IT-Supported Early Treatment of Childhood Overweight

IT 支持的儿童超重早期治疗

• 批准号: 6987997
• 负责人: WILLIAM G ADAMS
• 金额: $ 24.15万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-08 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6987997
• 关键词: behavior therapy; behavioral /social science research tag; body physical activity; clinical research; computer assisted patient care; diet; health behavior; human subject; human therapy evaluation; middle childhood (6-11); obesity; parent offspring interaction; self help; telemedicine

DESCRIPTION (provided by applicant): The prevention and treatment of pediatric obesity is a national priority. Minority children and those living in poverty are at additional risk for obesity. There is a pressing need for low-cost, effective interventions for the large numbers of overweight children. A reliable way to do this would have wide applicability and usefulness. The goal of this exploratory/developmental (R21) study is to develop and evaluate an integrated information system, Healthy Eating and Activity Today (HEAT), for promoting self-care in overweight children. HEAT is comprised of two components: 1) Telephone Linked Care-HEAT (TLC-HEAT), a self-care intervention delivered at home through totally automated telephone conversations; and 2) Primary Care-HEAT (PC-HEAT), a primary care intervention linked with TLCHEAT and delivered through an electronic health record (EHR). The HEAT system will guide children in the early stages of overweight (i.e., children with Body Mass Index (BMI) 0-3 BMI points above the 95th percentile for age and gender) toward healthy weight management and assist the child's parent(s) and primary care provider (PCP) to support the child's efforts. For this project we will: 1) develop TLC-HEAT for use by children in the earliest stage of overweight and their parents; 2) integrate TLC-HEAT with an electronic health record to provide child- and parent reported behavior summaries combined with evidence-based decision support to PCPs at the point-of care (PC-HEAT); and 3) conduct a pilot study of the combined HEAT system to explore the appropriateness of conducting a larger, randomized clinical trial in the future. We hypothesize that TLC use will 1) reduce the child's caloric and fat intake (% calories from total fat and saturated fat); 2) reduce the number of hours per week of recreational screen-time (TV, video, computer); 3) and lead to a reduced rate of BMI increase. We will also evaluate whether HEAT will be acceptable to children, parents, and their PCPs and feasible in pediatric practices using an EHR. The ultimate purpose of the development of HEAT is to create a program that is easy to disseminate widely in pediatric practice. If the aims of this study are met, the findings from this project will provide data to modify and improve the system, generate hypotheses, and determine the possibility of proposing a randomized clinical trial of the system with sufficient power to evaluate its effectiveness.

描述（由申请人提供）：儿童肥胖的预防和治疗是国家的优先事项。少数民族儿童和生活贫困的儿童面临着肥胖的额外风险。大量超重儿童迫切需要低成本、有效的干预措施。做到这一点的可靠方法将具有广泛的适用性和实用性。这项探索性/发展性 (R21) 研究的目标是开发和评估综合信息系统“健康饮食和今日活动”(HEAT)，以促进超重儿童的自我保健。 HEAT 由两个部分组成：1) 电话关联护理-HEAT (TLC-HEAT)，一种通过完全自动化的电话对话在家中提供的自我护理干预措施； 2) 初级保健-HEAT (PC-HEAT)，这是一种与 TLCEAT 相关的初级保健干预措施，并通过电子健康记录 (EHR) 提供。 HEAT 系统将指导处于超重早期阶段的儿童（即体重指数 (BMI) 高于年龄和性别第 95 个百分位数 0-3 BMI 点的儿童）进行健康体重管理，并协助儿童的家长和初级保健提供者 (PCP) 支持孩子的努力。 对于这个项目，我们将：1）开发TLC-HEAT，供超重早期儿童及其父母使用； 2) 将 TLC-HEAT 与电子健康记录相结合，为护理点 PCP 提供儿童和家长报告的行为摘要以及基于证据的决策支持 (PC-HEAT)； 3) 对组合 HEAT 系统进行试点研究，以探索未来进行更大规模的随机临床试验的适当性。 我们假设 TLC 的使用将 1) 减少孩子的热量和脂肪摄入量（来自总脂肪和饱和脂肪的热量百分比）； 2) 减少每周花在屏幕上的娱乐时间（电视、视频、电脑）； 3）并导致BMI增加率降低。我们还将评估 HEAT 是否会被儿童、家长及其 PCP 接受，以及在使用 EHR 的儿科实践中是否可行。 HEAT 开发的最终目的是创建一个易于在儿科实践中广泛传播的程序。如果本研究的目标得以实现，该项目的研究结果将提供数据来修改和改进系统，产生假设，并确定提出系统随机临床试验的可能性，并具有足够的能力来评估其有效性。