Parent Supported Weight Reduction in Down Syndrome

描述(由申请人提供)： 唐氏综合征(DS)患者有轻度至中度智力低下、身材矮小和相关的超重。针对患有DS的儿童和青少年的减肥干预措施尚未得到充分研究。对于典型的儿童，教育父母使用行为矫正来改善饮食和活动习惯的干预措施一直是有效的。需要进行研究来调查患有DS的青少年这一新人群的行为体重减轻情况。这项研究将比较：1)父母支持的减肥干预(PSWR)结合行为矫正和营养/活动教育(NAE)，2)NAE单独和3)等待名单(WL)对照组的有效性。主要的具体目标是确定PSWR条件下患有DS的青少年是否比单独接受NAE或WL的参与者减轻了更多的体重和体脂。两个次要的具体目标是确定PSWR组的青少年是否在以下方面比单独使用NAE组的青少年更成功：1)满足特定食物组的规定数量，以及2)增加体力活动。72名DS在13-18岁之间的超重青少年(体重指数和性别为95百分位数)及其父母将被随机分配到三组中的一组：PSWR组、NAE组或WL组。PSWR组和NAE组将接受为期6个月的干预，每周开会10周(90分钟疗程)，然后每两周和每月一次。两组的NAE部分将由一名营养教育者指导，由一名营养学家/注册营养师和一名物理治疗师监督，两人都具有DS(联合调查员)方面的专业知识。PSWR的行为部分将由具有DS(PI)专业知识的行为心理学家进行。在为期6个月的干预之后，仅PSWR和NAE的参与者将被跟踪6个月的维护阶段。我们将测量和比较干预前、10周、6个月(干预后)和12个月(维护)时体脂(BIA)、BMI-Z评分、特定食物组的服务数量和活动(加速计)的变化。WL的参与者不会同时接受干预，但将以相同的时间间隔参与BIA和BMI-z测量。WL参与者将在第二年被提供最有效的干预(PSWR或NAE)。我们这个项目的长期目标是：1)更多地了解患有DS和其他发展障碍儿童的家庭的健康促进，以及2)开发R01应用程序来调查与长期行为改变和健康相关的过程，特别是青少年管理的干预

DESCRIPTION (provided by applicant): Individuals with Down syndrome (DS) have mild to moderate mental retardation, short stature and associated overweight. Weight loss interventions for children and adolescents with DS have not been studied sufficiently. With typical children, interventions in which parents are taught to use behavior modification to improve dietary and activity habits have been effective. Research is needed to investigate behavioral weight reduction with a new population, adolescents with DS. This study will compare the effectiveness of: 1) a Parent Supported Weight Reduction intervention (PSWR) that combines behavior modification and nutrition/activity education (NAE), with 2) NAE alone and 3) a Wait List (WL) control group. The primary Specific Aim is to determine whether adolescents with DS in the PSWR condition lose more weight and body fat than participants in NAE alone or WL. Two secondary Specific Aims are to determine whether adolescents in PSWR are more successful than those in NAE alone in: 1) meeting the prescribed number of servings in specified food groups, and 2) increasing physical activity. Seventy-two (72) adolescents with DS between 13-18 who are overweight (body mass index > 95th percentile for age and gender), and their parents, will be randomly assigned to one of three groups: PSWR, NAE-alone or WL. PSWR and NAE-alone groups will receive a 6-month intervention, meeting weekly for 10 wks (90 min sessions), then bi-weekly and monthly. NAE components in both groups will be conducted by a nutrition educator, supervised by a nutritionist/registered dietician and a physical therapist, both with expertise in DS (co-investigators). Behavioral components of PSWR will be conducted by a behavioral psychologist with expertise in DS (the PI). Following the 6-month intervention, participants in PSWR and NAE-alone will be followed over a 6-month maintenance phase. We will measure and compare changes in body fat (BIA), BMI-z score, number of servings in specified food groups, and activity (accelerometer) at pre-intervention, 10 wks, 6 mos (post intervention) and 12 mos (maintenance). Participants in WL will not receive a concurrent intervention, but will participate in BIA and BMI-z measurement at the same intervals. WL participants will be offered the most effective intervention (PSWR or NAE) in Year 2. Our long-term goals with this project are to: 1) learn more about health promotion in families of children with DS and other developmental disabilities, and 2) develop an R01 application to investigate processes associated with long-term behavior change and health, especially adolescent-managed intervention