TEEN JOIN: A Scalable Weight Control Intervention for Adolescents

TEEN JOIN：针对青少年的可扩展体重控制干预措施

• 批准号: 8755445
• 负责人: ELISSA JELALIAN
• 金额: $ 22.32万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8755445
• 关键词: Academic Medical Centers; Address; Adolescent; Adult; Advisory Committees; Age; Area; Behavior; Behavioral; Benchmarking; Beverages; Body Weight decreased; Child; Childhood; Clinical; Collaborations; Communities; Consumption; Controlled Clinical Trials; Data; Development; Diet; Dietary intake; Drops; Educational Curriculum; Effectiveness; Effectiveness of Interventions; Epidemic; Evaluation; Family; Food; Goals; Health; Health behavior change; Height; Intervention; Interview; Maintenance; Measures; Monitor; Nutrient; Obesity; Outcome; Overweight; Parents; Patient Triage; Physical activity; Pilot Projects; Policies; Prevalence; Preventive; Procedures; Public Health; Randomized; Recommendation; Research; School-Age Population; Self Concept; Self Efficacy; Series; Services; Site; Teenagers; Testing; United States; Weight; Weight maintenance regimen; Youth; base; cohesion; community setting; cost; cost effectiveness; dissemination trial; effective intervention; evidence base; improved; innovation; lifestyle intervention; meetings; obesity prevention; obesity treatment; parental involvement; programs; psychosocial; public health priorities; public health relevance; sedentary; tertiary care; theories; treatment trial

DESCRIPTION (provided by applicant): The prevalence of overweight/obesity among children and adolescents remains a public health priority. Interventions to treat children and adolescents currently struggling with excess weight are critical for prevention of obesity into adulthood. There is increasing evidence to support the efficacy of comprehensive lifestyle interventions for adolescents. Despite the emergence of such treatments, few adolescents benefit because these interventions are available primarily through carefully controlled clinical trials or delivered in specialized/tertiary clinical settings affiliated with academic medical centers. In 2010, the U.S. Preventive Services Task Force (USPSTF) provided a Grade recommendation B (i.e. the service is recommended with moderate/high certainty of benefit) for clinicians to screen children ages 6-17 years for obesity and refer identified youth to comprehensive behavioral programs. The challenge in meeting this objective is the lack of community-based obesity treatments to which to refer, particularly for adolescents. The JOIN program, developed as a collaboration between United HealthGroup and Y-USA is a pediatric weight control intervention targeted toward a broad age range of youth from 6-17 years that is: 1) based on well established and evidence based principles; 2) delivered by YMCA facilitators within a community setting: and 3) potentially scalable nationally. Findings from a 6-month pilot study examining the effectiveness of JOIN demonstrated impressive changes in weight status for school age children, but more modest results for adolescents. The goal of the proposed study is to modify the JOIN program to increase its effectiveness with adolescents while retaining its potential for scalability A tota of {120} adolescents (ages 13-17) with BMI > 85th% and < {50} will be randomly assigned to a 16-week enhanced JOIN program (TEEN JOIN), or the traditional JOIN intervention, followed by 6 monthly maintenance sessions. Evaluation of adolescent height, weight, group cohesion, objective physical activity, {dietary intake} and psychosocial outcomes will be obtained at baseline, 4 months, and 10 months. Additional outcomes will include treatment feasibility, including attendance, completion of diet and physical activity monitoring logs, and exit interviews with adolescents and parents regarding the intervention. We will also obtain preliminary indicators of cost effectiveness. It is hypothesized that adolescents who are randomized to TEEN JOIN will demonstrate greater decrease in BMI at 4 and 10 months than those randomized to JOIN. It is further hypothesized that adolescents randomized to TEEN JOIN will demonstrate greater increases in participation in moderate-vigorous physical activity and greater improvements in self-concept, self-efficacy related to physical activity, and group cohesion than adolescents who receive the standard JOIN condition. The next objective in this line of research is to conduct a large scale dissemination trial (R18) to evaluate the effectiveness of TEEN JOIN for adolescent weight control.

描述（由申请人提供）：儿童和青少年超重/肥胖的患病率仍然是公共卫生的优先事项。治疗目前过多体重挣扎的儿童和青少年的干预措施对于预防肥胖症到成年至关重要。越来越多的证据支持青少年的全面生活方式干预措施的功效。尽管出现了这种治疗方法，但很少有青少年受益，因为这些干预措施主要是通过精心控制的临床试验获得的，或者在隶属于学术医疗中心的专业/第三级临床环境中提供。 2010年，美国预防服务工作队（USPSTF）提供了一年级建议B（即建议对临床医生进行中等/高的福利确定性服务），以筛查肥胖症6-17岁的儿童，并将其引用的青少年引用到全面的行为计划。实现这一目标的挑战是缺乏基于社区的肥胖症治疗，特别是对于青少年。加入计划作为联合健康组与Y-USA之间的合作开发，是一项儿科体重控制干预措施，针对6 - 17年的年龄范围的年龄范围为：1）基于良好的基于​​证据的原则； 2）由基督教青年会在社区环境中提供的促进者：3）在全国范围内有可能可扩展。一项为期6个月的试点研究的发现，研究了加入的有效性，表现出了学龄儿童体重状况的令人印象深刻的变化，但青少年的结果更为适中。拟议的研究的目的是修改加入计划，以提高其与青少年的有效性，同时保留其{120}青少年（13-17岁）的潜力，而BMI> 85％> 85％和<{50}将被随机分配给16周的增强程序（青少年加入）或传统的联接介入，或者是传统的6个月，以下是6个月。评估青少年身高，体重，群体凝聚力，客观体育锻炼，{饮食摄入量}和社会心理结局将在基线，4个月和10个月时获得。其他结果将包括治疗可行性，包括出席，饮食和体育锻炼监测日志的完成以及与青少年和父母在干预方面的访谈。我们还将获得成本效益的初步指标。假设，与随机加入的青少年结合到青少年联接的青少年在4和10个月时表现出BMI的减少。进一步假设，随机分为青少年的青少年将表明参与中度剧烈的体育活动的增加和自我概念，与体育锻炼相关的自我效能感和群体凝聚力的进步要比接受标准结合条件的青少年的进步更大。这一研究中的下一个目标是进行大规模传播试验（R18），以评估青少年加入青少年体重控制的有效性。