Lemstra Mark, Rogers Marla
Alliance Wellness and Rehabilitation Inc., Moose Jaw, Saskatchewan, Canada.
The Canadian Hub for Applied and Social Research, University of Saskatchewan, Saskatoon, Canada.
Patient Prefer Adherence. 2020 Dec 1;14:2347-2355. doi: 10.2147/PPA.S284511. eCollection 2020.
The comprehensive and free Healthy Kids Initiative (HKI) was developed with key features including social support, family support, and cognitive behavior education in order to promote program completion and improve health outcomes among youth. The first objective was to determine program completion rates and independent risk indicators for non-completion. The second objective was to determine the 12-week impact of the Healthy Kids Initiative on aerobic fitness, depressed mood and health-related quality of life.
Obese youth (ages 10-17) were referred to a community-based, multidisciplinary, free program by their doctor or pediatrician. Each participant was requested to attend the program with a "buddy" and complete three social support contracts with family and friends to support their behavioral modifications. The program duration was 12 weeks with physical activity, dietary, and cognitive behavior education sessions. Those who completed the program, and those who did not, were compared across socioeconomic variables, age, gender, depressed mood and aerobic fitness.
Across five cohorts, 1789 of 1995 youth completed the program (89.7% completion rate). Five referred youth never started. Independent risk indicators associated with non-completion included older age (OR 3.07, 95% CI 2.26-4.17; p<0.001), mother with a non-professional occupation (OR 1.84, 95% CI 1.22-2.78; p=0.004), and living in a low-income neighborhood (OR 9.37, 95% CI 5.61-15.65; p<0.001). There were significant improvements from baseline for aerobic fitness (mCAFT score 35.84 to 55.72 mL × kg × min; p<0.001), depressed mood (mean CES-D 12 score 21.47 to 17.40; p<0.001), and health-related quality of life (mean SF-12 score 23.4 to 33.8; p<0.001).
The HKI program had high completion rates and early success in improving outcomes. Knowing the independent risk indicators for non-completion will allow for program revision to help at-risk participants complete the program.
全面且免费的“健康儿童倡议”（HKI）项目具有社会支持、家庭支持和认知行为教育等关键特征，旨在促进项目完成率并改善青少年的健康状况。首要目标是确定项目完成率以及未完成的独立风险指标。第二个目标是确定“健康儿童倡议”对有氧适能、抑郁情绪和健康相关生活质量的12周影响。
肥胖青少年（10 - 17岁）由其医生或儿科医生转介至一个基于社区的多学科免费项目。要求每位参与者与一名“伙伴”一同参加项目，并与家人和朋友签订三份社会支持合同，以支持他们的行为改变。项目为期12周，包括体育活动、饮食和认知行为教育课程。对完成项目的参与者和未完成项目的参与者在社会经济变量、年龄、性别、抑郁情绪和有氧适能方面进行比较。
在五个队列中，1995名青少年中有1789名完成了项目（完成率为89.7%）。有五名被转介的青少年从未开始。与未完成相关的独立风险指标包括年龄较大（比值比3.07，95%置信区间2.26 - 4.17；p<0.001）、母亲从事非专业职业（比值比1.84，95%置信区间1.22 - 2.78；p = 0.004）以及居住在低收入社区（比值比9.37，95%置信区间5.61 - 15.65；p<0.001）。有氧适能从基线水平有显著改善（改良儿童有氧适能测试分数从35.84提升至55.72 mL×kg×min；p<0.001），抑郁情绪（儿童抑郁量表12项平均得分从21.47降至17.40；p<0.001），以及健康相关生活质量（简短健康调查12项平均得分从23.4提升至33.8；p<0.001）。
“健康儿童倡议”项目完成率高，且在改善结果方面取得了早期成功。了解未完成的独立风险指标将有助于对项目进行修订，以帮助有风险的参与者完成项目。
