Systems Approach to Obesity Prevention in Underserved Children in Texas

德克萨斯州服务不足的儿童预防肥胖的系统方法

• 批准号: 8255266
• 负责人: DEANNA MARIE HOELSCHER
• 金额: $ 174.62万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2015-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8255266
• 关键词: Systems; Approach; Obesity; Prevention; Underserved

DESCRIPTION (provided by applicant): Project Summary/Abstract Despite intensive national efforts to address childhood obesity, the epidemic persists. Recognizing the challenges, the National Institutes of Health (NIH) and the Institute of Medicine (IOM) have called for a systems-oriented approach to address childhood obesity. We hypothesize that among low-income, ethnically diverse overweight and obese children, aged 2-12 years, a systems approach to child obesity incorporating secondary prevention programs embedded within primary prevention will reduce body mass index (BMI) z-scores compared to primary prevention alone. Intervention strategies will be adapted from the portfolio of evidence-based programs developed by study investigators. An assets-based assessment will be conducted with research and community partners in disadvantaged neighborhood catchment areas in Austin and Houston; data will inform integration of intervention strategies and provide a structure for program sustainability. Our specific study aims are: Aim 1: To implement and evaluate a primary prevention obesity program in low-income, ethnically diverse catchment areas in Austin and Houston. Baseline and 2-year follow-up data on the prevalence of child overweight, risk factors, and the availability of healthcare services and community programs will be collected in 2 demonstration (n=1614) and 2 control catchment areas (n=1614). Parent, child and community data will provide matched comparison data to assess the efficacy of the primary prevention intervention. Aim 2: To implement and evaluate the efficacy of a systems approach to child obesity on reducing obesity by embedding a 12-month family-based secondary prevention program within the community primary prevention program. The secondary prevention weight management program will be conducted with overweight/obese children and their families in the primary prevention catchment areas. Families of overweight/obese children (total n=576), aged 2-12 years, will be randomly assigned to either the 12-month secondary prevention program (experimental) or prevention program alone (control), stratified by age (2-5, 6-8, and 9-12 y). Outcomes include child BMI z-score, quality of life measures, and program use indicators. Aim 3: To quantify the incremental cost-effectiveness of the 12-month family-based secondary prevention program relative to primary prevention alone for child obesity. Activity Based Costing methods will be used to quantify the incremental cost of delivering the secondary prevention program relative to primary prevention. Public Health Relevance: If this research trial is proven efficacious and cost-effective, the demonstration project could be disseminated widely to address obesity among underserved, at risk children. Program sustainability will be ensured through active involvement of community partners within healthcare, childcare, schools and community sectors.

描述（由申请人提供）：尽管全国性的努力解决了儿童肥胖症，但流行病仍然存在。认识到挑战，美国国立卫生研究院（NIH）和医学研究所（IOM）呼吁采取一种面向系统的方法来解决儿童肥胖症。我们假设在低收入，种族多样化的超重和肥胖儿童中，年龄在2-12岁之间，与单独预防相比，嵌入了嵌入初级预防的次要预防计划的儿童肥胖症的系统方法将减少体重指数（BMI）Z得分。干预策略将改编自研究研究人员开发的基于证据的计划的组合。基于资产的评估将与奥斯汀和休斯顿处境不利的社区集水区的研究和社区合作伙伴进行；数据将为干预策略的整合提供信息，并为计划的可持续性提供结构。我们的具体研究目的是：目标1：在奥斯丁和休斯敦的低收入，种族多样化的集水区中实施和评估一项主要的预防肥胖计划。关于儿童超重，危险因素以及医疗服务和社区计划的可用性，基线和2年的随访数据将在2个示范（n = 1614）和2个控制集水区（n = 1614）中收集。父母，儿童和社区数据将提供匹配的比较数据，以评估主要预防干预的功效。目标2：通过将基于12个月的家庭二级预防计划嵌入社区初级预防计划中，实施和评估儿童肥胖症系统方法对减少肥胖症的功效。二级预防体重管理计划将在主要预防集水区中的超重/肥胖儿童及其家人进行。超重/肥胖儿童（总计n = 576），年龄在2-12岁之间的家庭将被随机分配到12个月的二级预防计划（实验）或仅预防计划（对照）（对照），按年龄（2-5、6-8和9-12 y）分层。结果包括儿童BMI Z分数，生活质量措施和计划使用指标。目标3：量化基于12个月的家庭预防计划的增量成本效益相对于仅针对儿童肥胖的初级预防而量化。基于活动的成本核算方法将用于量化相对于初级预防的二级预防计划的增量成本。公共卫生相关性：如果这项研究试验被证明有效且具有成本效益，则可以广泛传播示范项目，以应对服务不足，危险儿童的肥胖症。将通过在医疗保健，育儿，学校和社区领域积极参与社区合作伙伴的积极参与来确保计划的可持续性。