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继续增加。最新的国家健康和营养检查调查（NHANES）的数据表明，大约37％的儿童和34％的青少年是超重或肥胖（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超重成年至关重要。尽管已经非常关注全面的行为干预措施以解决儿童的肥胖症，但经验证据较少，证明了与青少年这种干预措施的功效。拟议的研究的目的是测试一种新型的父母参与模型，以增强超重青少年的体重控制。该干预措施将标准化的认知行为青少年体重管理治疗与通过两种机制增加了父母参与：健康体重控制策略的父母建模以及与饮食，体育活动和体重有关的父母 - 成年沟通增强。研究目标是：1）评估干预的可行性； 2）将增强的干预措施与标准的青少年体重控制治疗相比，与青少年沟通和父母健康体重实践的变化有关，3）获得初步数据，以测试参与增强干预措施的假设会导致BMI的降低。 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).体重，身高，健康的父母体重控制策略和青少年沟通的度量将在基线和16周干预结束时获得。我们将通过收集每周出勤，饮食和体育活动监测日志的青少年和父母的完成，以及青少年和父母对治疗可接受性的评分来评估增强干预措施的可行性。青少年的沟通将通过问卷调查以及与饮食，体重和体育锻炼有关的青少年录像相互作用进行评估。单独的多元方差分析（MANOVA）将用于评估父母健康的体重策略，并结合了父母 - 青春期交流的录像带和录像数据。方差分析（ANOVA）将对从基线到治疗结束的变化评分进行，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验研究，我们希望获得BMI影响大小的估计值。这一研究中的下一个目标是进行全面的临床试验，以评估增强父母参与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继续增加，大约37％的儿童和34％的青少年被定义为超重（BMI大于85％和<94％，<94％）或肥胖（BMI大于95％）。青春期超重的干预措施对于预防超重到成年至关重要。拟议的研究将测试一种新颖的父母参与方法的可行性，包括专注于健康的母体体重实践和改善沟通，以增强青少年体重控制。