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一个多学科儿科肥胖治疗项目的挑战与成功

Challenges and successes of a multidisciplinary pediatric obesity treatment program.

作者信息

Walsh Stephanie M, Palmer Wendy, Welsh Jean A, Vos Miriam B

机构信息

Wellness Department, Children's Healthcare of Atlanta, Atlanta, Georgia Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.

Wellness Department, Children's Healthcare of Atlanta, Atlanta, Georgia.

出版信息

Nutr Clin Pract. 2014 Dec;29(6):780-5. doi: 10.1177/0884533614551839. Epub 2014 Oct 21.

Abstract

BACKGROUND

Despite the well-documented need for multidisciplinary pediatric obesity treatment programs, few programs exist and best practices are not clearly defined. We describe the design and initial quality-related outcomes of the Strong4Life multidisciplinary pediatric obesity treatment program along with some challenges and solutions implemented over the first 2 years. The purpose of this report is to inform others interested in designing similar programs.

PROGRAM DESCRIPTION

The Strong4Life Clinic obesity program was designed to provide children with the medical care, as well as the behavior change guidance and support needed to reverse their obesity and/or minimize the related health risks. This low-intensity program is designed to provide approximately 6 hours of care over 12 months from a medical provider, psychologist, registered dietitian nutritionist, exercise physiologist, and nurse.

RESULTS

Between August 2011 and February 2014, the Strong4Life clinic served 781 high-risk (mean sex- and age-adjusted body mass index [BMI] percentile 98.8) and racially/ethnically diverse (45% non-Hispanic black and 24% Hispanic) patients. Of the 781 patients seen, 66% returned for at least 1 visit. Nearly all returning Strong4Life patients stabilized or improved their BMI (90% of those who participated <6 months, 97% of those who participated 6 to <12 months, and 92% of those who participated ≥12 months).

CONCLUSIONS

This report describes a low-intensity multidisciplinary weight management program that is feasible. Initial assessment of the program suggests benefit in most patients who participate >6 months, but longer follow-up and assessment of comorbidities are needed.

摘要

背景

尽管多学科儿童肥胖治疗项目的必要性已有充分记录,但此类项目却很少,最佳实践方法也未明确界定。我们描述了“强4生活”多学科儿童肥胖治疗项目的设计、与质量相关的初始结果,以及头两年实施过程中遇到的一些挑战和解决方案。本报告旨在为有意设计类似项目的人提供信息。

项目描述

“强4生活”诊所肥胖项目旨在为儿童提供医疗护理,以及改变行为的指导和支持,以扭转其肥胖状况和/或降低相关健康风险。这个低强度项目旨在在12个月内为儿童提供约6小时的护理服务,护理人员包括医生、心理学家、注册营养师、运动生理学家和护士。

结果

2011年8月至2014年2月期间,“强4生活”诊所接待了781名高危(经性别和年龄调整后的平均体重指数百分位为98.8)且种族/民族多样化(45%为非西班牙裔黑人,24%为西班牙裔)的患者。在781名就诊患者中,66%的患者至少回访过一次。几乎所有回访的“强4生活”患者的体重指数都保持稳定或有所改善(参与治疗不到6个月的患者中有90%,参与治疗6至不到12个月的患者中有97%,参与治疗12个月及以上的患者中有92%)。

结论

本报告描述了一个可行的低强度多学科体重管理项目。对该项目的初步评估表明,大多数参与治疗超过6个月的患者都从中受益,但需要更长时间的随访和对合并症的评估。

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