Kaiser Permanente Center for Health Research, Portland, OR 97227, USA.
Pediatrics. 2012 Mar;129(3):e611-20. doi: 10.1542/peds.2011-0863. Epub 2012 Feb 13.
Most clinic-based weight control treatments for youth have been designed for preadolescent children by using family-based care. However, as adolescents become more autonomous and less motivated by parental influence, this strategy may be less appropriate. This study evaluated a primary care-based, multicomponent lifestyle intervention specifically tailored for overweight adolescent females.
Adolescent girls (N = 208) 12 to 17 years of age (mean ± SD: 14.1 ± 1.4 years), with a mean ± SD BMI percentile of 97.09 ± 2.27, were assigned randomly to the intervention or usual care control group. The gender and developmentally tailored intervention included a focus on adoptable healthy lifestyle behaviors and was reinforced by ongoing feedback from the teen's primary care physician. Of those randomized, 195 (94%) completed the 6-month posttreatment assessment, and 173 (83%) completed the 12-month follow-up. The primary outcome was reduction in BMI z score.
The decrease in BMI z score over time was significantly greater for intervention participants compared with usual care participants (-0.15 in BMI z score among intervention participants compared with -0.08 among usual care participants; P = .012). The 2 groups did not differ in secondary metabolic or psychosocial outcomes. Compared with usual care, intervention participants reported less reduction in frequency of family meals and less fast-food intake.
A 5-month, medium-intensity, primary care-based, multicomponent behavioral intervention was associated with significant and sustained decreases in BMI z scores among obese adolescent girls compared with those receiving usual care.
大多数基于诊所的青少年体重控制治疗方法都是通过家庭护理为青春期前的儿童设计的。然而,随着青少年变得更加自主,受父母影响的动力减少,这种策略可能不太合适。本研究评估了一种专门针对超重青少年女性的基于初级保健的多成分生活方式干预。
12 至 17 岁(平均±SD:14.1±1.4 岁)、平均±SD BMI 百分位数为 97.09±2.27 的青少年女孩(N=208)被随机分配到干预组或常规护理对照组。性别和发展量身定制的干预措施包括关注可采用的健康生活方式行为,并通过青少年的初级保健医生提供持续反馈加以强化。在随机分组的人群中,有 195 人(94%)完成了 6 个月的治疗后评估,有 173 人(83%)完成了 12 个月的随访。主要结局是 BMI z 分数的降低。
与常规护理组相比,干预组的 BMI z 分数随时间的下降幅度显著更大(干预组 BMI z 分数下降 0.15,常规护理组下降 0.08;P=0.012)。两组在次要代谢或心理社会结局方面没有差异。与常规护理相比,干预组报告家庭用餐频率和快餐摄入量减少。
与接受常规护理相比,5 个月、中等强度、基于初级保健的多成分行为干预与肥胖青少年女性 BMI z 分数的显著和持续降低相关。