MICCO - Mobile Integrated Care for Childhood Obesity: A technology-enhanced comprehensive approach to integrating obesity care in rural communities

MICCO - 儿童肥胖移动综合护理：一种技术增强的综合方法，将肥胖护理纳入农村社区

• 批准号: 10580770
• 负责人: Thao-Ly Tam Phan-Vo
• 金额: $ 25.28万
• 依托单位: ALFRED I. DU PONT HOSP FOR CHILDREN
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10580770
• 关键词: 12 year old; Academy; Address; Affect; American; Area; Behavior; Behavior Therapy; Cardiovascular Diseases; Caring; Child; Child Health; Childhood; Clinical; Color; Communities; Community Healthcare; Community Integration; Complex; Counseling; Diabetes Mellitus; Disparity; Electronic Health Record; Enhancement Technology; Ensure; Ethnic Origin; Face; Family; Feedback; Food; Foundations; Friends; Health; Healthcare; Healthcare Systems; Home environment; Inequity; Intervention; Life Style; Low income; Measures; Mental Health; Modeling; National Institute of Child Health and Human Development; National Institute of Diabetes and Digestive and Kidney Diseases; Nutritional; Obesity; Outcome; Parents; Pediatrics; Physical activity; Public Health; Qualitative Research; Quality of Care; Race; Randomized; Randomized, Controlled Trials; Recommendation; Research; Research Methodology; Resources; Risk; Role; Rural; Rural Community; Self Management; Site; Social Work; Socioeconomic Status; Specialist; Technology; Testing; Transportation; Treatment outcome; United States; Work; behavior change; body system; community center; community organizations; community-level factor; disparity reduction; effectiveness testing; efficacy evaluation; empowerment; ethnic minority population; evidence base; family management; health care quality; improved; innovative technologies; integrated care; intervention refinement; low socioeconomic status; member; mobile application; multi-component intervention; obesity in children; obesity treatment; patient centered medical home; primary care practice; primary care provider; primary care setting; primary care visit; psychoeducation; psychoeducational; psychosocial; racial minority population; recruit; rural underserved; standard care; success; telehealth; tool; usability

PROJECT SUMMARY Nearly 1 in 5 children in the United States are affected by obesity, with even higher rates among children of racial and ethnic minority groups, of low socioeconomic status, and living in rural communities. Obesity is a significant public health concern because it increases a child’s risk for health conditions within every organ system, including diabetes, cardiovascular disease, and mental health problems. Traditional lifestyle behavior interventions have not been as effective when implemented in communities of color, low-income communities, and rural communities. Guided by the Clinical and Community Integration Framework, which emphasizes the integration of community and healthcare systems to drive family engagement and empowerment in treating obesity, our work has demonstrated the importance of addressing psychosocial needs and leveraging technology to improve care for families of children with obesity. We have assembled a research team, with complimentary and relevant areas of expertise, to refine and test a multi-component intervention, Mobile Integrated Care for Childhood Obesity (MICCO). MICCO combines evidence-based approaches previously developed and tested by our research team, each delivered through a mobile app platform integrated with the electronic health record. Components will include: (1) coordinating social services in the community to meet families’ psychosocial needs, (2) integrating care from obesity specialists using telehealth, and (3) providing media-based psychoeducational tools to promote self-management of lifestyle behavior change. Community-engaged and qualitative research methods will be employed to refine MICCO to be community-centered and family-friendly (Aim 1). The refined intervention will be tested in a randomized controlled trial with 184 families of children 4-12 years of age with obesity, recruited from rural primary care practices, to determine the impact of the intervention on child adiposity and family engagement in treatment over six months (Aim 2) and disparities in these outcomes by race, ethnicity, and socioeconomic status (Aim 3). This study will inform a R01 application in Year 2 to expand the concept to a multi-site RCT to test the effectiveness of MICCO’s integrated, community-centered, and technologically state- of-the-art approach in improving the reach and relevance of childhood obesity treatments to families in underserved rural communities, increasing the likelihood of a positive impact on obesity outcomes and inequities in child health.

项目概要 在美国，近五分之一的儿童受到肥胖的影响，其中种族儿童的比例更高 社会经济地位较低且生活在农村社区的少数民族群体的肥胖问题很严重。 公共健康问题，因为它增加了儿童每个器官系统健康状况的风险，包括 糖尿病、心血管疾病和心理健康问题。 在有色人种社区、低收入社区和农村实施时效果不佳 以临床和社区整合框架为指导，强调整合。 社区和医疗保健系统，以推动家庭参与和赋权治疗肥胖，我们的 工作证明了解决社会心理需求和利用技术来改善的重要性 我们组建了一个研究团队，为肥胖儿童的家庭提供免费和相关的服务。 专业领域，完善和测试多成分干预措施，儿童移动综合护理 肥胖 (MICCO)。MICCO 结合了我们之前开发和测试的基于证据的方法。 研究团队的每个项目都通过与电子健康记录集成的移动应用程序平台进行交付。 组成部分将包括：(1) 协调社区的社会服务，以满足家庭的社会心理需求， (2) 使用远程医疗整合肥胖专家的护理，以及 (3) 提供基于媒体的心理教育 促进生活方式行为改变的自我管理的工具。社区参与和定性研究。 将采用方法将 MICCO 完善为以社区为中心和家庭友好型（目标 1）。 干预措施将在一项随机对照试验中进行测试，该试验涉及 184 个 4-12 岁儿童家庭 肥胖，从农村初级保健实践中招募，以确定干预措施对儿童肥胖的影响 和家庭在六个月内参与治疗（目标 2）以及这些结果因种族、族裔、 和社会经济地位（目标 3）。本研究将为第二年的 R01 申请提供信息，将这一概念扩展到 多站点 RCT 来测试 MICCO 综合的、以社区为中心的、技术状态的有效性 提高儿童肥胖治疗对家庭的影响力和相关性的最先进方法 服务不足的农村社区，增加对肥胖结果和不平等产生积极影响的可能性 在儿童健康方面。