Steno Diabetes Center Copenhagen, Health Promotion Research, Niels Steensens Vej 8, 2820 Gentofte, Denmark; Lund University, Paradisgatan 2, 221 00 Lund, Sweden.
Steno Diabetes Center Copenhagen, Health Promotion Research, Niels Steensens Vej 8, 2820 Gentofte, Denmark.
Obes Res Clin Pract. 2017 Nov-Dec;11(6):627-639. doi: 10.1016/j.orcp.2017.08.001. Epub 2017 Aug 24.
Child and adolescent obesity trends are rising throughout the world, revealing treatment difficulties and a lack of consensus about treatment. The family system is broadly viewed as a potential setting for facilitation of behaviour change. Therefore, family-based interventions have come into focus. However, the use of theoretical frameworks to strengthen these interventions is rare and very uneven.
To conduct a qualitative meta-synthesis of family-based interventions for child and adolescent obesity to identify the theoretical frameworks applied, thus understanding how theory is used in practice. A literature review was conducted between January and March 2016. A total of 35 family-based interventions were selected for analysis.
Eleven interventions explicitly stated that theory guided the development and were classified as theory-inspired. The social cognitive, self-efficacy and Family Systems Theory appeared most frequently. The remaining 24 were classified as theory-related as theoretical elements of self-monitoring; stimulus control, reinforcement and modelling were used.
The designs of family-based interventions reveal numerous inconsistencies and a significant void between research results and health care practice. Based on the analysis, this article proposes three themes to be used as focus points when designing future interventions and when selecting theories for the development of solid, theory-based frameworks for application. The themes are: (1) age of target group, (2) intervention objective, and (3) self-efficacy and readiness for change.
儿童和青少年肥胖趋势在全球范围内不断上升，这表明治疗存在困难，并且缺乏对治疗的共识。家庭系统被广泛视为促进行为改变的潜在环境。因此，基于家庭的干预措施成为焦点。然而，很少有研究使用理论框架来加强这些干预措施，而且应用情况也参差不齐。
对儿童和青少年肥胖的基于家庭的干预措施进行定性荟萃分析，以确定所应用的理论框架，从而了解理论在实践中的应用方式。文献综述于 2016 年 1 月至 3 月进行。共选择了 35 项基于家庭的干预措施进行分析。
有 11 项干预措施明确表示理论指导了其发展，并被归类为受理论启发。社会认知、自我效能和家庭系统理论出现的频率最高。其余 24 项被归类为与理论相关，因为使用了自我监测、刺激控制、强化和模仿等理论要素。
基于家庭的干预措施的设计存在诸多不一致之处，研究结果与医疗保健实践之间存在显著差距。基于分析结果，本文提出了三个主题，作为未来干预措施设计以及为开发基于理论的坚实框架以应用于治疗时选择理论的重点。这些主题是：（1）目标人群的年龄；（2）干预目标；（3）自我效能和改变的准备。
