Parent Supported Weight Reduction in Down Syndrome

描述（由申请人提供）： 唐氏综合征（DS）患者有轻度至中度的智力迟钝、身材矮小和相关的超重。对患有DS的儿童和青少年的减肥干预措施尚未进行充分研究。对于典型的儿童，教导父母使用行为矫正来改善饮食和活动习惯的干预措施是有效的。需要研究一个新的人群，青少年DS的行为减肥。本研究将比较以下干预措施的有效性：1）结合行为矫正和营养/活动教育（NAE）的家长支持减肥干预（PSWR），2）单独的NAE和3）等待列表（WL）对照组。主要的具体目的是确定是否与参与者相比，在PSWR条件下的DS青少年减少更多的体重和体脂NAE单独或WL。两个次要的具体目标是确定PSWR中的青少年是否比仅NAE中的青少年更成功：1）满足指定食物组的规定份量，2）增加体力活动。将72名DS在13-18岁之间的超重（体重指数>年龄和性别的第95百分位数）青少年及其父母随机分配至三组之一：PSWR、单独NAE或WL。PSWR组和NAE组将接受为期6个月的干预，每周开会10周（90分钟会议），然后每两周和每月一次。两组的NAE部分将由营养教育者进行，由营养师/注册营养师和物理治疗师监督，两者都具有DS（共同研究者）的专业知识。PSWR的行为部分将由具有DS专业知识的行为心理学家（PI）进行。在6个月的干预后，将在6个月的维持期内对PSWR和单独NAE的受试者进行随访。我们将测量和比较干预前、10周、6个月（干预后）和12个月（维持）时的体脂（BIA）、BMI-z评分、特定食物组的食用量和活动（加速度计）的变化。WL中的参与者将不接受同步干预，但将以相同的时间间隔参与BIA和BMI-z测量。WL参与者将在第二年获得最有效的干预措施（PSWR或NAE）。我们这个项目的长期目标是：1）了解更多关于DS和其他发育障碍儿童家庭的健康促进，2）开发R 01应用程序来调查与长期行为改变和健康相关的过程，特别是自主管理的干预

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