Foster Byron A, Aquino Christian, Gil Mario, Flores Glenn, Hale Daniel
Division of Inpatient Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX, US.
Regional Academic Health Center Clinical Research Unit, University of Texas Health Science Center at San Antonio, Harlingen, TX, US.
Contemp Clin Trials. 2015 Nov;45(Pt B):164-169. doi: 10.1016/j.cct.2015.08.017. Epub 2015 Sep 4.
Few effective community-based interventions exist for early childhood obesity. Parent mentors have been successful as an intervention for other conditions, but have not been used in childhood obesity. We designed an intervention for early childhood obesity using parent mentors and a positive outlier approach to assess potential efficacy, feasibility, and acceptability.
This trial enrolled obese (≥ 95th BMI percentile for age and gender) 2-5-year-old children in a Head Start program and their parents, with allocation to either parent mentors trained in positively deviant behaviors regarding childhood obesity, or community health workers delivering health education on obesity-related behaviors. The primary outcome is body mass index z-score change at the six-month follow-up assessment. Secondary outcomes include feeding behaviors and practices, health-related quality of life, dietary intake, and participation levels.
We enrolled three parent mentors and 60 parent-child dyads. The population is 100% Hispanic; 44% of parents speak Spanish as their primary language and 45% were not high-school graduates. Children had a reported median vegetable and fruit intake of 0.3 and 1.1 cups per day, respectively, at baseline, and a median daily screen time of three hours. There was no intergroup difference in quality-of-life scores at baseline. Retention has been high, at 90% in three months.
In this randomized trial of the effects of parent mentors on early childhood obesity, parent-child dyads from an underserved, Hispanic population were successfully enrolled through a partnership with a Head Start organization, with a high retention rate.
针对幼儿肥胖症,几乎没有有效的社区干预措施。家长导师作为一种干预手段在其他疾病治疗中取得了成功,但尚未应用于儿童肥胖症的治疗。我们设计了一种针对幼儿肥胖症的干预措施,采用家长导师和积极异常值方法来评估其潜在疗效、可行性和可接受性。
本试验招募了参加“启智计划”项目的2至5岁肥胖儿童(BMI处于年龄和性别的第95百分位及以上)及其父母,将其分为两组,一组由接受过关于儿童肥胖症积极异常行为培训的家长导师指导,另一组由提供肥胖相关行为健康教育的社区卫生工作者指导。主要结局是六个月随访评估时的体重指数z评分变化。次要结局包括喂养行为和习惯、健康相关生活质量、饮食摄入量和参与水平。
我们招募了三名家长导师和60对亲子。研究对象全部为西班牙裔;44%的家长以西班牙语为主要语言,45%的家长未高中毕业。据报告,儿童在基线时蔬菜和水果的摄入量中位数分别为每天0.3杯和1.1杯,每天屏幕使用时间中位数为三小时。基线时两组的生活质量评分无差异。三个月时的保留率很高,为90%。
在这项关于家长导师对幼儿肥胖症影响的随机试验中,通过与“启智计划”组织合作,成功招募了来自服务不足的西班牙裔人群的亲子,保留率很高。