Childhood obesity treatment targeting specific behaviors

美国正处于肥胖症流行之中，影响着年幼的儿童。儿科初级保健机构是 一个解决这个问题的理想场所，因为大多数家庭经常与他们的儿科医生和 在这种情况下，定期评估儿童的健康状况。对有身体的儿童的治疗建议 一位专家开发了初级保健中超过第85个百分位数的质量指数(BMI 儿童问题委员会。需要符合委员会建议的方案，该委员会 包括：1)尽早开始治疗；2)以家庭为重点，以父母为中心 治疗的主要改变剂；3)使用行为矫正技术改变饮食和活动 行为；以及4)一次在饮食和活动上做出2到3个非常具体的改变。因此，这样做的目的是 R21的应用是开发、实施和评估为期6个月的儿童期行为肥胖干预 这符合委员会的建议，并可在初级保健环境中实施。一秒钟 该项目的目的是确定哪些饮食和活动行为应该成为干预的目标。 135名4至8岁体重指数为第85百分位数的儿童，由 他们的儿科医生将被随机分为三种情况之一：1)时事通讯状况；2)行为状况 增加体力活动(每天60分钟)并减少含糖饮料的育儿计划 消费(&lt；每周3份)(传统)；或3)减少看电视的行为养育计划 每天看2小时)，增加低脂牛奶的摄入量(每天2份)(替代品)。跟进 对体重、身高和标准化BMI(z-BMI)的评估将是主要的因变量 分别在3个月、6个月、9个月和12个月进行。儿科医生将向家庭提供关于体重的后续信件 和身高状况，在评估之后。这项初步研究使我们能够确定可行性和 儿科肥胖干预的有效性，优化儿科医生的角色并满足 委员会建议在初级保健环境中进行治疗。此外，通过比较两种方法的效果 针对传统的或替代的行为，将获得数据用于全面的功率分析 试验这两种方法对长期减肥的影响。

The US is in the midst of an obesity epidemic, affecting young children. The pediatric primary care setting is an ideal place to address this problem since most families have frequent contact with their pediatrician and a child's health status is regularly assessed in this setting. Recommendations for treating children with a body mass index (BMI) over the 85th percentile in the primary care setting have been developed by an Expert Committee on childhood. Programs are needed that meet the recommendations from the Committee, which include: 1) beginning treatment as young as possible; 2) focusing on the family, with the parent being the primary change agent for treatment; 3) using behavior modification techniques to change eating and activity behaviors; and 4) making 2 or 3 very specific changes in diet and activity at one time. Thus, the aim of this R21 application is to develop, implement, and evaluate a 6-month behavioral childhood obesity intervention that meets the Committee's recommendations and can be implemented in a primary care setting. A second aim of this project is to determine which eating and activity behaviors should be targeted in the intervention. One hundred thirty-five children, aged 4 to 8 years with a BMI > 85th percentile, assessed and referred by their pediatricians, will be randomized to one of three conditions: 1) a newsletter condition; 2) a Behavioral Parenting Program that increases physical activity (60 min/day) and decreases sweetened drink consumption (< 3 servings/week) (Traditional); or 3) a Behavioral Parenting Program that reduces TV watching (< 2 hours/day) and increases low-fat milk consumption (2 servings/day) (Substitutes). Follow-up assessments on weight, height, and standardized BMI (z-BMI), the primary dependent variable, will be conducted at 3, 6, 9, and 12 months. Pediatricians will provide follow-up letters to families, regarding weight and height status, following the assessments. This pilot study allows us to determine the feasibility and efficacy of a pediatric obesity intervention that optimizes the role of the pediatrician and meets the Committee's recommendations for treatment in a primary care setting. Moreover, by comparing the effects of targeting the traditional or substitute behaviors, data will be obtained for a power analysis for a full-scale trial of the effects of these two approaches on long-term weight loss.