Warschburger Petra, Kroeller Katja, Haerting Johannes, Unverzagt Susanne, van Egmond-Fröhlich Andreas
Department of Counselling Psychology, University of Potsdam, Potsdam, Germany.
Department of Counselling Psychology, University of Potsdam, Potsdam, Germany.
Appetite. 2016 Aug 1;103:148-156. doi: 10.1016/j.appet.2016.04.007. Epub 2016 Apr 10.
Although inpatient lifestyle treatment for obese children and adolescents can be highly effective in the short term, long-term results are unconvincing. One possible explanation might be that the treatment takes place far from parents' homes, limiting the possibility to incorporate the parents, who play a major role in establishing and maintaining a healthy lifestyle in childhood and adolescence. The main goal was to develop a brief behaviorally oriented parent training program that enhances 'obesity-specific' parenting skills in order to prevent relapse. We hypothesized that the inclusion of additional parent training would lead to an improved long-term weight course of obese children. Parents of obese children (n = 686; 7-13 years old) either participated in complementary cognitive-behavioral group sessions (n = 336) or received written information only (n = 350) during the inpatient stay. Children of both groups attended multidisciplinary inpatient rehabilitation. BMI-SDS as a primary outcome was evaluated at baseline, post-intervention and at 6- and 12-month follow-up. Intention-to-treat (ITT) as well as per-protocol analyses (PPA) were performed. A significant within-group decrease of 0.24 (95% CI 0.18 to 0.30) BMI-SDS points from the beginning of the inpatient stay through the first year was found, but no group difference at the one-year follow-up (mean difference 0.02; 95% CI -0.04 to 0.07). We also observed an increase in quality of life scores, intake of healthy food and exercise for both groups, without differences between groups (ITT and PPA). Thus, while the inpatient treatment proved highly effective, additional parent training did not lead to better results in long-term weight maintenance or to better psychosocial well-being compared to written psycho-educational material. Further research should focus on subgroups to answer the question of differential treatment effects.
尽管针对肥胖儿童和青少年的住院生活方式治疗在短期内可能非常有效，但长期效果却难以令人信服。一种可能的解释是，治疗是在远离父母家的地方进行的，这限制了让父母参与进来的可能性，而父母在儿童和青少年时期建立和维持健康生活方式方面起着主要作用。主要目标是制定一个简短的以行为为导向的家长培训项目，以提高“针对肥胖问题”的育儿技能，从而预防复发。我们假设增加家长培训将改善肥胖儿童的长期体重变化趋势。肥胖儿童（n = 686；7 - 13岁）的父母在住院期间，要么参加补充性认知行为小组课程（n = 336），要么只收到书面信息（n = 350）。两组儿童都参加了多学科住院康复治疗。在基线、干预后以及6个月和12个月随访时评估作为主要结局的BMI-SDS。进行了意向性分析（ITT）以及符合方案分析（PPA）。发现从住院开始到第一年末，两组内BMI-SDS得分均显著下降0.24（95%CI 0.18至0.30），但在一年随访时两组之间没有差异（平均差异0.02；95%CI -0.04至0.07）。我们还观察到两组的生活质量得分、健康食品摄入量和运动量都有所增加，组间没有差异（ITT和PPA）。因此，虽然住院治疗证明非常有效，但与书面心理教育材料相比，额外的家长培训在长期体重维持方面并没有带来更好的结果，也没有带来更好的心理社会幸福感。进一步的研究应聚焦于亚组，以回答差异治疗效果的问题。
