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健康开端试验第二阶段研究:随访和成本效益分析。

Healthy Beginnings Trial Phase 2 study: follow-up and cost-effectiveness analysis.

机构信息

School of Public Health, Sydney Medical School, University of Sydney, 2006, Australia.

出版信息

Contemp Clin Trials. 2012 Mar;33(2):396-401. doi: 10.1016/j.cct.2011.11.008. Epub 2011 Nov 11.

Abstract

BACKGROUND

In 2007, we commenced the Healthy Beginnings Trial (HBT) Phase 1 study, which is the first randomised controlled trial (RCT) to test the effectiveness of an early childhood obesity intervention in children aged up to 2 years. The results were promising with significant improvements in infant feeding practices and a lower mean body mass index (BMI). The aims of this proposed Phase 2 study are to determine if the early intervention will lead to a lower mean BMI, lower screen time, improved dietary behaviours and demonstrated cost-effectiveness of the intervention, in children aged 3½ and 5 years.

METHODS/DESIGN: In Phase 1 of HBT 667 families participated in the RCT. No further intervention will be carried out in HBT Phase 2. In this study the intervention and control groups will be compared for children's outcomes at ages 3½ and 5 years. Primary outcome measures will be 1) BMI, 2) selected dietary measures using a validated survey tool, and 3) physical activity and screen time using a new generation of tri-axial accelerometers. Intention to treat principles will be used in the analysis. Multiple imputation will be used to impute outcomes for subjects lost to follow-up. A cost-effectiveness analysis (CEA) and cost-utility analysis for both HBT Phase 1 and 2 will also be conducted.

DISCUSSION

This is the first time that a home-based early intervention strategy has been implemented to prevent the development of childhood obesity and obesity-conducive behaviours. The results of this trial will ascertain whether early intervention during the first 2 years of life is effective and cost-effective in preventing childhood overweight and obesity at 3½ and 5 years old.

摘要

背景

2007 年,我们启动了健康开端试验(HBT)第一阶段研究,这是首个测试针对 2 岁以下儿童的儿童肥胖干预措施有效性的随机对照试验(RCT)。结果令人鼓舞,婴儿喂养方式有了显著改善,平均体重指数(BMI)有所降低。本研究旨在确定早期干预是否会降低儿童 3 岁半和 5 岁时的平均 BMI、减少屏幕时间、改善饮食行为,并证明干预措施具有成本效益。

方法/设计:在 HBT 第一阶段,有 667 个家庭参与了 RCT。HBT 第二阶段将不再进行进一步的干预。在这项研究中,干预组和对照组将在 3 岁半和 5 岁时对儿童的结果进行比较。主要结果测量将是:1)BMI;2)使用经过验证的调查工具评估的部分饮食指标;3)使用新一代三轴加速度计评估的身体活动和屏幕时间。分析将采用意向治疗原则。对于失访的受试者,将使用多重插补法对结果进行插补。还将对 HBT 第一阶段和第二阶段进行成本效益分析(CEA)和成本效用分析。

讨论

这是首次实施基于家庭的早期干预策略,以预防儿童肥胖和肥胖相关行为的发展。该试验的结果将确定生命最初 2 年的早期干预是否能有效且具有成本效益,从而预防 3 岁半和 5 岁时的儿童超重和肥胖。

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