Enhancing Family-Based Behavioral Pediatric Obesity Treatment via Social Networks

描述（由申请人提供）：以家庭为基础的儿童肥胖治疗（FBT）的长期有效性是有限的。肥胖环境威胁到家庭维持健康体重管理行为的能力，然而大多数干预措施只关注父母与孩子的关系（养育方式的改变），而忽视了更大的社会关系背景。现有的干预措施教给父母和孩子体重管理和短期坚持所需的行为技能，但缺乏支持维持行为改变的近端社会环境严重挑战了他们的长期成功。我们的初步数据表明，自然形成的社交网络能够也应该支持父母管理孩子的体重状况。本R21探索性试验探讨了父母的社会网络在行为改变过程中的作用。其目标是：(1)开发一种创新的干预措施，利用自然发生的关系，使父母的社会支持网络参与进来，以加强健康行为的维持和更好的体重管理（社会网络参与干预，或SNE）；(2)在单臂试验中进行干预试验。这种干预的新颖元素包括使用社会计量数据来创建SNE策略，以及教授父母核心技能以促进与家人和朋友的支持性互动。试点试验将(a)评估干预的可接受性和可行性，(b)评估其对干预目标（解决问题的能力、社会支持和社会网络特征）的影响，以及(c)估计有关儿童BMI的效应大小。我们的多学科研究团队在儿童肥胖治疗、行为改变和社会网络方面拥有专业知识。这项研究是首次评估和加强家庭周围的社会支持网络，以此作为改变社会环境以促进维持减肥行为的手段。

DESCRIPTION (provided by applicant): Long-term effectiveness of family-based pediatric obesity treatment (FBT) is limited. The obesogenic environment threatens the family's ability to maintain healthy weight management behaviors, yet most interventions focus only on the parent-child dyad (changes in parenting) ignoring the larger social-relational context. Existing interventions teach parents and children behavioral skills needed for weight management and short-term adherence, but a failure of the proximal social environment to support maintenance of behavior change severely challenges their long-term success. Our preliminary data suggest that naturally-occurring social networks can and should be engaged in support of parents' attempts to manage their children's weight status. This R21 exploratory pilot address the role of parents' social network on the behavior change process. Its aims are (1) to develop an innovative intervention that capitalizes on naturally-occurring relationships to engage the parents' social support networks to enhance maintenance of healthy behaviors and better weight management (Social Network Engagement intervention, or SNE); and (2) to pilot this intervention in a single- arm trial. Novel elements of this intervention include the use of sociometric data to create a SNE strategy as well as teaching parents core skills to promote supportive interaction with their family and friends. The pilot trial will (a) assess the acceptability and feasibility of intervention, (b) evaluate its impact on intervention targets (problem-solving skill, social support and social network characteristics) and (c) estimate effect size with respect to child BMI. Our multi-disciplinary research team has expertise in pediatric obesity treatment, behavior change, and social networks. This study is among the first to assess and enhance social support networks surrounding the family as a means of changing the social environment to promote maintenance of obesity reduction behaviors.