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基于营地的家庭肥胖治疗后的健康相关生活质量:一项随机对照试验。

Health-related quality of life after camp-based family obesity treatment: an RCT.

作者信息

Benestad Beate, Karlsen Tor-Ivar, Småstuen Milada Cvancarova, Lekhal Samira, Hertel Jens Kristoffer, Steinsbekk Silje, Kolotkin Ronette L, Ødegård Rønnaug Astri, Hjelmesæth Jøran

机构信息

Department of Medicine, Vestfold Hospital Trust, The Morbid Obesity Centre (MOC), Tønsberg, Norway.

Faculty of Medicine, University of Oslo, Oslo, Norway.

出版信息

BMJ Paediatr Open. 2019 Apr 3;3(1):e000413. doi: 10.1136/bmjpo-2018-000413. eCollection 2019.

Abstract

OBJECTIVE

To compare the effects of a 2-year camp-based immersion family treatment for obesity with an outpatient family-based treatment for obesity on health-related quality of life (HRQoL) in two generations.

DESIGN

Randomised controlled trial.

SETTING

Rehabilitation clinic, tertiary care hospital and primary care.

PATIENTS

Families with at least one child (7-12 years) and one parent, both with obesity.

INTERVENTIONS

Summer camp for 2 weeks, with four repetition weekends, or lifestyle school, including four outpatient days over 4 weeks. Behavioural techniques to promote a healthier lifestyle.

MAIN OUTCOME MEASURES

Children's and parents' HRQoL were assessed using generic and obesity-specific measures. Outcomes were analysed using linear mixed models according to intention to treat, and multiple imputations were used for missing data.

RESULTS

Ninety children (50% girls) with a mean (SD) age of 9.7 (1.2) years and body mass index 28.7 (3.9) kg/m were included in the analyses. Summer camp children had an estimated mean (95% CI) of 5.3 (0.4 to 10.1) points greater improvement in adiposity-specific HRQoL score at 2 years compared with the lifestyle school children, and this improvement was even larger in the parent proxy-report, where mean difference was 7.3 (95% CI 2.3 to 12.2). Corresponding effect sizes were 0.33 and 0.44. Generic HRQoL questionnaires revealed no significant differences between treatment groups in either children or parents from baseline to 2 years.

CONCLUSIONS

A 2-year family camp-based immersion obesity treatment programme had significantly larger effects on obesity-specific HRQoL in children's self-report and parent proxy-reports in children with obesity compared with an outpatient family-based treatment programme.

TRIAL REGISTRATION NUMBER

NCT01110096.

摘要

目的

比较为期2年的以营地为基础的肥胖症沉浸式家庭治疗与门诊家庭肥胖症治疗对两代人健康相关生活质量(HRQoL)的影响。

设计

随机对照试验。

地点

康复诊所、三级护理医院和初级保健机构。

患者

至少有一个孩子(7 - 12岁)和一位父母均患有肥胖症的家庭。

干预措施

为期2周的夏令营,包括四个重复周末,或生活方式学校,包括4周内的四个门诊日。采用行为技术促进更健康的生活方式。

主要观察指标

使用通用和肥胖症特异性测量方法评估儿童和父母的HRQoL。根据意向性分析使用线性混合模型分析结果,并对缺失数据进行多次插补。

结果

分析纳入了90名儿童(50%为女孩),平均(标准差)年龄为9.7(1.2)岁,体重指数为28.7(3.9)kg/m。与生活方式学校的儿童相比,夏令营儿童在2年时肥胖症特异性HRQoL评分的估计平均(95%CI)改善高5.3(0.4至10.1)分,在父母代理报告中这种改善更大,平均差异为7.3(95%CI 2.3至12.2)。相应的效应大小为0.33和0.44。通用HRQoL问卷显示,从基线到2年,治疗组在儿童或父母中均无显著差异。

结论

与门诊家庭肥胖症治疗方案相比,为期2年的以家庭营地为基础的肥胖症沉浸式治疗方案对肥胖儿童的儿童自我报告和父母代理报告中的肥胖症特异性HRQoL有显著更大的影响。

试验注册号

NCT01110096。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c43/6542445/899627709918/bmjpo-2018-000413f01.jpg

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