Prado Guillermo, Fernandez Alejandra, St George Sara M, Lee Tae K, Lebron Cynthia, Tapia Maria I, Velazquez Maria Rosa, Messiah Sarah E
School of Nursing and Health Studies, University of Miami, Coral Gables, Florida.
School of Nursing and Health Studies, University of Miami, Coral Gables, Florida.
Am J Prev Med. 2020 Nov;59(5):658-668. doi: 10.1016/j.amepre.2020.06.010. Epub 2020 Oct 1.
Hispanic adolescents in the U.S. are disproportionately affected by overweight and obesity compared with their White, non-Hispanic counterparts. This study examines the efficacy of an evidence-based family intervention adapted to target obesity-related outcomes among Hispanic adolescents who were overweight/obese compared with prevention as usual.
This study was an RCT.
SETTING/PARTICIPANTS: Participants were Hispanic adolescents who were overweight/obese (n=280, mean age=13.01 [SD=0.82] years) in the 7th/8th grade and their primary caregivers. Primary caregivers were majority female legal guardians (88% female, mean age=41.88 [SD=6.50] years).
Participants were randomized into the family-level obesity-targeted intervention or referral to community services offered for overweight/obese adolescents and families (condition). Data collection began in 2015.
Primary outcomes included dietary intake (e.g., reduction of sweetened beverages) and past-month moderate-to-vigorous physical activity. Secondary outcomes were BMI and family functioning assessed among adolescents and primary caregivers.
Study analyses (2019) indicated no significant intervention effects for adolescents' primary outcomes. Intervention effects were found for parents' intake of fresh fruits and vegetables (β=0.12, 95% CI=0.02, 0.23), added sugar (β= -0.11, 95% CI= -0.22, -0.004), and sweetened beverages (β= -0.12, 95% CI=-0.23, -0.02), and parents showed decreased BMI (β= -0.05, 95% CI= -0.11, -0.01) at 6 months after baseline compared with usual prevention. Intervention effects were found for adolescent family communication (β=0.13, 95% CI=0.02, 0.24), peer monitoring (β=0.12, 95% CI=0.01, 0.23), and parental involvement (β=0.16, 95% CI=0.06, 0.26) at 6 months after baseline compared with prevention as usual.
This intervention was not effective in improving overweight/obesity-related outcomes in adolescents. The intervention was effective in improving parents' dietary intake and BMI; however, the effects were not sustained in the long term. Other intervention strategies (e.g., booster sessions, increased nutritional information) may be necessary to sustain beneficial effects and extend effects to adolescent participants.
This study is registered at www.clinicaltrials.gov NCT03943628.
与非西班牙裔白人青少年相比，美国的西班牙裔青少年受超重和肥胖问题的影响更为严重。本研究探讨了一种基于证据的家庭干预措施针对超重/肥胖的西班牙裔青少年肥胖相关结局的效果，并与常规预防措施进行比较。
本研究为随机对照试验。
研究地点/参与者：参与者为七/八年级超重/肥胖的西班牙裔青少年（n = 280，平均年龄 = 13.01 [标准差 = 0.82]岁）及其主要照顾者。主要照顾者大多为女性法定监护人（88%为女性，平均年龄 = 41.88 [标准差 = 6.50]岁）。
参与者被随机分为家庭层面的肥胖针对性干预组或转介至为超重/肥胖青少年及家庭提供的社区服务组（对照组）。数据收集于2015年开始。
主要结局包括饮食摄入（如减少含糖饮料）和过去一个月的中度至剧烈身体活动。次要结局为青少年和主要照顾者的体重指数（BMI）及家庭功能评估。
研究分析（2019年）表明，该干预措施对青少年的主要结局无显著干预效果。在父母的新鲜水果和蔬菜摄入量（β = 0.12，95%置信区间 = 0.02，0.23）、添加糖摄入量（β = -0.11，95%置信区间 = -0.22，-0.004）和含糖饮料摄入量（β = -0.12，95%置信区间 = -0.23，-0.02）方面发现了干预效果，与常规预防措施相比，基线后6个月父母的BMI有所下降（β = -0.05，95%置信区间 = -0.11，-0.01）。与常规预防措施相比，在基线后6个月发现该干预措施对青少年的家庭沟通（β = 0.13，95%置信区间 = 0.02，0.24）、同伴监督（β = 0.12，95%置信区间 = 0.01，0.23）和父母参与度（β = 0.16，95%置信区间 = 0.06，0.26）有干预效果。
该干预措施在改善青少年超重/肥胖相关结局方面无效。该干预措施在改善父母的饮食摄入和BMI方面有效；然而，长期效果未得到维持。可能需要其他干预策略（如强化课程、增加营养信息）来维持有益效果并将效果扩展至青少年参与者。
