Pediatric Practice-based Obesity Intervention to Support Families: FITLINE

以儿科实践为基础的肥胖干预措施为家庭提供支持：FITLINE

• 批准号: 9335420
• 负责人: LORI PBERT
• 金额: $ 79.32万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-19 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9335420
• 关键词: 12 year old; Academy; Accelerometer; Adult; Age; Agreement; American; Behavior; Body Weight decreased; Body mass index; Calories; Caring; Child; Childhood; Chronic Disease; Counseling; Development; Diet; Eating; Educational Curriculum; Educational Materials; Effectiveness; Family; Family Practice; Feedback; Goals; Guidelines; Habits; Hour; Intake; Intervention; Life Style; Modeling; Morbid Obesity; Nurse Practitioners; Nutritionist; Obesity; Overweight; Pamphlets; Parents; Patients; Pediatrics; Persons; Physical activity; Pilot Projects; Prevalence; Prevention; Primary Health Care; Protocols documentation; Provider; Questionnaires; Randomized; Recommendation; Recruitment Activity; Resources; Risk; Schedule; Services; Structure; System; Telephone; Testing; Time; Training; Transportation; Weight; Weight maintenance regimen; base; behavior change; biomedical referral center; compare effectiveness; cost; cost effective; cost effectiveness; disability; family support; follow-up; fruits and vegetables; improved; innovation; obesity in children; obesity treatment; pediatrician; programs; response; saturated fat; scale up; social cognitive theory; sugar; sweetened beverage

Project Summary/Abstract The American Academy of Pediatrics (AAP) recommends a staged approach to the management of pediatric overweight and obesity, starting with Stage 1, Prevention Plus, which encourages families to improve lifestyle choices related to eating and activity in order to improve BMI status. Most pediatric practices have difficulty implementing these guidelines, however, due to limited time and access to weight loss experts to whom they can refer their patients and families, and burden to families in accessing in-person weight loss services. In response, our team developed the FITLINE pediatric practice-based referral program which provides practices an easily accessible resource to help families make AAP-recommended lifestyle changes. The program includes two components: (1) a pediatric practice-based component based on the Let's Go 5-2-1-0 intervention involving systems to assess and document BMI, a healthy habits screener and brief provider- delivered intervention, referral to the FITLINE counseling program, and feedback from the FITLINE nutritionist; and (2) a parent support component consisting of eight weekly FITLINE telephone counseling calls by centrally located nutritionists to provide parents coaching tailored to their family's unique needs and culture to help them set goals and make targeted lifestyle changes recommended by the AAP for Stage 1, Prevention Plus, accompanied by a parent booklet. The proposed five-year cluster randomized controlled pediatric practice-based trial will compare the effectiveness of two practice-based interventions on improving diet and physical activity and reducing BMI among overweight and obese 8-12 year olds seen in pediatric practice: (1) PP-FITLINE, consisting of the pediatric practice-based component plus FITLINE counseling and booklet, or (2) PP-Materials, consisting of the same practice-based component, but only the parent materials mailed over 8 weeks, with no referral to FITLINE counseling. Sixteen pediatric primary care practices will be randomized to either the PP-FITLINE (N=8) or the PP-Mailings (N=8) condition. Five hundred and twelve parents and their children ages 8-12 with a body mass index (BMI) of > 85th percentile (overweight or obese) will be recruited from the practices to achieve N=400 at 12 month follow-up. Assessments will be completed at baseline and 6- and 12-months post-baseline. The specific aims of this study are to determine the effectiveness of the PP-FITLINE program in reducing BMI in overweight and obese children and improving the child's diet and physical activity behaviors; explore possible mechanisms of the effect of the PP-FITLINE program on BMI, diet and physical activity; and estimate the cost-effectiveness of the PP-FITLINE compared with the PP-Mailing program. If found to be effective and cost-effective, the PP-FITLINE program will provide an innovative model which can be scaled up for widespread implementation of Stage 1, Prevention Plus of the AAP expert committee recommendations through pediatric practices nationwide, contributing significantly to the development of new standards for weight management care in pediatric practice.

项目摘要/摘要 美国儿科学会（AAP）建议采用分阶段的小儿管理方法 从第1阶段，预防加上超重和肥胖，鼓励家庭改善生活方式 与饮食和活动有关的选择以提高BMI状态。大多数儿科实践都困难 但是，由于时间有限和与他们的减肥专家的访问，实施这些准则 可以将其患者和家庭推荐给家庭，以获得亲自减肥服务的家庭。在 回应，我们的团队开发了基于小儿实践的转诊计划，该计划提供实践 一种易于使用的资源，可帮助家庭改变AAP推荐的生活方式。该程序 包括两个组件：（1）基于Let's 5-2-1-0的儿科实践组件 涉及评估和记录BMI的系统的干预措施，健康习惯筛选器和简短的提供商 - 提供干预措施，转介到列线咨询计划以及从填充线上的反馈 营养学家； （2）由八个每周填充电话咨询组成的父母支持部分 中心营养学家的呼吁为父母提供量身定制的父母教练，以满足其家人的独特需求和 文化以帮助他们设定目标并进行针对性的生活方式改变，该AAP为阶段1推荐， 预防加上父母小册子的陪同。提议的五年聚类随机控制 基于儿科实践的试验将比较两种基于实践的干预措施在改善的有效性 饮食和体育锻炼，并减少在小儿8-12岁的超重和肥胖的BMI 实践：（1）PP-FITLINE，由儿科实践的组件以及装修咨询和 小册子或（2）PP材料，由相同的基于实践的组件组成，但只有母材料 邮寄超过8周，没有转介到填充咨询。十六个小儿初级保健实践将是 随机分为PP-Fitline（n = 8）或PP-Mailings（n = 8）条件。五百十二 父母和他们的孩子8-12岁，体重指数（BMI）> 85％（超重或肥胖） 将从实践中招募，以在12个月的随访中实现n = 400。评估将完成 在基线以及6个月和12个月后 - 基线。这项研究的具体目的是确定 PP-Fitline计划在减少超重和肥胖儿童中BMI并改善的有效性 孩子的饮食和体育锻炼行为；探索PP-Fitline效果的可能机制 关于BMI，饮食和体育锻炼的计划；并估计PP-Fitline的成本效益 使用PP邮件程序。如果发现有效且具有成本效益，PP-Fitline计划将提供 一个创新的模型，可以扩大规模，以广泛实施第1阶段，预防和 AAP专家委员会通过全国儿科实践提出的建议，贡献了很大的贡献 在小儿实践中制定重量管理护理的新标准。