Sensible Treatment of Obesity in Rural Youth- STORY

描述（由申请人提供）： 儿童肥胖症的流行是一个主要的公共卫生问题。儿童肥胖与2型糖尿病、胰岛素抵抗、糖耐量异常和其他负面健康结果有关。儿童肥胖症的成功治疗与显著的健康益处相关。包括儿童和父母在内的以家庭为基础的行为干预措施成功地减轻了儿童的体重。然而，这些干预措施的普遍性是有限的，几乎没有随机试验检查以社区为基础的农村环境中的儿童和家庭的减肥干预措施。最近的研究表明，在儿童肥胖症的行为治疗中专门针对父母可能会导致类似的结果，并且可能比包括儿童和父母的干预措施更具成本效益。然而，这两种治疗方法尚未在随机对照试验（RCT）中进行比较。这项可行性研究需要一个三臂随机对照试验，以测试两组干预措施的有效性，这些干预措施旨在促进超重儿童及其父母在医疗服务不足的农村地区的体重管理。参与者将被随机分配到基于行为家庭的干预（BFI），基于行为父母的干预（BPI）或等待列表控制（WLC）。这两种治疗方案都将采取行为生活方式的方法来改变饮食和身体活动模式。在BPI中，只有父母将参加小组会议，而在BFI中，儿童和父母都将参加小组会议。两种干预措施将包括4个月内的12次会议，在基线、治疗后和6个月随访（第10个月）时进行评估。假设：（a）在第10个月时，BFI和BPI中的儿童体重状况改善程度将大于WLC中的儿童，（B）在第10个月时，BPI中的儿童体重状况改善程度将大于BFI中的儿童，（c）BPI将显示出比BFI更高的成本效益。研究结果将为规划R18 RCT提供关键信息。

DESCRIPTION (provided by applicant): The epidemic of childhood obesity is a major public health concern. Childhood obesity has been linked to type 2 diabetes, insulin resistance, abnormal glucose tolerance, and other negative health outcomes. Successful treatment of childhood obesity is associated with significant health benefits. Behavioral family-based interventions including both children and parents have been successful in producing weight loss in children. However, the generalizability of these interventions is limited, and there are virtually no randomized trials examining weight loss interventions for children and families in community-based, rural settings. Recent research suggests that exclusively targeting parents in the behavioral treatment of childhood obesity may lead to similar outcomes, and may be more cost-effective than interventions including both children and parents. These two treatment approaches, however, have yet to be compared in a randomized controlled trial (RCT). This feasibility study entails a three arm RCT to test the effectiveness of two group interventions designed to promote weight management in overweight children and their parents in medically underserved, rural settings. Participants will be randomly assigned to a Behavioral Family-Based Intervention (BFI), Behavioral Parent-Based Intervention (BPI), or a Wait List Control (WLC). Both treatment programs will take a behavioral lifestyle approach to modify dietary and physical activity patterns. In the BPI, only parents will attend group meetings, while in the BFI both children and parents will attend group sessions. Both interventions will include 12 sessions over 4-months, with assessment at baseline, post-treatment, and 6-month follow-up (month 10). It is hypothesized that, (a) children in the BFI and BPI will exhibit greater improvements in weight status than children in the WLC at month 10, (b) children in the BPI will exhibit greater improvements in weight status than those in the BFI at month 10, and (c) the BPI will demonstrate greater cost-effectiveness than the BFI. Findings will provide critical information for planning the R18 RCT.