MA Childhood Obesity Research

项目摘要：“运动中的群众：减少儿童肥胖的社区-临床合作伙伴关系”将使用肥胖慢性护理模型来实施和评估一项全面、系统的干预措施，以减少服务不足的儿童的儿童肥胖。马萨诸塞州公共卫生部门（MDPH）与哈佛医学院人口医学系、哈佛公共卫生学院和全国儿童保健质量倡议合作，寻求通过全州范围内的大众运动健康倡议，在社区建立有前途的社区经验和相关的临床肥胖预防工作，在菲奇堡和新贝德福德两个城市开展干预措施。这可以在全州范围内复制。该研究提出了一种多部门、多层次的综合方法。它将以证据为基础的干预措施纳入初级卫生保健（为儿童击掌）、儿童保育（我在运动，我在学习；NAP SACC）和学校/课后方案（食物与乐趣、健康饮食和保持运动以及地球健康），以及政策变化和社区范围的社会营销活动，以预防或减少主要是低收入2-12岁儿童的肥胖。采用前后时间序列和准实验设计相结合的方法，我们将检验我们的干预措施对个人生活方式行为、身体质量指数（BMI）变化、医疗服务满意度和生活质量的有效性。具体目标是：(1)在干预与比较社区中，检查基于儿科初级保健，早期教育和儿童保育计划，小学和中学，课后计划以及社区范围内的社会营销活动的多层次，多部门儿童干预对肥胖行为改善的程度。(2)在干预组与对照组中，BMI的年龄相关性增加较小。(3)在干预社区的卫生中心，对所有2-12岁儿童的BMI筛查和5种针对性肥胖相关行为的咨询均有所增加；由多学科临床小组和社区卫生工作者对年龄和性别特定的BMI在第85百分位的儿童进行协调护理；父母服务满意度与儿童肥胖相关的生活质量。(4)收集有关干预活动成本的数据，为成本效益分析做准备。(5)为MDPH制定详细的实施和传播指南，用于支持全州其他社区的采用。

DESCRIPTION (provided by applicant): Project abstract The proposed Mass in Motion: Community-Clinical Partnerships to Reduce Childhood Obesity will use the Obesity Chronic Care Model to implement and evaluate a comprehensive, systematic intervention to reduce childhood obesity among underserved children. The Massachusetts Department of Public Health (MDPH), in partnership with the Department of Population Medicine at Harvard Medical School, the Harvard School of Public Health, and the National Initiative for Children's Healthcare Quality, seeks to build on promising community-level experience and related clinical obesity prevention work in communities through the statewide Mass in Motion wellness initiative to develop an intervention in two cities, Fitchburg and New Bedford, that could be replicated throughout the state. The study proposes an integrated multi-sector and multi-level approach. It incorporates evidence-based interventions in primary health care (High Five for Kids), child care (I Am Moving, I am Learning; NAP SACC) and schools/after-school programs (Food & Fun, Eat Well and Keep Moving, and Planet Health), as well as policy change and a community-wide social marketing campaign to prevent or reduce obesity among predominantly low-income 2-12-year- old children. Using a combination of pre- post time series and quasi-experimental designs, we will examine the effectiveness of our intervention on individual-level lifestyle behaviors, change in body mass index (BMI), satisfaction with health care services, and quality of life. The Specific Aims are: (1) In intervention v. comparison communities, examine the extent to which a multi-level, multi-sector intervention for children, based in pediatric primary care, early educatin and child care programs, elementary and middle schools, after school programs, and a community-wide social marketing campaign results in improvements in obesogenic behaviors. (2) In intervention v. comparison communities, achieve smaller age associated increases in BMI. (3) In health centers in the intervention communities, demonstrate increases in: BMI screening and counseling on the 5 targeted obesity-related behaviors for all children ages 2-12 years; Coordinated care by a multi-disciplinary clinical team and community health workers for children with an age- and sex-specific BMI e 85th percentile; Parental satisfaction with services and child obesity-related quality of life. (4) Collect data on the costs of the intervention activiies in preparation for cost-effectiveness analyses. (5) Develop a detailed implementation and dissemination guide for MDPH to use to support adoption in other communities across the state.