Parents as peer interventionists in treatment for pediatric weight management

 描述（由申请人提供）：美国儿童超重和肥胖的高患病率需要开发有效但具有成本效益且易于传播的干预措施，以改善和维持更好的儿童体重结局。累积的证据表明，中到高强度（>25小时接触）的家庭治疗（FBT）对小学学龄儿童具有初始和长期疗效，但由于人员成本高（由行为健康专业人员提供），这种治疗过于昂贵，因此可用性有限，范围和影响。很少有超重/肥胖儿童接受循证治疗以改善他们的体重状况或健康。我们的试点数据表明，一种新的模式，以同伴为基础的交付FBT与FBT治疗的父母培训，随后提供FBT给其他家庭，是可行的，并显示出初步的疗效。这种交付模式可以显著降低FBT成本并提高FBT可用性。初步数据还表明，作为一个同伴干预者也可能有利于同伴自己和他们的孩子更好地维持自己的体重结果。本研究的目的是提供一个更明确的测试的短期和长期疗效的同龄人与专业提供的FBT对儿童体重的结果。嵌入在这个比较是一个检查的可行性，以同伴为基础的FBT交付，调查的影响，作为一个同伴的干预对同伴自己和他们的孩子的长期体重状况，和一个更全面的检查的差异成本专业与同伴为基础的FBT交付。本研究还将测试潜在的传播和可持续性，通过检查同伴干预者之间的同伴提供的FBT的有效性，他们自己从其他同伴那里接受FBT，而不是从专业的干预者那里。适度的治疗结果也进行了检查，侧重于同伴干预和儿童的特点。这项多期试验将在我们地区的多个地点招募304个7-11岁超重/肥胖儿童家庭，并包括短期（治疗后）和长期（治疗停止后1年）评估。这项创新方法的研究可以显着降低FBT的交付成本，同时还可以改善治疗效果的维持，对于改善许多已经超重的儿童的健康状况至关重要。

 DESCRIPTION (provided by applicant): The high prevalence of pediatric overweight and obesity in the U.S. necessitates the development of efficacious, but cost-effective and easily disseminable interventions that improve and sustain better pediatric weight outcomes. Accumulated evidence finds initial and long-term efficacy of moderate-to-high intensity (>25 contact hours) family-based treatment (FBT) for elementary school-aged children, but such treatment is prohibitively expensive because of high personnel costs (delivery by behavioral health professionals) and therefore limited in availability, reach, and impact. Very few overweight/obese children receive evidence-based treatment to improve their weight status or health. Our pilot data suggest a new model, peer-based delivery FBT with FBT-treated parents trained and subsequently delivering FBT to other families, is feasible and demonstrates initial efficacy. This delivery model could dramatically reduce FBT costs and increase FBT availability. Preliminary data also suggest that serving as a peer interventionist may also benefit the peers themselves and their children in better sustaining their own weight outcomes. The present study aims to provide a more definitive test of the short- and long-term efficacy of peer- versus professionally-delivered FBT on child weight outcomes. Embedded in this comparison is an examination of the feasibility of peer-based FBT delivery, investigating the impact of serving as a peer interventionist on the peers' own and their child's long- term weight status, and a more comprehensive examination of differential costs of professional- versus peer- based FBT delivery. The present study will also test potential dissemination and sustainability by examining the efficacy of peer-delivered FBT among peer interventionists who themselves received FBT from other peers and not from professional interventionists. Moderation of treatment outcome is also examined, focusing on peer interventionist and child characteristics. This multi-phase trial will enroll 304 families with 7-11 year old overweight/obese children in multiple sites throughout our region, and include short-term (post-treatment) and long-term (up through 1 year after treatment cessation) assessments. This investigation of an innovative approach that could significantly reduce FBT delivery costs, while also improving the maintenance of treatment effects, is critical to improving the health of the many already overweight children at risk for chronic disease.