Extension Family Lifestyle Intervention Project (FLIP for Kids)

项目摘要 生活在农村地区的儿童超重的可能性比城市同龄人高25%。点研究 重点关注解决这一差距的战略。制定和评估具有成本效益的干预措施， 积极影响儿童的长期体重状况和相关的健康参数是至关重要的， 改善农村青年的健康状况。儿童肥胖症的成功治疗可以产生显着的健康 效益以家庭为基础的行为干预，包括儿童和父母，已经证明， 在儿童减肥方面取得了成功。然而，这些干预措施的普遍性有限。 在医疗服务不足的社区环境中进行的试验很少。需的资源水平 提供有效的干预措施是向农村社区传播的一个重大障碍。 越来越多的研究表明，在治疗儿童肥胖症时， 可能和以家庭为基础的项目一样有效。只有父母的干预可能是特别有益的， 为农村人口提供具有成本效益的替代方案。来自我们的试点生活方式干预（R34 DK 071555）的数据 通过农村社区的合作推广服务办事处提供的信息表明， 在这些农村地区，只有干预可能是以家庭为基础的方案的一种具有成本效益的替代干预。 设置.这一研究路线的下一个合乎逻辑的步骤是评估全面的长期影响。 对儿童体重和健康状况进行“以家庭为基础”和“仅限父母”的行为干预， 成本效益。拟议的研究需要一个三臂随机对照试验，以测试干预措施的有效性 旨在促进长期体重管理和改善超重和肥胖者的健康状况 来自医疗条件差的农村地区的儿童。8-12岁儿童（n = 240）及其父母将 随机分配至仅父母（PO）、基于家庭（FB）或健康教育对照（HEC） 干预PO和FB干预措施都将采取行为生活方式方法来改变饮食和 身体活动模式在PO干预中，只有父母将参加小组会议，而在FB中， 干预儿童和父母都将参加小组会议。孩子和父母都将参加 在HEC条件下的小组会议。所有干预措施都将通过欧洲统计员会议各办事处提供， 在接下来的8个月里，每月举行一次小组会议。重量 将在基线时评估状态、代谢参数、体力活动、营养摄入和生活质量， 治疗后（12个月）和随访（24个月）。我们亦会评估这些措施的成本效益 干预措施。假设：（a）PO和FB中的儿童将表现出更大的体重改善 在第12个月和第24个月时，与HEC中的儿童相比，PO的状况更好，并且（B）PO将证明更大的成本- 比FB和HEC更有效。结果可能对儿童肥胖症的治疗有重要意义 在服务不足的农村地区，通过确定一种成本效益高和有效的替代家庭干预措施的办法。

Project Summary Children living in rural areas are 25% more likely to be overweight than their metropolitan peers. Little research has focused on strategies to address this disparity. Developing and evaluating cost-effective interventions that positively impact children's long-term weight status and related health parameters are critical to promoting improved health of youth in rural settings. Successful treatment of childhood obesity can yield significant health benefits. Behavioral family-based interventions, including both the child and parent, have demonstrated success in producing weight loss in children. The generalizability of these interventions, however, is limited. Few trials have been conducted in medically underserved community settings. The level of resources needed to deliver effective interventions represents a significant barrier to dissemination into rural community settings. A growing body of researchsuggests that exclusively targeting parents in the treatment of childhood obesity may be as effective as family-based programs. A parent-only intervention may be a particularly beneficial and cost-effective alternative for rural populations. Data from our pilot lifestyle intervention (R34 DK071555) delivered through Cooperative Extension Service (CES) offices in rural communities suggests that a parent- only intervention may be a cost-effective alternative intervention to family-based programs in these rural settings. The next logical step in this line of research is to evaluate the long-term effects of comprehensive "Family-Based" and "Parent-Only" behavioral interventions on measures of child weight and health status, and cost-effectiveness. The proposed study entails a three arm RCT to test the effectiveness of interventions designed to promote long-term weight management and improved health status in overweight and obese children from medically underserved, rural areas. Children (n = 240), ages 8-12 years, and their parent(s) will be randomly assigned to a Parent-Only (PO), Family-Based (FB), or a Health Education Control (HEC) intervention. Both the PO and FB interventions will take a behavioral lifestyle approach to modify dietary and physical activity patterns. In the PO intervention, only the parent(s) will attend group meetings, while in the FB intervention both the child and parent(s) will attend group sessions. Both the child and parent(s) will attend group sessions in the HEC condition. All interventions will be delivered through CES offices and will include 12 sessions over the course of 4 months, followed by monthly group sessions for the next 8 months. Weight status, metabolic parameters, physical activity, nutritional intake and quality of life will be assessed at baseline, post-treatment (month 12), and follow-up (month 24). We will also evaluate the cost effectiveness of these interventions. It is hypothesized that: (a) children in the PO and FB will exhibit greater improvements in weight status than children in the HEC at months 12 and 24, and (b) the PO will demonstrate greater cost- effectiveness than the FB and HEC. Results may have significant implications for treatment of pediatric obesity in underserved rural areas by identifying a cost-efficient and effective alternative to family-based interventions.