儿科体重管理服务不同照护模式的可接受性、有效性及影响：一项同期混合方法研究的方案

The acceptability, effectiveness, and impact of different models of care for pediatric weight management services: protocol for a concurrent mixed-methods study.

作者信息

Cohen Jennifer, Alexander Shirley, Critekos Michelle, Garnett Sarah P, Hayes Alison J, Shaw Tim, Sim Kyra A, Baur Louise A

机构信息

Weight Management Services, The Children's Hospital at Westmead, Westmead, NSW, Australia.

Discipline of Pediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, NSW, Australia.

出版信息

BMC Health Serv Res. 2018 Jun 7;18(1):417. doi: 10.1186/s12913-018-3222-7.

DOI:10.1186/s12913-018-3222-7

PMID:29879963

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5992636/

Abstract

BACKGROUND

Pediatric obesity is a serious, but clinically neglected, chronic health problem. Despite the high prevalence, excess weight problems are rarely managed when children attend clinical services. It is recommended that obesity treatment uses a "chronic-care" approach to management, with different types and intensity of treatment dependent upon severity of obesity. There are several new secondary and tertiary weight management services being implemented within New South Wales (NSW), Australia in 2017/2018 with differing models of care. This study will ascertain what factors affect acceptability, reach, and participation, as well as measure the clinical effectiveness of these services.

METHODS

This is a acceptability and effectiveness study building upon existing and planned secondary and tertiary level service delivery in several health districts. This study will recruit participants from seven different pediatric weight management services (PWMS) across five Local Health Districts in NSW, Australia. Using a mixed-methods approach we will document a range of process, impact and clinical outcome measures in order to better understand the context and the effectiveness of each PWMS model. The project development and implementation is guided by the Theoretical Domains Framework. Participants will include parents of children less than 18 years of age attending PWMS, clinicians working as part of PWMS and health service managers. Data will be captured using a combination of anthropometric measures, questionnaires, one-on-one semi-structured interviews and focus groups.

DISCUSSION

Results from this study will assess the acceptability and effectiveness of different models of care for pediatric weight management. Such information is required to inform long-term sustainability and scalability of secondary and tertiary care services to the large number of families with children above a healthy weight.

摘要

背景

儿童肥胖是一个严重但在临床上被忽视的慢性健康问题。尽管患病率很高，但儿童在接受临床服务时，超重问题很少得到处理。建议肥胖治疗采用“慢性病护理”方法进行管理，治疗的类型和强度因肥胖严重程度而异。2017/2018年，澳大利亚新南威尔士州（NSW）正在实施几种新的二级和三级体重管理服务，其护理模式各不相同。本研究将确定哪些因素会影响可接受性、覆盖范围和参与度，并衡量这些服务的临床效果。

方法

这是一项基于几个健康区现有和计划中的二级及三级服务提供情况的可接受性和有效性研究。本研究将从澳大利亚新南威尔士州五个地方卫生区的七个不同的儿科体重管理服务（PWMS）中招募参与者。我们将采用混合方法记录一系列过程、影响和临床结果指标，以便更好地了解每个PWMS模式的背景和有效性。项目的开发和实施以理论领域框架为指导。参与者将包括参加PWMS的18岁以下儿童的家长、作为PWMS一部分工作的临床医生和卫生服务管理人员。数据将通过人体测量、问卷调查、一对一的半结构化访谈和焦点小组相结合的方式收集。