Management of overweight pre-pubertal children - a randomised controlled trial

肥胖是澳大利亚社区日益普遍的问题，对成年人和儿童都有影响。多达四分之一的澳大利亚儿童超重或肥胖，使其成为这个年龄段最常见的慢性疾病之一。儿童时期的肥胖与高血压、糖尿病风险、高胆固醇水平、臀部、膝盖和脚踝问题以及心理困扰等并发症有关。鉴于超重和肥胖对儿童健康的影响，如何才能最好地治疗呢？令人惊讶的是，几乎没有可用的信息来指导这一常见问题的管理。在这项研究中，我们将检验这样一种假设，即父母技能培训计划的增加将显着提高旨在减轻6至9岁超重儿童体重的饮食活动计划的有效性。参加这项研究的儿童将接受两种干预措施之一(I)育儿+活动-饮食或(Ii)饮食-活动。参加育儿干预的父母将在饮食活动计划之前参加育儿技能培训计划(Triple P)。Trip包括每周4次2小时的小组会议和4次15分钟的后续电话，重点是监督生活方式改变所需的技能和策略。饮食活动计划包括在5个月的时间里为父母提供8次小组会议，讨论具体的饮食和活动变化，以及同时为儿童举行有组织的活动会议。成功与否将从几个方面进行评判。在两年的时间里，我们将监测孩子的体重、自尊、幸福感、血压和胆固醇水平。我们还将监测家庭的运作情况以及父母的育儿技巧和效能感。这项研究的结果应该使我们能够确定在社区环境中建立哪种儿童肥胖管理的治疗方法最合适。

Obesity is an increasingly common problem in the Australian community, affecting both adults and children. Up to 1 in 4 Australian children are overweight or obese, making it one of the most common chronic disorders in this age-group. Obesity in childhood is associated with such complications as high blood pressure, risk of diabetes, high cholesterol levels, hip, knee and ankle problems, and psychological distress. Given the impact of overweight and obesity on the health of children, how can it be best treated? Surprisingly, there is little information available to guide the management of this common problem. In this study we will test the hypothesis that the addition of a parent skills training program will significantly increase the effectiveness of a diet-activity program designed to reduce weight in overweight 6 to 9-year-olds. Children enrolled in the study will receive one of two interventions (i) parenting + activity-diet or (ii) diet-activity. Parents in the parenting intervention will participate in a parenting skills training program (Triple P) preceding the diet-activity program. Triple P comprises four 2-hour weekly group sessions and four, 15 minute follow-up phone calls which will focus on the skills and strategies required to supervise lifestyle changes. The diet-activity program comprises 8 group sessions for parents over a 5 month period on specific dietary and activity changes and simultaneous structured activity sessions for the children. Success will be judged in several ways. Over a 2 year period, we will monitor the child's weight, self-esteem, sense of well-being, blood pressure and cholesterol levels. We will also monitor the family's functioning and the parents' parenting skills and sense of efficacy. Results from the study should allow us to determine which treatment approach for management of childhood obesity is the most appropriate to be established in community settings.