Teen CHAT:Improving physician communication with adolescents about healthy weight

青少年聊天：改善医生与青少年关于健康体重的沟通

基本信息

批准号：
7735452
负责人：
KATHRYN I POLLAK
金额：
$ 78.09万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-15 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7735452
关键词：
Academy Address Adherence Adolescent Adolescent Risk Behavior Adult Age Alcohol consumption American American Heart Association Baseline Surveys Behavior Body mass index CD-ROM Cardiovascular Diseases Child Chronic Disease Clip Code Communication Communities Counseling Diabetes Mellitus Diagnosis Education Elements Epidemic Family Physicians Future Goals Health Hyperlipidemia Hypertension Intervention Lead Malignant Neoplasms Mediator of activation protein Obesity Outcome Overweight Patients Pediatrics Phase Physical activity Physicians Play Randomized Randomized Controlled Trials Research Risk Behaviors Role Self Efficacy Sleep Smoking Summary Reports Surveys Techniques Teenagers Testing Time United States United States National Institutes of Health Upper arm Visit Weight base design effectiveness measure expectation fast food improved innovation motivational enhancement therapy multidisciplinary nutrition pediatrician primary outcome public health relevance secondary outcome skills sweetened beverage theories tv watching

项目摘要

DESCRIPTION (provided by applicant): The rise in adolescent obesity contributes to diabetes, cardiovascular disease, and eventually will lead to adulthood obesity. Physicians counsel overweight adolescent patients about nutrition and physical activity; however, few theory-based, easily disseminable interventions have been tested to improve physician counseling. We propose a randomized, controlled trial to assess the efficacy of a staggered delivery intervention to improve physician communication. The proposed intervention should increase physician Motivational Interviewing (MI) communication (e.g., eliciting "change talk", exploring ambivalence, etc.) and increase counseling time via a Summary Report that details adolescent's risk behaviors that contribute to unhealthy weight (i.e., sweetened beverages, fast food, breakfast, physical activity, screen time, and sleep). Our multidisciplinary team plans to audio record 200 baseline adolescent patient-physician visits (50 pediatricians and family physicians practicing in the community; 4 visits each). Then, half of the physicians will be randomly assigned to receive a tailored CD-ROM that contains didactic information and audio clips from physicians' own baseline visits to demonstrate MI communication. We then will audio record a new set of 200 post CD-ROM visits for all physicians. Then all physicians will receive the Summary Report, and we will audio record a new set of 200 Post Summary Report visits. Our innovative design allows us to test the effects of the CD-ROM alone, Summary Report alone and the combination. The primary outcome is physician adherence to MI techniques. Secondary outcomes are physicians discussing the six health risk behaviors and adolescent changes in nutrition, physical activity, and weight three months after the visit. We hypothesize that, compared to physicians in the control arm, physicians in the intervention arm will provide more effective (MI adherent) nutrition and physical activity counseling. Results of this study will expand the field of patient- physician communication by testing a low intensity, self-directed communication intervention for physicians to improve counseling, which over time and multiple visits, will improve adolescent patients' nutrition and physical activity. PUBLIC HEALTH RELEVANCE: Adolescent obesity is at an all time high. Physicians can play a role in helping adolescents attain a healthy weight. This study will test an intervention to help physicians counsel adolescents about nutrition and physical activity more effectively. This intervention should improve physician communication, which then in turn, should improve adolescents9 nutrition and physical activity behaviors.

描述（由申请人提供）：青春期肥胖症的兴起会导致糖尿病，心血管疾病，并最终导致肥胖。医师律师律师超重的青少年患者关于营养和体育锻炼；但是，很少有基于理论的，很容易分发的干预措施经过测试以改善医师咨询。我们提出了一项随机，对照试验，以评估交错干预以改善医师沟通的功效。拟议的干预措施应增加医师的动机访谈（MI）沟通（例如，引起“变化谈话”，探索矛盾情绪等），并通过摘要报告增加咨询时间，详细介绍了青少年的风险行为，这些风险行为有助于不健康的体重（即甜食饮料，快餐，早餐，早餐，体育活动，筛查时间和睡眠）。我们的跨学科团队计划记录200个基线青少年的患者访问（50位儿科医生和家庭医生，在社区中执业；每次访问4次）。然后，一半的医生将被随机分配以接收量身定制的CD-ROM，其中包含医生自己基线访问的教学信息和音频剪辑，以证明MI通信。然后，我们将为所有医生记录一次新的200张CD-ROM访问。然后，所有医生都将收到摘要报告，我们将音频记录一组200个摘要报告访问。我们的创新设计使我们能够仅测试CD-ROM的效果，仅摘要报告和组合。主要结果是医师遵守MI技术。次要结果是医生讨论访问三个月后营养，体育锻炼和体重的六种健康风险行为以及青少年变化。我们假设，与控制部门的医生相比，干预部门的医生将提供更有效的（MI辅助）营养和体育锻炼咨询。这项研究的结果将扩大患者医师沟通的领域，通过测试低强度，自我指导的沟通干预措施，以改善咨询，随着时间的流逝和多次就诊，这将改善青少年患者的营养和体育锻炼。公共卫生相关性：青少年肥胖症一直很高。医师可以在帮助青少年达到健康体重方面发挥作用。这项研究将测试一项干预措施，以帮助医生更有效地咨询青少年关于营养和体育锻炼。这种干预措施应改善医师的沟通，然后再改善青少年9营养和体育锻炼行为。