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基于家庭的体重控制计划对初级保健中小儿的疗效。

Efficacy of family-based weight control program for preschool children in primary care.

机构信息

Pediatric University at Buffalo, Buffalo, New York, USA.

出版信息

Pediatrics. 2012 Oct;130(4):660-6. doi: 10.1542/peds.2012-0701. Epub 2012 Sep 17.

Abstract

OBJECTIVE

To test the efficacy of an innovative family-based intervention for overweight preschool-aged children and overweight parents conducted in the primary care setting.

METHODS

Children with BMI ≥ 85th percentile and an overweight parent were randomized to intervention or information control (IC). Trained staff delivered dietary and physical/sedentary activities education to parents over 6 months (10 group meetings and 8 calls). Parents in the intervention received also behavioral modification. An intention-to-treat analysis was performed by using mixed analysis of variance models to test changes in child percent over BMI (%OBMI) and z-BMI and to explore potential moderators of group differences in treatment response.

RESULTS

Ninety-six of 105 randomized families started the program: 46 children (31 girls/15 boys) in the intervention and 50 (33 girls/17 boys) in the IC, with 33 and 39 mothers and 13 and 11 fathers in intervention and IC, respectively. Baseline characteristics did not differ between groups. Children in the intervention group had greater %OBMI and z-BMI decreases at 3 and 6 months compared with those assigned to IC (P < .0021). A greater BMI reduction over time was also observed in parents in the intervention compared with parents assigned to IC (P < .0001). Child %OBMI and parent BMI changes were correlated (r = .31; P = .003). Children with greater baseline %OBMI were more likely to have a greater %OBMI decrease over time (P = .02).

CONCLUSIONS

Concurrently targeting preschool-aged overweight youth and their overweight parents for behavioral weight control in a primary care setting reduced child %OBMI and parent BMI, with parent and child weight changes correlating.

摘要

目的

检验在初级保健环境中对超重学龄前儿童及其超重父母进行的创新家庭为基础的干预的效果。

方法

体重指数(BMI)≥第 85 百分位数且有超重父母的儿童被随机分配到干预组或信息对照组(IC)。经过培训的工作人员在 6 个月内为父母提供饮食和身体/久坐活动教育(10 次小组会议和 8 次电话)。干预组的父母还接受行为修正。采用混合方差分析模型进行意向治疗分析,以检验儿童 BMI 百分率(%OBMI)和 z-BMI 的变化,并探讨治疗反应组间差异的潜在调节因素。

结果

96 个 105 个随机家庭开始了该项目:干预组 46 个儿童(31 个女孩/15 个男孩)和 50 个 IC(33 个女孩/17 个男孩),干预组和 IC 组分别有 33 个和 39 个母亲和 13 个和 11 个父亲。两组基线特征无差异。与 IC 组相比,干预组儿童在 3 个月和 6 个月时 %OBMI 和 z-BMI 的下降更大(P<.0021)。干预组父母的 BMI 随时间的减少也大于 IC 组(P<.0001)。儿童的 %OBMI 和父母的 BMI 变化呈正相关(r =.31;P =.003)。基线时 %OBMI 较高的儿童随时间的变化更有可能有更大的 %OBMI 下降(P =.02)。

结论

在初级保健环境中同时针对超重学龄前儿童及其超重父母进行行为体重控制,可降低儿童的%OBMI 和父母的 BMI,父母和儿童的体重变化呈正相关。

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