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: 8338486
• 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/8338486
• 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）： 项目摘要/摘要 尽管国家大力努力解决儿童肥胖问题，但这种流行病仍然存在。认识到这些挑战，美国国立卫生研究院 (NIH) 和医学研究所 (IOM) 呼吁采取以系统为导向的方法来解决儿童肥胖问题。我们假设，在 2-12 岁低收入、种族多样化的超重和肥胖儿童中，与一级预防相比，在一级预防中纳入二级预防计划的儿童肥胖系统方法将降低体重指数 (BMI) z 分数独自的。干预策略将根据研究人员开发的循证计划组合进行调整。将与研究和社区合作伙伴一起在奥斯汀和休斯顿的弱势社区集水区进行基于资产的评估；数据将为干预战略的整合提供信息，并为方案的可持续性提供结构。我们的具体研究目标是： 目标 1：在奥斯汀和休斯顿的低收入、种族多元化的地区实施和评估一级预防肥胖计划。将在 2 个示范区 (n=1614) 和 2 个控制区 (n=1614) 收集关于儿童超重患病率、危险因素以及医疗服务和社区计划可用性的基线和 2 年随访数据。家长、儿童和社区数据将提供匹配的比较数据，以评估一级预防干预措施的有效性。目标 2：通过在社区一级预防计划中嵌入为期 12 个月的基于家庭的二级预防计划，实施并评估儿童肥胖系统方法对减少肥胖的效果。二级预防体重管理项目将针对一级预防覆盖范围内的超重/肥胖儿童及其家庭进行。 2-12 岁超重/肥胖儿童家庭（总共 n=576）将被随机分配到为期 12 个月的二级预防计划（实验）或单独的预防计划（对照），按年龄（2-5 岁）分层、6-8 岁和 9-12 岁）。结果包括儿童 BMI z 分数、生活质量测量和项目使用指标。目标 3：量化针对儿童肥胖的 12 个月家庭二级预防计划相对于单独一级预防的增量成本效益。基于活动的成本计算方法将用于量化实施二级预防计划相对于一级预防的增量成本。公共卫生相关性：如果这项研究试验被证明是有效且具有成本效益的，那么该示范项目可以广泛传播，以解决服务不足、高危儿童的肥胖问题。通过医疗保健、儿童保育、学校和社区部门的社区合作伙伴的积极参与，将确保计划的可持续性。