针对肥胖学龄前儿童的家长治疗方案:一项随机对照试验。

A Parent Treatment Program for Preschoolers With Obesity: A Randomized Controlled Trial.

机构信息

Division of Pediatrics, Department of Clinical Science, Intervention, and Technology,

Oregon Social Learning Center, Eugene, Oregon.

出版信息

Pediatrics. 2019 Aug;144(2). doi: 10.1542/peds.2018-3457. Epub 2019 Jul 12.

Abstract

BACKGROUND AND OBJECTIVES

Early obesity treatment seems to be the most effective, but few treatments exist. In this study, we examine the effectiveness of a parent-only treatment program with and without booster sessions (Booster or No Booster) focusing on parenting practices and standard treatment (ST).

METHODS

Families of children 4 to 6 years of age with obesity were recruited from 68 child care centers in Stockholm County and randomly assigned to a parent-only program (10 weeks) with or without boosters (9 months) or to ST. Treatment effects on primary outcomes (BMI score) and secondary outcomes (BMI and waist circumference) during a 12-month period were examined with linear mixed models. The influence of sociodemographic factors was examined by 3-way interactions. The clinically significant change in BMI score (-0.5) was assessed with risk ratios.

RESULTS

A total of 174 children (mean age: 5.3 years [SD = 0.8]; BMI score: 3.0 [SD = 0.6], 56% girls) and their parents (60% foreign background; 39% university degree) were included in the analysis (Booster, = 44; No Booster, = 43; ST, = 87). After 12 months, children in the parent-only treatment had a greater reduction in their BMI score (0.30; 95% confidence interval [CI]: -0.45 to -0.15) compared with ST (0.07; 95% CI: -0.19 to 0.05). Comparing all 3 groups, improvements in weight status were only seen for the Booster group (-0.54; 95% CI: -0.77 to -0.30). The Booster group was 4.8 times (95% CI: 2.4 to 9.6) more likely to reach a clinically significant reduction of ≥0.5 of the BMI score compared with ST.

CONCLUSION

A parent-only treatment with boosters outperformed standard care for obesity in preschoolers.

摘要

背景与目的

早期肥胖治疗似乎最为有效,但目前治疗方法有限。本研究旨在评估仅针对家长的治疗方案(含或不含强化课程)在改善儿童肥胖方面的效果,该方案聚焦于养育实践和标准治疗(ST)。

方法

从斯德哥尔摩县的 68 家儿童保育中心招募 4 至 6 岁肥胖儿童的家庭,并将其随机分为仅接受家长参与的治疗方案(10 周)、含或不含强化课程(9 个月)的方案,以及标准治疗组。采用线性混合模型评估治疗 12 个月期间主要结局(BMI 得分)和次要结局(BMI 和腰围)的变化。通过三因素交互作用检验社会人口学因素的影响。采用风险比评估 BMI 得分变化 0.5 的临床显著变化。

结果

共纳入 174 名儿童(平均年龄:5.3 岁[标准差=0.8];BMI 得分:3.0[标准差=0.6],女孩占 56%)及其家长(60%有外国背景;39%有大学学历)参与分析(强化组=44 例,非强化组=43 例,标准治疗组=87 例)。12 个月后,仅接受家长参与的治疗组儿童 BMI 得分降低更为显著(0.30;95%置信区间[CI]:-0.45 至 -0.15),而标准治疗组仅降低 0.07(95% CI:-0.19 至 0.05)。与所有 3 组相比,仅强化组儿童的体重状况得到改善(-0.54;95% CI:-0.77 至 -0.30)。与标准治疗相比,强化组达到 BMI 得分降低≥0.5 的临床显著改善的可能性高 4.8 倍(95% CI:2.4 至 9.6)。

结论

针对家长的治疗方案辅以强化课程在学龄前儿童肥胖症的治疗中优于标准治疗。

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