A School Nurse-Delivered Intervention for Overweight and At Risk Adolescents

学校护士为超重和高危青少年提供干预措施

• 批准号: 7385785
• 负责人: LORI PBERT
• 金额: $ 25.76万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-02-05 至 2010-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7385785
• 关键词: Adherence; Adolescence; Adolescent; Age; Attention; Behavior; Behavioral; Blood Pressure; Body mass index; Calories; Centers for Disease Control and Prevention (U.S.); Child; Clinical; Cognitive; Computers; Condition; Cost Effectiveness Analysis; Counseling; Data Collection; Diet; Enrollment; Environmental Risk Factor; Gender; Goals; Guidelines; Health system; Healthcare; Hour; Individual; Intervention; Interview; Knowledge; Low income; Massachusetts; Measurement; Measures; Mediating; Mental Depression; Modeling; Nursing Schools; Obesity; Outcome; Overweight; Pamphlets; Participant; Patient Self-Report; Patients; Physical activity; Physiological; Pilot Projects; Population; Procedures; Protocols documentation; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Research Personnel; Risk; School Nursing; Schools; Self Efficacy; Self Management; Series; Smoker; Smoking Cessation Intervention; Staging; Stress; Students; Techniques; Testing; Time; Tobacco; Tobacco Use Cessation; Tobacco use; Treatment Efficacy; Visit; Weight; Withholding Treatment; base; behavior change; cost; day; demographics; drinking; follow-up; fruits and vegetables; high school; improved; innovation; instrument; obesity prevention; prevent; psychologic; psychosocial; school health; sedentary; size; skills; smoking cessation; social; social cognitive theory; sugar; theories; waist circumference

DESCRIPTION (provided by applicant): Overweight in adolescents has nearly tripled in the past two decades and has serious physical and psychosocial consequences, both during adolescence and into adulthood. School nurses have tremendous potential to identify, prevent, and treat overweight in this population, as over 95% of children and adolescents have contact with the school health system each year and school nurses have the credibility and skills to provide guidance regarding weight, diet and physical activity. However, to our knowledge there have been no randomized controlled school-based trials that have utilized the school nurse to deliver weight-related intervention to adolescents. In a RCT conducted by the investigators, we found a school nurse-delivered smoking cessation intervention was successful in assisting adolescent smokers to quit, being both feasible to deliver in the school health setting and very well received by adolescents. This two-year exploratory study will adapt this innovative, theory-based school nurse-delivered intervention model for the treatment of adolescent overweight, and test its feasibility and potential efficacy in reducing BMI, improving diet, increasing physical activity and decreasing sedentary behavior. The content of the intervention will be based on current clinical guidelines for the treatment of overweight in adolescents and Social Cognitive Theory (SCT), employing cognitive-behavioral techniques to facilitate changes in a set of very focused self- management behaviors: diet (at least 5 fruits vegetables a day; avoid soda and sugar sweetened drinks), physical activity (at least 1 hour on most days), and sedentary behavior (less than 2 hours of TV, video, and computer time a day). Four high schools in Massachusetts will be pair matched on demographics, school size, and percent low income and randomly assigned to one of two conditions: (1) Counseling Intervention (CI) consisting of six 30-minute individual student-centered counseling sessions delivered by school nurses over 2 months (weekly in month 1, biweekly in month 2); or (2) Information Intervention (II) attention-control comparison condition consisting of six individual sessions with the school nurse over 2 months (weekly in month 1, biweekly in month 2) to check status regarding weight and behavior changes and deliver a series of standardized pamphlets on weight and weight management. Adolescents (n=84) enrolled in grades 9 through 12 at-risk for overweight (body mass index (BMI) between the 85th and 94th percentile for age and gender) or overweight (BMI at or greater than the 95th percentile) will be recruited from the four schools. Assessments will be conducted at baseline and at 3-and 6-month follow-up. Should the results of this exploratory study prove promising the efficacy of the intervention will be evaluated in a large scale RCT. If found to be effective, such a school nurse-delivered intervention for adolescent overweight would have tremendous potential for wide-scale dissemination. Overweight in adolescents has nearly tripled in the past two decades and has serious physical and psychosocial consequences, both during adolescence and into adulthood. School nurses have tremendous potential to prevent and treat overweight in this population, as over 95% of adolescents have contact with the school health system each year and school nurses have the credibility and skills to provide guidance regarding weight, diet and physical activity. The goals of the proposed exploratory study are to adapt an innovative, theory-based school nurse-delivered counseling intervention model used effectively for smoking cessation for the treatment of adolescent overweight, and test its feasibility and potential efficacy in reducing BMI, improving diet, increasing physical activity and decreasing sedentary behavior. If the results of this exploratory study prove promising, the efficacy of the intervention will be evaluated in a large scale randomized controlled trial.

描述（由申请人提供）：在过去的二十年中，青少年的超重几乎增加了两倍，并且在青春期和成年期都会产生严重的身体和社会心理后果。学校护士具有巨大的潜力来识别，预防和治疗这一人群超重，因为超过95％体育锻炼。但是，据我们所知，没有随机对照的学校试验来利用学校护士向青少年提供与体重相关的干预措施。在调查人员进行的RCT中，我们发现，一名学校护士放弃的戒烟干预措施成功地协助青少年吸烟者戒烟，这既可以在学校健康环境中进行可行，并且受到青少年的良好接待。这项为期两年的探索性研究将适应这种创新的，基于理论的学校护士分配干预模型，以治疗青少年超重，并测试其在减少BMI，改善饮食，增加体育活动并减少久坐行为方面的可行性和潜在功效。干预措施的内容将基于当前的临床指南，以治疗青少年和社会认知理论（SCT），采用认知行为技术来促进一组非常专注的自我管理行为的变化：至少（至少每天5个水果蔬菜；马萨诸塞州的四所高中将与人口统计，学校规模和低收入百分比进行配对，并随机分配给两个条件之一：（1）由六个30分钟的个人以学生为中心的咨询课程组成的咨询干预（CI）。学校护士超过2个月（第1个月，每两周一次，第2个月）；或（2）信息干预（ii）注意力控制比较条件，由六个单独的会议与学校护士组成2个月（每周1个月，每两周一次，第2个月），以检查有关体重和行为变化的状态，并提供一系列体重和体重管理的标准化小册子。参加9至12年级的青少年（n = 84）超重（体重指数（BMI）在年龄和性别的第85％至94个百分位之间）或超重（BMI（BMI）将被招募来自四所学校。评估将在基线和3个月的随访中进行。如果这项探索性研究的结果证明有望在大规模的RCT中评估干预措施的功效。如果发现有效，那么对青少年超重的学校护士进行干预将具有巨大的大规模传播潜力。在过去的二十年中，青少年的超重几乎增加了两倍，并且在青春期和成年期都会产生严重的身体和社会心理后果。学校护士在预防和治疗这一人群中超重的潜力很大，因为超过95％的青少年每年都与学校卫生系统接触，学校护士具有有关体重，饮食和体育活动的指导性的信誉和技能。拟议的探索性研究的目标是适应一种创新的，基于理论的学校护士分配的咨询干预模型体育活动和久坐行为减少。如果这项探索性研究的结果证明了有希望的，则将在大规模的随机对照试验中评估干预措施的功效。