Teen CHAT:Improving physician communication with adolescents about healthy weight

青少年聊天：改善医生与青少年关于健康体重的沟通

基本信息

批准号：
8309909
负责人：
KATHRYN I POLLAK
金额：
$ 71.68万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-15 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8309909
关键词：
Academy Address Adherence Adolescent Adolescent Risk Behavior Adult Age Alcohol consumption American American Heart Association Baseline Surveys Behavior Body mass index CD-ROM Cardiovascular Diseases Child Chronic Disease Clip Code Communication Communities Counseling Diabetes Mellitus Diagnosis Education Elements Epidemic Family Physicians Future Goals Health Hyperlipidemia Hypertension Intervention Lead Malignant Neoplasms Mediator of activation protein Obesity Outcome Overweight Patients Pediatrics Phase Physical activity Physicians Play Randomized Randomized Controlled Trials Research Risk Behaviors Role Self Efficacy Sleep Smoking Summary Reports Surveys Techniques Teenagers Testing Time United States United States National Institutes of Health Visit Weight arm base design effectiveness measure expectation fast food improved innovation motivational enhancement therapy multidisciplinary nutrition pediatrician primary outcome secondary outcome skills sweetened beverage theories tv watching

项目摘要

DESCRIPTION (provided by applicant): The rise in adolescent obesity contributes to diabetes, cardiovascular disease, and eventually will lead to adulthood obesity. Physicians counsel overweight adolescent patients about nutrition and physical activity; however, few theory-based, easily disseminable interventions have been tested to improve physician counseling. We propose a randomized, controlled trial to assess the efficacy of a staggered delivery intervention to improve physician communication. The proposed intervention should increase physician Motivational Interviewing (MI) communication (e.g., eliciting "change talk", exploring ambivalence, etc.) and increase counseling time via a Summary Report that details adolescent's risk behaviors that contribute to unhealthy weight (i.e., sweetened beverages, fast food, breakfast, physical activity, screen time, and sleep). Our multidisciplinary team plans to audio record 200 baseline adolescent patient-physician visits (50 pediatricians and family physicians practicing in the community; 4 visits each). Then, half of the physicians will be randomly assigned to receive a tailored CD-ROM that contains didactic information and audio clips from physicians' own baseline visits to demonstrate MI communication. We then will audio record a new set of 200 post CD-ROM visits for all physicians. Then all physicians will receive the Summary Report, and we will audio record a new set of 200 Post Summary Report visits. Our innovative design allows us to test the effects of the CD-ROM alone, Summary Report alone and the combination. The primary outcome is physician adherence to MI techniques. Secondary outcomes are physicians discussing the six health risk behaviors and adolescent changes in nutrition, physical activity, and weight three months after the visit. We hypothesize that, compared to physicians in the control arm, physicians in the intervention arm will provide more effective (MI adherent) nutrition and physical activity counseling. Results of this study will expand the field of patient- physician communication by testing a low intensity, self-directed communication intervention for physicians to improve counseling, which over time and multiple visits, will improve adolescent patients' nutrition and physical activity. PUBLIC HEALTH RELEVANCE: Adolescent obesity is at an all time high. Physicians can play a role in helping adolescents attain a healthy weight. This study will test an intervention to help physicians counsel adolescents about nutrition and physical activity more effectively. This intervention should improve physician communication, which then in turn, should improve adolescents9 nutrition and physical activity behaviors.

描述（由申请人提供）：青少年肥胖的增加会导致糖尿病、心血管疾病，并最终导致成年肥胖。医生为超重青少年患者提供有关营养和身体活动的咨询；然而，很少有基于理论的、易于传播的干预措施经过测试来改善医生咨询。我们提出一项随机对照试验来评估交错分娩干预措施对改善医生沟通的功效。拟议的干预措施应增加医生动机访谈（MI）沟通（例如，引发“改变谈话”、探索矛盾心理等），并通过总结报告增加咨询时间，该报告详细说明青少年导致不健康体重的风险行为（即加糖饮料）、快餐、早餐、体力活动、屏幕时间和睡眠）。我们的多学科团队计划对 200 次基线青少年患者医生就诊进行录音（50 名在社区执业的儿科医生和家庭医生；每人 4 次就诊）。然后，一半的医生将被随机分配接收定制的 CD-ROM，其中包含来自医生自己的基线访问的教学信息和音频剪辑，以演示 MI 沟通。然后，我们将为所有医生录制一组新的 200 次 CD-ROM 后就诊音频。然后，所有医生都将收到总结报告，并且我们将录制一组新的 200 次总结报告后就诊录音。我们的创新设计使我们能够测试单独的 CD-ROM、单独的总结报告以及组合的效果。主要结果是医生对 MI 技术的遵守情况。次要结果是医生在就诊三个月后讨论六种健康风险行为以及青少年在营养、体力活动和体重方面的变化。我们假设，与对照组的医生相比，干预组的医生将提供更有效的（符合 MI 的）营养和身体活动咨询。这项研究的结果将通过测试医生的低强度、自我导向的沟通干预来改善咨询，从而扩大医患沟通的领域，随着时间的推移和多次就诊，这将改善青少年患者的营养和身体活动。公共健康相关性：青少年肥胖率空前高涨。医生可以在帮助青少年达到健康体重方面发挥作用。这项研究将测试一种干预措施，以帮助医生更有效地为青少年提供有关营养和身体活动的咨询。这种干预措施应改善医生的沟通，进而改善青少年9的营养和身体活动行为。