Development and Validation of an Observational Rating System for Individual Tailoring in Family-Based Pediatric Obesity Interventions

基于家庭的儿科肥胖干预措施中个体定制观察评级系统的开发和验证

• 批准号: 10561594
• 负责人: Emily Suzan Fu
• 金额: $ 2.46万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-12-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10561594
• 关键词: Address; Affect; Age; Area; Attenuated; Behavioral; Behavioral Medicine; Body mass index; Cardiovascular Diseases; Caregivers; Child; Child Development; Child Health; Child Rearing; Chronic Disease; Clinical Psychology; Clinical Research; Code; Communities; Community Services; Data; Development; Disease; Dropout; Drops; Effectiveness; Effectiveness of Interventions; Emotional; Enrollment; Epidemic; Equation; Etiology; Evaluation; Evidence based intervention; Failure; Family; Family health status; Future; Gender; Goals; Health; Health Promotion; Health Status; Health and Behavior in Children; Health behavior; Health behavior change; Health education; Individual; Intervention; Intervention Studies; Libraries; Low income; Measures; Methodology; Methods; Modeling; Motivation; National Heart, Lung, and Blood Institute; Obesity; Obesity Epidemic; Outcome; Participant; Process; Process Assessment; Process Measure; Program Development; Psychometrics; Public Health; Quality of life; Recommendation; Research; Research Personnel; Resources; Risk; Risk Reduction; Role; Sampling; Self Determination; Self Efficacy; Standardization; Students; System; Testing; Theoretical model; Training; Transcript; Validation; Video Recording; Weight Gain; Weight maintenance regimen; career; checkup examination; clinical implementation; cost; design; ethnic minority; excessive weight gain; expectation; implementation research; implementation science; improved; individualized medicine; intervention effect; low socioeconomic status; novel; obesity in children; obesity management; obesity risk; obesity treatment; obesogenic; patient engagement; pre-doctoral; prevent; preventable death; primary care services; programs; racial diversity; racial minority; services as usual; skills; social; socioeconomic disadvantage; theories; therapy design; therapy development; tool; tool development; treatment as usual; treatment planning

Project Summary/Abstract Pediatric obesity is a public health crisis associated with costly cardiovascular and chronic diseases and decreased quality of life. A disproportionate number of children with obesity, defined as a body mass index (BMI)≥95th percentile for age and gender, are racial/ethnic minorities or socioeconomically disadvantaged. Family-based treatments for childhood obesity have demonstrated effectiveness but struggle with high participant drop-out and inconsistent attendance, limiting opportunities for intervention effects and improving health outcomes. Caregivers frequently drop out due to a program overloading irrelevant information or not meeting their expectations. Due to the complexity of pediatric obesity, contributors to children's weight gain can greatly vary from family to family. Individually tailored family-based programs use rigorous assessment to develop individualized treatment plans that address a family's unique needs and treatment priorities. The Family Check-Up 4 Health (FCU4Health) is an assessment-driven individually tailored family-based pediatric obesity program that targets parenting skills and health behaviors and has had high rates of participation and retention among a low-income predominantly ethnic minority sample. Despite the promise of individual tailoring, tools to quantify the process of individual tailoring are understudied, hindering the ability to evaluate individual tailoring and analyze the theory that tailoring affects program engagement and outcomes. The proposed study will develop and validate an observational rating system to measure the process and degree of individual tailoring in family-based pediatric obesity interventions. Videorecorded sessions, transcripts and multimethod data from a completed trial of the FCU4Health, the Raising Healthy Children (RHC) project, will be used to develop the observational rating system. Next, a second trial of the FCU4Health, the Healthy Communities 4 Healthy Students (HC4HS) project, will be used to validate the new rating system. Finally, scores from the new rating system will be used to test the relationship between individual tailoring, program engagement and changes in health behaviors and anthropometric outcomes using a combined RHC and HC4HS sample. This novel research will employ video observation coding, psychometrics, structural equation modeling, and implementation science methods. The new tool will advance the field of pediatric obesity research by providing a rating system to guide the design, implementation, and evaluation of pediatric obesity interventions with an individual tailoring component. Quantifying individual tailoring will elucidate its relationship with program engagement and outcomes to inform adaptations for evidence-based interventions. The enhanced interventions will accommodate participants' needs, facilitate health behavior change and ultimately prevent and manage pediatric obesity and reduce risk for associated diseases.

项目摘要/摘要 小儿肥胖是一种公共卫生危机，与昂贵的心血管和慢性疾病有关 生活质量下降。肥胖儿童数量不成比例，定义为体重指数 （BMI）年龄和性别的≥95％是种族/族裔少数民族或社会经济上的处境不利。 基于家庭的儿童对象治疗已经表现出有效性，但在高度挣扎 参与者辍学和出勤率不一致，限制了干预效果的机会 健康结果。由于计划超载不相关的信息，护理人员经常退出 达到他们的期望。由于小儿肥胖的复杂性，儿童体重增加的贡献者可以 因家庭而异。单独量身定制的基于家庭的计划使用严格的评估 制定个性化的治疗计划，以满足家庭的独特需求和治疗重点。 家庭检查4 Health（FCU4Health）是评估驱动的单独量身定制的基于家庭的儿科 针对育儿技能和健康行为的肥胖计划，参与率很高， 低收入少数民族样本中的保留。尽管有个人的承诺 裁缝，量化单个裁缝过程的工具已被理解，阻碍了评估的能力 个人量身定制和分析裁缝会影响计划参与和结果的理论。这 拟议的研究将开发和验证考试评级系统，以衡量过程和程度 在基于家庭的小儿肥胖干预措施中进行裁缝。视频记录会议，成绩单和 来自FCU4Health的完整试验（培养健康的儿童（RHC）项目）将是多途径的数据，将是 用于开发观测评级系统。接下来，第二次对FCU4Health的试验，健康 社区4健康学生（HC4HS）项目将用于验证新的评级系统。最后， 新评级系统的分数将用于测试单个裁缝，程序之间的关系 使用合并的RHC和 HC4HS样本。这项新研究将采用视频观察编码，精神计量学，结构方程 建模和实施科学方法。新工具将推进小儿肥胖领域 通过提供评级系统来指导小儿肥胖的设计，实施和评估来进行研究 与单个裁缝组件的干预措施。量化个人裁缝将阐明其关系 通过计划参与和成果，以适应基于证据的干预措施。这 加强干预措施将满足参与者的需求，促进健康行为的改变，并最终 预防和管理小儿肥胖，并降低相关疾病的风险。