Parental Involvement as a Strategy to Enhance Adolescent Weight Control

家长参与作为加强青少年体重控制的策略

• 批准号: 7907831
• 负责人: ELISSA JELALIAN
• 金额: $ 7.76万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-10 至 2012-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7907831
• 关键词: Address; Adolescence; Adolescent; Adult; Age; Analysis of Variance; Attention; Behavior; Behavior Therapy; Behavioral; Body Weight decreased; Child; Clinical Trials; Code; Cognitive; Cognitive Therapy; Combined Modality Therapy; Communication; Data; Diet; Failure; Health behavior; Height; Intervention; Lead; Measures; Modeling; Monitor; Multivariate Analysis; National Health and Nutrition Examination Survey; Obesity; Outcome; Overweight; Parent-Child Relations; Parenting behavior; Parents; Physical activity; Pilot Projects; Prevalence; Prevention; Protocols documentation; Questionnaires; Randomized; Recruitment Activity; Research; Risk-Taking; Sample Size; Sampling; School-Age Population; Smoking; Testing; Treatment Efficacy; United States; Videotape; Weight; Weight maintenance regimen; Weights and Measures; base; design; improved; innovation; novel; novel strategies; obesity in children; parental involvement; parental role; programs; public health relevance; treatment effect

DESCRIPTION (provided by applicant): The prevalence of overweight among children and adolescents continues to increase. Data from the most recent National Health and Nutrition Examination Survey (NHANES) indicate that approximately 37 percent of children and 34 percent of adolescents are either overweight or obese (BMI greater than 85th percent). Interventions to treat currently overweight children and adolescents are critical for prevention of overweight into adulthood. While considerable attention has been given to comprehensive behavioral interventions to address obesity in children, there is less empirical evidence demonstrating efficacy of such interventions with adolescents. The purpose of the proposed study is to test a novel model of parental involvement for enhancing weight control among overweight adolescents. The intervention combines standardized cognitive behavioral adolescent weight management treatment with increased parental involvement through two mechanisms: parental modeling of healthy weight control strategies and enhanced parent-adolescent communication related to diet, physical activity, and weight. Study objectives are to: 1) evaluate the feasibility of the intervention; 2) compare the enhanced intervention to standard adolescent weight control treatment with regard to changes in adolescent-parent communication and parent healthy weight practices, and 3) obtain preliminary data to test the hypothesis of whether participation in the enhanced intervention results in greater decrease in BMI. A total of 48 adolescents between the ages of 13 and 17 years and 30 percent and 90 percent overweight will be randomized to one of two group-based treatment conditions: adolescent weight control that includes standard cognitive-behavioral intervention combined with minimal parent involvement (CBT+MPC) or an enhanced parental support condition focused on healthy parent weight control practices and improved communication (CBT+ EPS). Measures of weight, height, healthy parent weight control strategies, and adolescent-parent communication will be obtained at baseline and at the end of the 16-week intervention. We will evaluate feasibility of the enhanced intervention by collecting measures of weekly attendance, adolescent and parent completion of diet and physical activity monitoring logs, and adolescent and parent ratings of treatment acceptability. Adolescent-parent communication will be evaluated through questionnaire measures as well as coding of adolescent-parent videotaped interactions related to diet, weight, and physical activity. Separate multivariate analysis of variance (MANOVA) will be used to evaluate parent healthy weight strategies and combined questionnaire and videotaped data of parent-adolescent communication. Analysis of variance (ANOVA) will be conducted on the change scores from baseline to end of treatment to evaluate the effects of treatment condition on adolescent BMI and z-BMI. Given that this is an exploratory pilot study, we expect to obtain estimates of effect size for BMI. The next objective in this line of research is to conduct a full-scale clinical trial to evaluate the efficacy of enhanced parent involvement for adolescent weight control. PUBLIC HEALTH RELEVANCE: The prevalence of overweight in children and adolescents in the United States continues to increase, with approximately 37 percent of children and 34 percent of adolescents defined as either overweight (BMI greater than 85th percent and < 94th percent) or obese (BMI greater than 95th percent). Interventions to decrease overweight during adolescence are critical for prevention of overweight into adulthood. The proposed study will test the feasibility of a novel approach for parental involvement, including focus on healthy parent weight practices and improved communication, in enhancing adolescent weight control.

描述（由申请人提供）：儿童和青少年超重的患病率持续增加。最新的国家健康和营养调查 (NHANES) 数据表明，大约 37% 的儿童和 34% 的青少年超重或肥胖（BMI 大于 85%）。治疗当前超重儿童和青少年的干预措施对于预防成年后超重至关重要。尽管人们对解决儿童肥胖问题的综合行为干预措施给予了相当多的关注，但很少有实证证据表明此类干预措施对青少年有效。拟议研究的目的是测试一种父母参与的新模式，以加强超重青少年的体重控制。该干预措施将标准化认知行为青少年体重管理治疗与通过两种机制增加家长参与相结合：健康体重控制策略的家长建模以及加强与饮食、身体活动和体重相关的家长与青少年的沟通。研究目标是： 1）评估干预措施的可行性； 2) 将强化干预与标准青少年体重控制治疗在青少年与家长沟通和家长健康体重实践方面的变化进行比较，以及 3) 获得初步数据来检验参与强化干预是否会导致 BMI 更大程度下降的假设。总共 48 名年龄在 13 岁到 17 岁之间、超重 30% 到 90% 的青少年将被随机分配到两组治疗条件之一：青少年体重控制，包括标准认知行为干预和最低程度的家长参与 (CBT) +MPC）或增强的父母支持条件，重点关注健康的父母体重控制实践和改善的沟通（CBT + EPS）。将在基线和 16 周干预结束时获取体重、身高、健康父母体重控制策略以及青少年与父母沟通的测量结果。我们将通过收集每周出勤率、青少年和家长饮食和身体活动监测日志的完成情况以及青少年和家长对治疗可接受性的评级来评估强化干预的可行性。将通过问卷调查以及对与饮食、体重和身体活动相关的青少年与父母录像互动的编码来评估青少年与父母的沟通。将使用单独的多变量方差分析（MANOVA）来评估父母的健康体重策略以及结合问卷和父母与青少年沟通的录像数据。对从基线到治疗结束的评分变化进行方差分析（ANOVA），以评估治疗条件对青少年BMI和z-BMI的影响。鉴于这是一项探索性试点研究，我们期望获得 BMI 效应大小的估计值。该研究的下一个目标是进行全面的临床试验，以评估加强家长参与对青少年体重控制的功效。 公共卫生相关性：美国儿童和青少年超重的患病率持续增加，大约 37% 的儿童和 34% 的青少年被定义为超重（BMI 大于 85% 且 < 94%）或肥胖（BMI 大于 85% 且 < 94%）。大于 95%）。减少青春期超重的干预措施对于预防成年后超重至关重要。拟议的研究将测试父母参与的新方法的可行性，包括关注健康的父母体重实践和改善沟通，以加强青少年体重控制。