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“青少年谈健康体重”:一部激励性数字视频光盘对青少年诊所中家长关于肥胖相关疾病知识的影响

"Teens Talk Healthy Weight": the impact of a motivational digital video disc on parental knowledge of obesity-related diseases in an adolescent clinic.

作者信息

Windham Meghan E, Hastings Elisabeth S, Anding Roberta, Hergenroeder Albert C, Escobar-Chaves Soledad Liliana, Wiemann Constance M

出版信息

J Acad Nutr Diet. 2014 Oct;114(10):1611-8. doi: 10.1016/j.jand.2014.04.014. Epub 2014 May 29.

Abstract

The purpose of the study was to investigate the impact of a 7-minute educational and motivational weight-management digital video disc (DVD) that uses real patient/parent testimonials and provider-patient interactions, on adolescent and parent knowledge of obesity-related diseases; readiness, motivation, and self-efficacy to lose weight; connectedness to care provider; and likelihood of return to clinic for follow-up care. A randomized controlled trial was conducted among 40 overweight/obese adolescent participants (22.5% male, 77.5% female, mean age=15.43 years) and their parents (n=38) who visited a referral-only adolescent clinic for the first time from October 2009 to March 2010. Adolescents were randomly assigned by a research assistant to standard care alone or standard care plus DVD. Standard care (protocol-driven medical and nutritional assessment and counseling) was provided to all adolescents by a registered dietitian nutritionist and physician or nurse practitioner. Adolescents in the intervention group also viewed the DVD. Adolescents and parents completed assessments pre- and post-clinic visit. Repeated measures analysis of covariance was used to evaluate group differences, while controlling for race/ethnicity and age. Parents who viewed the DVD experienced greater improvements in obesity-related disease knowledge than parents who did not view the DVD. Adolescents in both groups improved on measures of motivation to lose weight and dieting self-efficacy, based on pre and post-test questionnaires. A 7-minute educational and motivational DVD helped improve parent knowledge, but was not more powerful than standard care alone in changing other weight-related outcomes in this adolescent clinic. Because it led to increased parental knowledge, incorporating the DVD into clinical practice could also allow more time for health providers to focus on specific obesity-related treatment/education. Future research might examine whether the DVD has more utility in different settings, such as primary care.

摘要

本研究的目的是调查一段7分钟的教育性和激励性体重管理数字视频光盘(DVD)的影响,该光盘使用真实患者/家长的推荐以及医护人员与患者的互动,探究其对青少年及其家长关于肥胖相关疾病的知识、减肥的意愿、动机和自我效能感、与医护人员的联系以及返回诊所接受后续护理的可能性的影响。2009年10月至2010年3月期间,对首次前往一家仅接受转诊的青少年诊所的40名超重/肥胖青少年参与者(男性占22.5%,女性占77.5%,平均年龄 = 15.43岁)及其家长(n = 38)进行了一项随机对照试验。研究助理将青少年随机分配至仅接受标准护理组或标准护理加DVD组。由注册营养师、医生或执业护士向所有青少年提供标准护理(遵循方案驱动的医学和营养评估及咨询)。干预组的青少年还观看了DVD。青少年和家长在诊所就诊前后完成评估。采用重复测量协方差分析来评估组间差异,同时控制种族/民族和年龄因素。观看DVD的家长在肥胖相关疾病知识方面的改善程度高于未观看DVD的家长。根据前后测试问卷,两组青少年在减肥动机和节食自我效能感方面均有所改善。在这家青少年诊所,一段7分钟的教育性和激励性DVD有助于提高家长的知识水平,但在改变其他与体重相关的结果方面并不比单独的标准护理更有效。由于该DVD能增加家长的知识,将其纳入临床实践还可使医护人员有更多时间专注于特定的肥胖相关治疗/教育。未来的研究可以考察该DVD在不同环境(如初级保健)中是否具有更大的效用。

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