Improving primary care to prevent childhood obesity

改善初级保健以预防儿童肥胖

基本信息

批准号：
8316310
负责人：
MATTHEW W GILLMAN
金额：
$ 5.44万
依托单位：
HARVARD PILGRIM HEALTH CARE, INC.
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-15 至 2015-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8316310
关键词：
5 year old Address Administrator Age Asthma Behavior Behavioral Body Weight decreased Body mass index Child Child Behavior Child Care Childhood Cities Clinic Collaborations Consumption Counseling Data Development Diet Dietary Fiber Dietary intake Eating Effectiveness Effectiveness of Interventions Energy Intake Energy Metabolism Ensure Environment Epidemic Epidemiology Experimental Designs Family Family Nursing Family Physicians Fatty acid glycerol esters Food Frequencies Funding Future Goals Grant Group Practice Healthcare Height Human Resources Individual Institutes Insulin Resistance Intake Integrated Health Care Systems Interdisciplinary Study International Intervention Knowledge Leptin resistance Life Longevity Massachusetts Measurement Medical Mexican Mexico Nursery Schools Nutrient Obesity Overweight Parents Patients Physical activity Population Preschool Child Prevalence Preventive Intervention Primary Health Care Provider Public Health Randomized Randomized Controlled Trials Readiness Relative (related person)Research Research Infrastructure Research Personnel Resources Science Services Site Social Security Specific qualifier value Television Testing Time Training Trust United States National Institutes of Health Weight Weight Gain Work age group aged base behavior change cardiovascular risk factor chronic care model combat cost cost effectiveness empowered experience fast food follow-up fruits and vegetables group intervention improved innovation interest intervention effect medical schools novel strategies obesity in children obesity prevention obesity risk outreach parent grant prevent prevention service primary outcome programs sex success sugar sweetened beverage time use tool treatment as usual

项目摘要

Over the past 20 years, the prevalence of obesity in Mexico has more than doubled among individuals across the lifespan, including even the youngest populations. Once present, obesity is difficult to treat. To halt the obesity epidemic, we need to intervene early in life before excess weight gain takes hold. An important and untapped resource to halting this obesity epidemic is the primary care provider. Primary care providers, including family physicians and nurses, are interested in combating the rise of obesity in their patients, and families trust the advice they get from their providers. The overall goal of this research is to test the feasibility and effectiveness of an innovative clinic-based intervention to promote healthy eating and activity behaviors among Mexican children aged 2-5 years at elevated risk of obesity. Our proposed intervention will build upon our work with High Five for Kids, a U.S.-based, NIH funded obesity prevention intervention that involved restructuring primary care based on the chronic care model and training clinicians to provide behavior change counseling to parents of children age 2-5 years. To achieve this goal, we will conduct a randomized controlled trial (RCT) in 10 family medical clinics of the Mexican Institute of Social Security (IMSS), a large integrated health care system that provides health care for over 45 million Mexicans. The primary aim is to assess the extent to which the intervention, compared with the usual care control condition, reduces change in body mass index over a 6-month intervention and 6-month follow-up period. We will also assess the intervention's effect on specified obesity-related behaviors and its feasibility and acceptance. The proposed study unites a multidisciplinary research team with diverse strengths; the Harvard researchers provide expertise in the epidemiology of childhood overweight in the development of innovative obesity prevention interventions, while the IMSS researchers provide expertise in experimental design and an established record of research collaboration with IMSS clinics. This research will be conducted primarily in Mexico City at IMSS in collaboration with Ricardo P¿rez-Cuevas, as an extension of NIH Grant No. 5R01HD050966-05, 8-22-2005 to 06-30-2010, with a planned one-year no-cost extension to 06-30-2011.

在过去的20年中，墨西哥肥胖的患病率在个体中增加了一倍以上在整个生命周期中，包括最年轻的人群。一旦存在，肥胖就很难治疗。停止肥胖流行，我们需要在生命早期进行干预，然后再增加体重增加。制止这种肥胖流行的重要且未开发的资源是初级保健提供者。包括家庭医生和护士在内的初级保健提供者有兴趣打击肥胖的兴起在他们的患者中，家人相信他们从提供者那里得到的建议。这项研究的总体目标是测试基于创新诊所干预措施的可行性和有效性，以促进健康的饮食和 2至5岁的墨西哥儿童的活动行为，肥胖风险升高。我们的建议干预将基于我们的高五人的工作，这是美国NIH资助的肥胖症预防涉及根据慢性护理模型和培训临床医生进行重组的干预措施向2-5岁儿童的父母提供行为改变咨询。为了实现这一目标，我们将进行墨西哥社会保障研究所的10个家庭医疗诊所的随机对照试验（RCT）（IMSS），一种大型综合医疗保健系统，可为超过4500万墨西哥人提供医疗保健。主要目的是评估干预措施与通常的护理控制条件相比在6个月的干预和6个月的随访期内，体重指数的变化减少了。我们也会评估干预措施对特定肥胖相关行为的影响及其可行性和接受。拟议的研究将一个多种优势的多学科研究团队组成。哈佛研究人员在创新的发展方面提供了童年超重流行病学的专业知识肥胖预防干预措施，而IMS研究人员提供了实验设计方面的专业知识，与IMSS诊所建立了研究合作的记录。这项研究将主要进行 IMSS的墨西哥城与RicardoP¿Rez-Cuevas合作，作为NIH Grant No. 5R01HD050966-05，8-22-2005至06-30-2010，计划为期一年的一年无成本扩展到06-30-30-2011。