Clinic and Home Family Based Behavioral Treatment for Obese Preschoolers: LAUNCH

针对肥胖学龄前儿童的基于诊所和家庭的行为治疗：启动

• 批准号: 8225593
• 负责人: LORI J STARK
• 金额: $ 63.13万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-20 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8225593
• 关键词: 21 year old; 6 year old; Address; Adult; Affect; Aftercare; Age; Attention; Behavior; Behavior Therapy; Behavioral; Beverages; Body Weight Changes; Body mass index; Caregivers; Child; Child Behavior; Child health care; Childhood; Clinic; Community Practice; Comorbidity; Data; Development; Dietary intake; Disease; Eating; Educational process of instructing; Energy Intake; Environment; Environmental Risk Factor; Evidence based treatment; Family; Food; Goals; Growth; Habits; Health; Health Care Costs; Home environment; Home visitation; House Call; Individual; Insulin-Dependent Diabetes Mellitus; Intervention; Intervention Studies; Knowledge; Learning; Life Cycle Stages; Life Expectancy; Life Style; Longevity; Maintenance; Measures; Modeling; NIH Program Announcements; Non obese; Non-Insulin-Dependent Diabetes Mellitus; Nursery Schools; Obesity; Outcome; Overweight; Parenting behavior; Parents; Participant; Pattern; Pediatric Research; Physical activity; Population; Population Decreases; Positioning Attribute; Preschool Child; Prevalence; Prevention approach; Programmed Learning; Public Health; Quality of life; Randomized; Randomized Clinical Trials; Recommendation; Recording of previous events; Recruitment Activity; Research; Risk; School-Age Population; Spouses; Staging; Stimulus; Techniques; Testing; Time; Weight; age group; arm; base; cost; design; diet and exercise; early childhood; effective therapy; feeding; follow-up; grandparent; in vivo; innovation; meetings; motivational enhancement therapy; novel strategies; nutrition; obesity in children; obesity treatment; practice-based research network; randomized trial; sedentary; social cognitive theory; standard of care; treatment program; trend

DESCRIPTION (provided by applicant): Obesity now affects an estimated 2.8 million children between the ages of 2 and 5 years, as the prevalence of obesity among preschool school age children has almost tripled from 5 percent of the population in 1971-1980 to 13.9 percent by 2004. Being obese at age 5 confers a 47 times greater risk of being overweight or obese at age 12. In fact being obese any time between 2 and 5 year increases the risk of remaining overweight or obese as an adult by four times the risk of nonobese preschoolers. Being obese as a preschooler also increases the risk of a number of serious health conditions, including a 2.6 times greater risk of developing type 2 diabetes by age 21 years. In fact, the obesity rate among preschoolers is thought to impose such a cumulative health risk across the life span that children born today, for the first time in history, are expected to have a shorter life expectancy than their parents by to 2 to 5 years. Early effective treatments for establish obesity during the preschool years have the potential to change the trajectory of obesity and related co-morbid health condition across the life-span by reducing obesity and changing the development of lifestyle habits of diet and exercise at a time when these are being formed. Yet research on interventions to reduce obesity in preschool children is severely limited and none exist that addresses established obesity in this age group. Therefore the current study has the potential to have a significant impact on public health by providing evidence-based treatment for obesity in preschoolers, a developmental period in which eating and activity patterns are being formed, that could significantly impact the trajectory of obesity thereby decreasing the population obesity rates and associated healthcare costs at across the life span. Fortunately, we are on our way to addressing the problem of obesity reduction in already obese preschoolers. We have developed and conducted a pilot randomized clinical trial of a treatment program aimed at reducing obesity in already obese preschool children. Our program (Learning about Activity and Understanding Nutrition for Child Health: LAUNCH) is tailored to the developmental stage of preschool children and produced promising preliminary results. In the proposed trial a 3 arm, randomized, parallel group design will test LAUNCH against 1) motivational interviewing (attention control; MI) and 2) standard of care (true standard of care control; STC) with 168 children ages 2 to 5 years who meet the criteria for obesity (>95th percentile for body mass index; BMI). Participants will be randomized to receive a 6 month intervention (LAUNCH, MI) or standard of care. The primary end-point will be change in BMI z-score at the end of treatment. We will also assess maintenance of treatment gains at 6 and 12 months after treatment, and changes in factors thought to be mechanisms for change in weight (food intake and activity level), changes in the obesiogenic environment (parent weight, food intake and activity, and changes in the home food environment) and factors that could be negatively impacted (parent and child eating and feeding interactions). PUBLIC HEALTH RELEVANCE: Obesity among preschool children is a significant health problem affecting approximately 2.8 million children ages 2 to 5 years. There are no treatment studies to reduce established obesity in this age group. Because obesity during the preschool years tracks into childhood and adulthood and increases the likelihood of disorders such as type 1 diabetes, effective treatments for preschoolers are critical in order to change the trajectory of obesity and co-morbidities throughout the life course. Without intervention it is speculated that obesity trends will continue to occur at younger ages, children will carry obesity related health risks for a greater portion of their lives, and, for the first time in history, children born today will have a shorter life expectancy than their parents.

描述（由申请人提供）：肥胖现在影响了280岁和5岁的年龄之间的280万儿童，因为学龄前儿童年龄段的肥胖症的普遍性几乎从1971- 1980年的5％人口中的5％到2004年的13.9％到2004年的13.9％。到2004年，肥胖在5岁时越来越多的肥胖率增加了47倍的超过47倍的风险，而在5年龄的情况下，肥胖的风险越来越多。超重或成年人的肥胖是非肥胖学龄前儿童的四倍。肥胖作为学龄前儿童也增加了许多严重健康状况的风险，其中包括到21岁时患2型糖尿病的风险高2.6倍。实际上，据认为，学龄前儿童之间的肥胖率在整个生命周期内施加了这样的累积健康风险，以至于今天出生的孩子在历史上首次有预期的预期寿命要比父母短至2至5年。在学龄前期间建立肥胖的早期有效治疗方法有可能通过减少肥胖症并改变饮食习惯的发展，并在形成这些习惯的时候改变肥胖和相关的合并健康状况的轨迹。然而，对减少学龄前儿童肥胖症的干预措施的研究非常有限，没有任何解决该年龄段肥胖的问题。因此，当前的研究有可能通过提供学龄前儿童的肥胖症的循证治疗来对公共卫生产生重大影响。幸运的是，我们正在解决已经肥胖学龄前儿童减少肥胖问题的问题。我们已经开发了一项旨在减少已经肥胖学龄前儿童的肥胖症的治疗计划的试验随机临床试验。我们的计划（了解活动和了解儿童健康的营养：发射）是针对学龄前儿童的发展阶段量身定制的，并产生了有希望的初步结果。在拟议的试验中，一个3 ARM，随机的平行组设计将针对1）动机访谈（注意控制； MI）和2）护理标准（真正的护理标准控制标准； STC），有168名2至5岁儿童符合肥胖标准（> 95个百分位数（> 95个百分位数的体重指数）； BMI）。参与者将被随机接受6个月的干预（发布，MI）或护理标准。主要终点是在治疗结束时BMI Z得分的变化。我们还将评估治疗后6和12个月的治疗收益的维持，以及被认为是体重变化（食物摄入量和活动水平）的机制的变化，肥胖环境的变化（父母体重，食物摄入量和活动的变化以及家庭食物环境的变化）以及可能受到负面影响的因素（父母和儿童饮食和喂养互动）。 公共卫生相关性：学龄前儿童的肥胖是一个重大的健康问题，影响约280万儿童2至5岁。没有治疗研究可以减少该年龄段的肥胖症。由于学龄前年份的肥胖症迹象到童年和成年，并增加了诸如1型糖尿病等疾病的可能性，因此对学龄前儿童的有效治疗对于改变整个生活过程中的肥胖和合并症的轨迹至关重要。如果不干预，据推测，肥胖趋势将继续发生在年轻人时代，儿童将对自己的一生中肥胖危害与肥胖有关的风险，并且，历史上第一次，今天出生的孩子的预期寿命将比父母短。