A Family-Based Weight Loss Intervention for Youth with Intellectual Disability

针对智障青少年的家庭减肥干预

• 批准号: 8710297
• 负责人: RICHARD K FLEMING
• 金额: $ 45.87万
• 依托单位: UNIVERSITY OF MASSACHUSETTS BOSTON
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-22 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8710297
• 关键词: Address; Adherence; Adolescence; Adolescent; Adult; Age; Area; Audiotape; Behavior; Behavior Therapy; Behavioral; Body Weight decreased; Body mass index; Child; Clinical; Cognitive; Control Groups; Counseling; Data; Diet; Down Syndrome; Eating; Education; Family; Food; General Population; High Prevalence; Independent Living; Individual; Intellectual functioning disability; Intervention; Investigation; Knowledge; Life; Life Style; Maintenance; Measurement; Nutrient; Obesity; Outcome Study; Overweight; Parents; Participant; Persons; Physical activity; Population; Randomized; Randomized Controlled Trials; Reporting; Research; Sampling; Self Efficacy; Time; Training; United States Dept. of Health and Human Services; Weight; Work; Youth; aged; base; critical period; design; efficacy testing; efficacy trial; experience; follow-up; food consumption; fruits and vegetables; innovation; nutrition; nutrition education; post intervention; primary outcome; programs; secondary outcome; sedentary; skills; theories; therapy design; treatment duration; tv watching; weight loss intervention; weight maintenance; young adult

DESCRIPTION (provided by applicant): Obesity is more prevalent in persons with intellectual disabilities (ID) than in the general population. Weight loss in this population is particularly important during adolescence, a critical period in which parents can impart healthful dietary and physical activity knowledge and skills in anticipation of their child's transition into adulthood ad independent living. Family-based treatments have been effective in promoting weight loss among typically developing children and adolescents, but to our knowledge no randomized controlled trials (RCTs) have been reported with children or adolescents with ID, and research is sorely needed. This R01 proposal seeks to build upon our recently completed RCT (N=21) with adolescents/young adults with Down syndrome in which we found encouraging results favoring what we refer to as family-based behavioral intervention (FBBI) over a purely educational approach. The specific aims of this R01 proposal are to: 1) conduct a needed larger replication of our pilot program (FBBI) with 48 adolescents with ID aged 15-22 years, participating in the program with a parent, randomized to FBBI or delayed treatment (DT); and 2) develop, implement and evaluate a follow-up maintenance intervention (FBBI+MI) designed to sustain weight loss through longer-term lifestyle maintenance strategies. After completion of the FBBI, participants will be randomized to either a FBBI-MI intervention for 6 months or a no treatment period. The primary outcome of this study is change in adolescent participants' weight status, reported as body mass index (BMI). Secondary outcomes are changes in adolescents': fruit, vegetable and high energy-dense food consumption; time spent in moderate to vigorous physical activity; screen time; and self-efficacy. Data are collected at baseline, 6 months (end of FBBI), 12 months (end of FBBI+MI) and 18 months (no-intervention follow-up). Participants assigned to DT begin FBBI after an initial 6-month delay, during which they serve as controls, and therefore receive an additional baseline measurement. Treatment fidelity is assessed by direct observation or audiotape review for 20% of sessions, covering the interventionists' implementation of nutrition education, individual nutrition counseling and parent behavioral training components. The results of this study will contribute to the research on weight reduction for adolescents and inform larger-scale research and clinical interventions.

描述（由申请人提供）：智力残疾人（ID）的肥胖比一般人群更为普遍。在青春期，这一人群的体重减轻尤其重要，这是一个关键时期，在这个关键时期中，可以预期孩子过渡到成年后的独立生活，以赋予健康的饮食和体育锻炼知识和技能。基于家庭的治疗方法可以有效地促进通常发展的儿童和青少年的体重减轻，但是据我们所知，与具有ID的儿童或青少年有关，尚未报告任何随机对照试验（RCT），并且非常需要研究。这项R01提案旨在以我们最近完成的RCT（n = 21）为基础，其中青少年/年轻人患有唐氏综合症，我们发现令人鼓舞的结果有利于我们所谓的基于家庭的行为干预（FBBI）而不是纯粹的教育方法。该R01提案的具体目的是：1）对我们的试点计划（FBBI）进行更大的复制，其中48名ID年龄15-22岁的青少年与父母一起参加该计划，并随机分配给FBBI或延迟治疗（DT）； 2）开发，实施和评估旨在通过长期生活方式维护策略来维持体重减轻的后续维护干预措施（FBBI+MI）。 FBBI完成后，参与者将被随机地进行6个月或无治疗期的FBBI-MI干预。这项研究的主要结果是青少年参与者体重状况的变化，报道为体重指数（BMI）。次要结果是青少年的变化：水果，蔬菜和高能量浓缩食品消费；在中度到剧烈的体育锻炼中度过的时间；屏幕时间；和自我效能。数据在基线时收集6个月（结束了 FBBI），12个月（FBBI+MI结束）和18个月（无干预随访）。在最初的6个月延迟后，分配给DT的参与者开始FBBI，在此期间作为对照，因此获得了额外的基线测量。治疗保真度通过直接观察或录音带审查评估20％的课程，涵盖了干预者的营养教育，个人营养咨询和父母行为培训组件的实施。这项研究的结果将有助于减轻青少年体重的研究，并为大规模的研究和临床干预提供信息。