Rhee Kyung E, Herrera Lourdes, Strong David, DeBenedetto Anthony M, Shi Yuyan, Boutelle Kerri N
University of California, San Diego, Department of Pediatrics, United States.
Wake Forrest University, Department of Pediatrics, United States.
Contemp Clin Trials Commun. 2021 Apr 20;22:100771. doi: 10.1016/j.conctc.2021.100771. eCollection 2021 Jun.
Currently one-third of children in the United States have overweight or obesity (OW/OB). The goal of Healthy People 2020 is to reduce the proportion of children with OW/OB and increase the proportion of primary care visits that include nutrition and weight-related counseling. Unfortunately, many health care providers find it difficult to offer effective weight-related counseling and treatment in the primary care setting. Therefore, new models of care are needed that allow a greater proportion of children with OW/OB and their parents to access care and receive quality weight management treatment. The current paper describes the GOT Doc study which is designed to test the effectiveness of a Guided Self-Help (GSH) model of obesity treatment that can be delivered in the primary care setting compared to a traditional Family-Based Behavioral weight loss treatment (FBT) delivered at an academic center. We will assess the impact of this program on attendance (access to care) and changes in child BMI percentile/z-score. We will also examine the impact of this treatment model on change in child lifestyle behaviors, parent support behaviors, and parent self-efficacy and empowerment to make behavior change. Finally, we will assess the cost-effectiveness of this model on changes in child BMI percentile/z-score. We believe the GSH intervention will be a cost-effective model of obesity management that can be implemented in community practices around the country, thereby increasing access to treatment for a broader proportion of our population and decreasing rates of childhood obesity.
目前,美国三分之一的儿童超重或肥胖。“健康人民2020”的目标是降低超重或肥胖儿童的比例,并增加包含营养和体重相关咨询的初级保健就诊比例。不幸的是,许多医疗保健提供者发现在初级保健环境中提供有效的体重相关咨询和治疗很困难。因此,需要新的护理模式,使更大比例的超重或肥胖儿童及其父母能够获得护理并接受高质量的体重管理治疗。本文描述了“GOT Doc研究”,该研究旨在测试一种可在初级保健环境中提供的引导式自助(GSH)肥胖治疗模式与在学术中心提供的传统家庭行为减肥治疗(FBT)相比的有效性。我们将评估该项目对就诊率(获得护理的情况)以及儿童BMI百分位数/ z分数变化的影响。我们还将研究这种治疗模式对儿童生活方式行为变化、家长支持行为以及家长自我效能和进行行为改变的能力的影响。最后,我们将评估该模式对儿童BMI百分位数/ z分数变化的成本效益。我们相信,GSH干预将是一种具有成本效益的肥胖管理模式,可以在全国的社区实践中实施,从而使更多人口能够获得治疗,并降低儿童肥胖率。