标是进行大规模传播试验 (R18)，以评估 TEEN JOIN 对青少年体重控制的有效性。