Melnyk Bernadette Mazurek, Small Leigh, Morrison-Beedy Dianne, Strasser Anne, Spath Lisa, Kreipe Richard, Crean Hugh, Jacobson Diana, Kelly Stephanie, O'Haver Judith
Arizona State University College of Nursing & Healthcare Innovation, 500 N 3rd St, Phoenix, AZ 85004, USA.
J Pediatr Health Care. 2007 Sep-Oct;21(5):315-22. doi: 10.1016/j.pedhc.2007.02.009.
There has been a paucity of theory-based interventions to improve health outcomes in overweight adolescents. Therefore, two intervention studies were conducted to: (a) determine the feasibility of implementing the Creating Opportunities for Personal Empowerment (COPE) Healthy Lifestyles Thinking, Emotions, Exercise, and Nutrition (TEEN) program with overweight adolescents; (b) obtain feedback that could be used to refine the program; and (c) examine the preliminary efficacy of the COPE program on the adolescents' weight and body mass index (BMI).
Phase I and Phase II clinical trials were conducted with 23 overweight teens. The Phase 1 trial used a pre-experimental design with one group of 11 urban adolescents. The Phase 2 trial was conducted with 12 suburban teens using a randomized controlled pilot study. COPE teens received a 15-session cognitive-behavioral skills building program that included physical activity, while the control group received an attention control program. Weight change and BMI were the key outcomes.
COPE teens experienced a significantly greater reduction in weight and BMI than did teens in the control group, who gained weight over time. Although the COPE program was well received by all of the teens, retention of subjects across time and parent involvement in the program were challenges in the urban high school.
These studies provide preliminary data to indicate that the implementation of COPE is feasible and may lead to a reduction in weight and BMI in overweight teens. Implementing COPE within the context of the school day may be more successful in sustaining adolescent involvement in the program versus using an after-school format.
基于理论的干预措施在改善超重青少年健康状况方面一直较为匮乏。因此,开展了两项干预研究,目的是:(a) 确定对超重青少年实施“创造个人赋权机会(COPE)健康生活方式:思维、情感、运动和营养(TEEN)”项目的可行性;(b) 获取可用于完善该项目的反馈意见;(c) 检验COPE项目对青少年体重和体重指数(BMI)的初步疗效。
对23名超重青少年进行了I期和II期临床试验。I期试验采用单组11名城市青少年的预实验设计。II期试验对12名郊区青少年采用随机对照试验研究。参与COPE项目的青少年接受了一个为期15节的认知行为技能培养项目,其中包括体育活动,而对照组接受的是注意力控制项目。体重变化和BMI是关键结果。
与随着时间推移体重增加的对照组青少年相比,参与COPE项目的青少年体重和BMI显著下降。尽管COPE项目受到了所有青少年的好评,但在城市高中,随着时间推移受试者的留存率以及家长对该项目的参与度仍是挑战。
这些研究提供了初步数据,表明实施COPE项目是可行的,可能会使超重青少年的体重和BMI降低。与采用课外形式相比,在学校日常教学中实施COPE项目可能更有利于维持青少年对该项目的参与度。