Pona Ashleigh A, Dreyer Gillette Meredith L, Odar Stough Cathleen, Gerling Janelle K, Sweeney Brooke R
1 Department of Pediatrics, Center for Children's Healthy Lifestyles and Nutrition , Kansas City, MO.
2 Department of Psychology, University of Missouri-Kansas City , Kansas City, MO.
Child Obes. 2017 Dec;13(6):455-461. doi: 10.1089/chi.2016.0334. Epub 2017 Jul 18.
Youth with disabilities are at increased risk for obesity compared with their typically developing peers and face unique barriers to healthy lifestyles. A limited number of weight management programs have been specifically tailored to accommodate youth with disabilities, and outcomes research in this population is scarce. We investigated the effectiveness of a specialized multidisciplinary weight management program for children with disabilities.
Youth (N = 115) ages 2-18 years (mean age = 10.46) and their families receiving care in the Special Needs Weight Management Clinic (SNWMC) were followed over a period of 12 months. Child height and weight were measured by trained clinicians and used to calculate Body Mass Index z-scores (BMIz). A two-level multilevel model was estimated with repeated measurements of BMIz nested within patients.
Significant BMIz reductions of 0.02 per month were observed over the course of treatment when controlling for child age and baseline BMIz. A significant interaction between child age and time revealed that younger (vs. older) children exhibited greater decreases in BMIz over the course of treatment. Sex, ethnicity, disability diagnosis, and insurance moderated change in BMIz over the course of treatment.
Outcomes of the SNWMC revealed significant decreases in BMIz with <5 sessions on average over 12 months and indicated the increased efficacy of early intervention in youth with disabilities. Future research should continue to modify interventions for families with adolescent children with disabilities as well as investigate additional variables that may impact success in treatment.
与发育正常的同龄人相比,残疾青年肥胖风险更高,且在健康生活方式上面临独特障碍。专门为残疾青年量身定制的体重管理项目数量有限,针对这一人群的结果研究也很匮乏。我们调查了一项针对残疾儿童的专门多学科体重管理项目的效果。
对年龄在2至18岁(平均年龄 = 10.46岁)的青年(N = 115)及其在特殊需求体重管理诊所(SNWMC)接受治疗的家庭进行了为期12个月的跟踪。儿童的身高和体重由经过培训的临床医生测量,并用于计算体重指数z评分(BMIz)。采用两级多水平模型,对患者体内嵌套的BMIz重复测量值进行估计。
在控制儿童年龄和基线BMIz的情况下,治疗过程中每月BMIz显著降低0.02。儿童年龄与时间之间的显著交互作用表明,年龄较小(与年龄较大相比)的儿童在治疗过程中BMIz下降幅度更大。性别、种族、残疾诊断和保险在治疗过程中调节了BMIz的变化。
SNWMC的结果显示,在12个月内平均不到5次就诊的情况下,BMIz显著下降,表明对残疾青年进行早期干预的效果更佳。未来的研究应继续为有残疾青少年子女的家庭调整干预措施,并调查可能影响治疗成功的其他变量。