A Coordinated Parent/Child Dyad Weight Loss Intervention: Dyad Plus

年轻人中超重和肥胖的流行正在成为一个全球健康问题，有必要 通过促进生活方式改变来治疗肥胖的临床干预。青少年的干预措施 在健康饮食和体力活动方面有所改善，体重只有轻微下降 结果。因此，人们对制定策略以提高临床治疗的有效性越来越感兴趣。 干预措施，特别是针对肥胖率和辍学率最高的青少年 治疗。以家庭成员为目标治疗青少年肥胖症可能是一种有效的方法，但坚持 家庭治疗可能是次优的，尽管研究表明亲子干预可以更多地 比主要针对儿童的治疗方案更有效。我们建议发展一种协调的 护理模式并评估相对于标准护理的可行性、可接受性和有效性。 这项拟议的研究将利用维克森林实施的两个成功的减肥计划 浸信会医疗中心：布伦纳家庭的培训(布伦纳适合)和设计。Brenner Fit是一种 以家庭为基础的2-18岁青少年儿童体重管理诊所由医生转介 超重或肥胖。11-14 by Design是一家成人(18年)减肥诊所，包括量身定制的饮食和 体力活动行为咨询。我们的初步数据显示，大多数注册的青少年 Brenner Fit至少有一名成年照顾者符合条件，并将从By Design的注册中受益。 因此，我们建议开发一个协调计划(DYAD Plus)，从理论上讲，这将是一个- 基于协调的方法，旨在促进自我监控、积极沟通、联合 解决问题，社会支持，以增加体力活动，健康饮食，减肥 相对于不协调的方法或布伦纳独自适应。我们将随机抽查45名家长/青少年 三种情况中的一种(n=15)；只适合Brenner，如果孩子和父母都符合，则为二元 同时注册适龄计划，或DYAD Plus，如果孩子和父母都 同时注册，但与协调部分一起。这项研究将会达到以下目标： 具体目标1：为肥胖青少年和成年人制定协调干预措施 Brenner Fit and by Design减肥诊所。 具体目标2：在青少年/照料者双方中试行协调干预，以确定 应计利润、留存和坚持方面的干预 具体目标3：确定与实施DYAD Plus有关的费用 设计和布伦纳配合没有协调组件。 这项建议意义重大，因为它解决了服务不足人群中一种紧迫的慢性病(肥胖) (青少年)，并将第一个制定协调的青少年/成人减肥干预措施。

The prevalence of overweight and obesity in youth is emerging as a global health concern, necessitating clinical interventions to treat obesity through promotion of lifestyle modification. Interventions in adolescents have demonstrated improvements in healthy eating and physical activity, with only modest weight loss outcomes. As a result, there is growing interest in developing strategies to enhance effectiveness of clinical interventions, especially those targeting adolescents who have the highest rates of obesity and dropout from treatment. Targeting family members to treat obesity in youth can be an effective approach, but adherence to family treatment can be sub-optimal despite research suggesting that parent-child interventions can be more effective than treatment programs that focus primarily on the child. We propose to develop a coordinated care model and assess the feasibility, acceptability, and effectiveness relative to standard care. The proposed study will leverage two successful weight loss programs administered at the Wake Forest Baptist Medical Center: Brenner Families in Training (Brenner FIT) and By Design. Brenner FIT is a family-based pediatric weight management clinic for youth 2-18 years old referred by a physician for overweight or obesity.11-14 By Design is an adult (>18yrs) weight loss clinic that includes tailored dietary and physical activity behavioral counseling. Our preliminary data suggest that most adolescent youth who enroll in Brenner FIT have at least one adult caregiver who is eligible and would benefit from enrollment in By Design. Therefore, we propose the development of a coordinated program (Dyad Plus) that would be a theoretically- based, coordinated approach designed to facilitate self-monitoring, positive communication, joint problem solving, and social support to increase physical activity, healthy eating, and weight loss relative to a non-coordinated approach or Brenner FIT alone. We will randomize 45 parent/adolescent Dyads to one of three conditions (n=15 for each); Brenner FIT only, Dyad where the child and parent both enrolled simultaneously in the age appropriate program, or Dyad Plus where the child and parent both enrolled simultaneously, but with the coordinated component. The study will achieve the following aims: Specific Aim 1: Develop a coordinated intervention for adolescents and adults with obesity co-enrolled in the Brenner FIT and By Design weight loss clinics. Specific Aim 2: Pilot the coordinated intervention in adolescent/caregiver dyads to establish the feasibility of the intervention in terms of accrual, retention, and adherence.17 Specific Aim 3: Establish costs associated with the implementation of Dyad Plus relative to delivering By Design and Brenner FIT without the coordination component. The proposal is significant, as it addresses a pressing chronic disease (obesity) in an underserved population (adolescents) and would be the first to develop a coordinated adolescent/adult weight loss intervention.