Parent Risk Communication

 描述(申请人提供)：与正常体重的儿童相比，早期肥胖会增加儿童患成人肥胖症、心血管疾病(CVD)、早期死亡和其他风险的风险。大多数肥胖儿童的父母并不关心孩子的体重，父母严重低估了他们的孩子成年后肥胖并患上心血管疾病的概率。参加肥胖治疗计划的肥胖儿童的父母将改善孩子长期健康的愿望作为参与行为改变的一个原因。对儿童健康的担忧可能是行为改变参与的一个重要推动者。因此，我们有兴趣了解如何促进对儿童长期健康风险的准确了解，以提高对肥胖儿童体重的适当关注程度，并增加对健康行为的接受。医疗保健提供者对于帮助父母了解他们的孩子是否处于健康的体重轨迹上至关重要，但提供者没有有效的工具来与父母谈论肥胖及其相关的不利健康风险；仅有BMI增长图表是不够的。这项提案的总体研究目标是确定基于临床的风险沟通方法，这些方法可以激励肥胖儿童的父母改变行为，以防止未来的肥胖和心血管疾病。在目标1中，我们将开发新的风险沟通信息。我们将考虑几种围绕消息内容和框架的新方法，但主要是建议使用微模拟模型来预测儿童的长期健康风险，基于他的年龄、种族、性别、BMI和心血管疾病家族史。对提供者和家长的定性访谈，以及由健康研究人员和家长研究伙伴组成的利益相关者小组，将用于评估潜在的有效和可接受的信息。在目标2中，我们将利用一项基于网络的全国性调查，对四种新的风险沟通信息对父母行为改变意愿和意图的有效性进行实验评估。最后，在目标3中，我们将在临床环境中测试新的风险沟通信息的可接受性和有效性，并观察新信息对行为改变活动的影响。一项调查将评估父母感知的风险、感知的信息准确性、对儿童健康的担忧和焦虑。这项研究计划是K01计划的一部分，该计划旨在为Wright博士提供学术培训、指导和支持，以获得所需的技能和经验，以开展研究，研究与肥胖相关的风险沟通信息如何影响儿童行为变化。赖特博士是一名决策科学家，他的职业目标是成为一名独立的调查员，专注于使用决策科学方法来推动儿童肥胖症治疗和行为改变的接受。为了实现这一目标，她将接受以下方面的培训：(1)医疗决策心理学和儿科风险沟通原则，(2)定性研究方法，(3)行为健康干预措施的设计、实施和评估。(摘要结束)

 DESCRIPTION (provided by applicant): Early obesity puts children at increased risk for adult obesity, cardiovascular disease (CVD), early mortality, and other risks relative to normal weight children. Most parents of obese children are not concerned about their child's weight, and parents grossly underestimate the probabilities that their child will be obese and develop CVD in adulthood. Parents of obese children who have enrolled in obesity treatment programs cite a desire to improve their child's long-term health as a reason for engaging in behavior change. Concern about a child's health may be an important facilitator for behavior change engagement. Therefore, we are interested in understanding ways to promote accurate understanding of children's long-term health risks in order to raise an appropriate level of concern about obese children's weight and increase uptake of healthful behaviors. Health care providers are essential to help parents understand whether their child is on a healthy weight trajectory, but providers do not have effective tools for talking to parents about obesity and its associated adverse health risks; BMI growth charts alone are insufficient. This proposal's overall research goal is to identiy clinic-based risk communication approaches that can motivate parents of obese children to engage in behavior change to prevent future obesity and CVD. In Aim 1, we will develop novel risk communication messages. We will consider several novel approaches around message content and framing, but primarily, we propose using microsimulation models to forecast a child's long-term health risks, based on his age, race, gender, BMI, and family history of CVD. Qualitative interviews with providers and parents, and a stakeholder panel comprised of health researchers and parent research partners, will be used to evaluate potentially effective and acceptable messages. In Aim 2, we will experimentally evaluate the efficacy of four novel risk communication messages on parental behavior change willingness and intent using a national web-based survey. Finally, in Aim 3, we will test the acceptability and effectiveness of new risk communication messages in a clinical setting, and we will observe the impact of new messages on behavior change activities. A survey will assess parent-perceived risks, perceived message accuracy, concern about child health, and anxiety. This research plan is part of a K01 proposal designed to provide scholarly training, mentorship, and support for Dr. Wright to gain skills and experience needed to conduct research on how improved obesity-related risk communication messages may affect child behavior change. Dr. Wright is a decision scientist whose career goal is to become an independent investigator with a focus on using decision science methods to motivate uptake of childhood obesity treatment and behavior change. To achieve this objective, she will pursue training in: (1) the psychology of medical decision making and principles of pediatric risk communication, (2) qualitative research methods, and (3) the design, implementation, and evaluation of behavioral health interventions. (End of Abstract)