Stages of Change as Determinants of Health Service Use: Adaptation and Validation of the German Short Version of the University of Rhode Island Change Assessment (URICA-S) for the Perspective of Parents of Children with Obesity.

儿童和青少年肥胖症的治疗方案往往因为利用不足(持续)而无效。根据申请人的主要假设，此类服务的(持续)利用在很大程度上取决于受影响儿童父母的变化阶段。个别变化阶段的识别和特定调节是承诺提高利用率并因此获得更好临床结果的策略。对变化阶段进行及时有效和标准化诊断的先决条件是一份简短的调查问卷。从受影响儿童的父母的角度来看，到目前为止还没有这样的文书。因此，这里介绍的项目的目的是将现有的工具--罗德岛大学变化评估所有16个项目的调整将通过合格专家的德尔菲法迭代程序进行。新工具的验证将通过验证性因素分析进行，并在320名超重或肥胖儿童或青少年的父母队列中就质量维度的客观性、可靠性(内部一致性)、结构效度和标准效度进行验证。鉴于这一新的工具，将有可能检验申请人的主要假设，即变化的阶段在很大程度上决定了卫生服务的利用情况，针对父母的阶段特定干预措施将改善(继续)受影响儿童的利用情况和结果。本文所申请的项目是对安徒生的卫生服务利用行为模型(BM)和普罗查斯卡的跨理论模型(TM)的变化阶段进行扩展的第一个研究。对这一概念改进的经验评估将在申请人的后续研究中进行。

Programs for the treatment of obesity in children and adolescents are often ineffective because of inadequate (continuing) utilization. Following the main hypothesis of the applicant, the (continuing) utilization of such services is significantly determined by the stages of change of parents of the affected children. The identification and the specific modulation of the individual stage of change are strategies which promise improved utilization and hence better clinical outcomes. The prerequisite for the time-efficient and standardized diagnosis of the stages of change is a short-form questionnaire. Such an instrument does not exist so far for the perspective of parents of affected children. Hence, it is the aim of the project presented here, to adapt an existing instrument - the University of Rhode Island Change Assessment - Short (URICA-S) - from the Self-Perspective ('I am myself affected') to the Parent-Perspective ('my child is affected') and to validate the instrument subsequently. The adaptation of all 16 items will be performed through an iterative Delphi-Process of eligible experts. The validation of the new instrument will be conducted by confirmatory factor analysis and with regards to the quality dimensions objectiveness, reliability (internal consistency), construct- and criteria-validity within a cohort of 320 parents of overweight or obese children or adolescents. Given this new instrument, it will be possible to test the main hypothesis of the applicant that the stages of change significantly determine the utilization of health services and that stage-specific interventions targeting parents will improve (continuing) utilization and outcome of affected children. The project applied for here is the first study to extent the Behavioral Model of Health Service Utilization by Andersen (BM) with the Stages of Change of the Transtheoretical Model (TM) by Prochaska. The empirical assessment of this conceptual amelioration will follow within successor studies of the applicant.