Exploring the Familial Reach of Adolescent Obesity Treatment

探索青少年肥胖治疗的家庭影响力

基本信息

批准号：
10589875
负责人：
Melanie K Bean
金额：
$ 21.05万
依托单位：
VIRGINIA COMMONWEALTH UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-03-10 至 2025-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10589875
关键词：
Adolescence Adolescent Adolescent obesity Adult Age Behavioral Black race Body Weight Changes Body Weight decreased Caregivers Child Child Rearing Clinical Data Development Diet Dietary intake Educational process of instructing Electronics Enrollment Environment Exercise Familial disease Family Family member Feeding behaviors Female Food Frequencies Future Guidelines Home Home environment Household Individual Intervention Measures Mediator Modeling Obesity Outcome Overweight Parents Participant Patient Self-Report Randomized Recommendation Research Siblings Weight Weight maintenance regimen arm clinically significant digital imaging experience feeding food environment group intervention improved improved outcome lifestyle intervention novel obesity treatment obesogenic primary endpoint programs randomized, clinical trials sex skills training social success therapy design treatment arm treatment group treatment response weight loss intervention weight maintenance

项目摘要

PROJECT SUMMARY Family-based lifestyle intervention (FBLI) is the gold standard for treating adolescent obesity, which emphasizes the importance of making family-wide changes to the shared home environment. Yet, program assessments overwhelmingly focus on the individual adolescent. Understanding the impact of FBLIs beyond the identified adolescent is important, given that obesity is a familial disease and there are likely bidirectional relations between an adolescent’s treatment success and broader changes in their household. It is unknown if family-wide changes are made within FBLI, or if non-targeted family members experience weight-related benefits. These data are critical, given that weight losses observed in adolescent obesity treatments are generally modest, with no clear guidance regarding the optimal family-based treatment approach during this distinct developmental period. Towards that end, we propose to leverage our ongoing randomized clinical trial (RCT) of TEENS+, a FBLI for adolescents with obesity, to determine: 1) if family-wide changes to the shared home environment are implemented, 2) if ripple effects to untreated family members are observed, and 3) whether these changes are predictive of adolescents’ weight management success. Via R01HD095910, we are evaluating two approaches to involving parents in FBLI to treat adolescent obesity. In this RCT, all adolescents participate in TEENS+, our 4m behavioral weight loss (BWL) treatment. Parents are randomized to either 1) parent skills training based on authoritative parenting (Parents as Coaches; PAC) or 2) concurrent parent BWL (Parent Weight Loss; PWL). TEENS+ was informed by our pilot (HD084930), which included 82 adolescent (M age=13.7±1.2yrs; 52% Black)/parent dyads. We demonstrated that both parent treatments yielded adolescent weight loss at the end of the 4m treatment. Further, improvements to the obesogenic home food environment were observed in both groups; yet a more comprehensive assessment of the shared home environment is needed to determine if broader family-wide changes, including weight changes of non-targeted family members, are executed, and if these changes predict adolescent weight loss. To that end, adolescent/parent dyads will be randomized to TEENS+PAC or TEENS+PWL via our ongoing R01 trial. This ancillary R21 will expand trial assessments and conduct a comprehensive assessment of the shared home feeding and weight environment of the target adolescents. Specifically, we will enroll non-targeted children (8- 17yrs) and caregivers living in the same household as the target parent/adolescent dyad (N=60 families; 30 per treatment group). At 0, 2, 4 (primary endpoint), and 8m, the target parent/adolescent dyad and non- targeted children (n=~80) and caregivers (n=~60), will complete anthropometric assessments. Measures of the shared home feeding and weight environment will also be conducted. Results will determine the familial reach of TEENS+ and reveal potential mediators of treatment response to target directly in future iterations of FBLI to optimize adolescent outcomes.

项目概要以家庭为基础的生活方式干预（FBLI）是治疗青少年肥胖的金标准，然而，该计划强调了在家庭范围内改变共享家庭环境的重要性。评估绝大多数侧重于了解 FBLI 的影响。鉴于肥胖是一种家族性疾病，并且可能存在双向性，因此确定的青少年很重要青少年的治疗成功与家庭中更广泛的变化之间的关系尚不清楚。在 FBLI 内进行全家庭范围的改变，或者如果非目标家庭成员出现体重相关问题鉴于青少年肥胖治疗中观察到的体重减轻情况，这些数据至关重要。总体上比较温和，在此期间没有关于最佳的基于家庭的治疗方法的明确指导为此，我们建议利用我们正在进行的随机临床试验。 TEENS+（一项针对肥胖青少年的 FBLI）的随机对照试验 (RCT)，旨在确定：1) 家庭范围内的共享实施家庭环境，2) 是否观察到对未经治疗的家庭成员产生连锁反应，以及 3) 通过 R01HD095910，我们研究这些变化是否可以预测青少年的体重管理成功。正在评估让父母参与 FBLI 治疗青少年肥胖的两种方法。青少年参加我们的 4m 行为减肥 (BWL) 治疗 TEENS+ 家长是随机的。 1) 基于权威育儿的家长技能培训（家长作为教练；PAC）或 2) 同时进行我们的飞行员 (HD084930) 通知了家长 BWL（家长减肥；PWL），其中包括 82 名家长。青少年（M 年龄 = 13.7±1.2 岁；52% 黑人）/父母二人组我们证明了父母双方的治疗。 4m 治疗结束后，青少年体重减轻了，并且改善了肥胖家庭。对两组的食物环境进行了观察；对共享家庭进行了更全面的评估；需要环境来确定是否会发生更广泛的家庭范围的变化，包括非目标人群的体重变化家庭成员被处决，如果这些变化预示着青少年体重减轻，通过我们正在进行的 R01 试验，青少年/家长二人组将被随机分配到 TEENS+PAC 或 TEENS+PWL。配套R21将扩大试验评估并对共享住宅进行全面评估具体来说，我们将招募非目标儿童（8-6岁）。 17 岁）以及与目标父母/青少年二人生活在同一家庭的看护者（N=60 个家庭；30 每个治疗组）在 0、2、4（主要终点）和 8m 时，目标父母/青少年二元组和非目标儿童 (n=~80) 和护理人员 (n=~60) 将完成人体测量评估。还将进行共享的家庭喂养和体重环境，结果将决定家庭范围。 TEENS+ 的研究，并在 FBLI 的未来迭代中直接揭示治疗反应对目标的潜在调节因素优化青少年结局。