Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA.
Kinesiology and Sport Sciences Department, University of Nebraska at Kearney, Kearney, NE, USA.
Child Obes. 2022 Jul;18(5):324-332. doi: 10.1089/chi.2021.0160. Epub 2021 Nov 15.
Building Healthy Families (BHF) was developed through a community-academic partnership to provide a 12-week family-based obesity treatment program. Nine cohorts of BHF have been delivered in multiple micropolitan settings between 2009 and 2016, but participant outcomes have varied. This study sought to explore the variation in BHF outcomes to identify the necessary and sufficient conditions that are associated with larger 12-week reductions in BMI z-scores. A qualitative comparative analysis was used to determine potential causal conditions or combination of conditions associated with larger reductions in BMI z-score. Seventy-five participants with 12-week outcome data were rank ordered as the 10 most successful participants (largest reductions in BMI z-score; m ± std = -0.64 ± 0.18) and the 10 least successful participants (smallest reductions or an increase in BMI z-score; m ± std = 0.02 ± 0.04). The conditions selected for analysis were identified based on theory and the delivery team's experience with implementing BHF. Necessary conditions (, present in all highly successful participants, but also some less successful participants) included children with high attendance and self-regulation, at least one adult with high attendance and self-regulation, a mother who lost weight during the program and achieved clinically meaningful weight loss. Sufficient conditions (, present in only the highly successful participants) included mothers with self-regulation scores >45% (range 46.7%-98.2%), and children with a combination of high attendance (72%-100%) and self-regulation scores ≥45% (45%-92.7%). Program implementers should continue to focus on encouraging high attendance and emphasize the necessity of enacting self-regulation strategies at both the child and parent level.
健康家庭建设（BHF）是通过社区-学术合作开发的，旨在提供一个为期 12 周的基于家庭的肥胖治疗计划。自 2009 年至 2016 年，在多个中小城市环境中已经开展了 9 个 BHF 队列，但参与者的结果各不相同。本研究旨在探讨 BHF 结果的变化，以确定与 BMI z 分数 12 周降幅较大相关的必要和充分条件。采用定性比较分析来确定与 BMI z 分数较大降幅相关的潜在因果条件或条件组合。对具有 12 周结局数据的 75 名参与者进行了排序，将前 10 名最成功的参与者（BMI z 分数降幅最大；m ± std = -0.64 ± 0.18）和后 10 名最不成功的参与者（BMI z 分数降幅最小或增加）进行了排序（m ± std = 0.02 ± 0.04）。选择用于分析的条件是基于理论和实施 BHF 的交付团队的经验。必要条件（存在于所有高成功率的参与者中，但也存在一些低成功率的参与者）包括高出勤率和自我调节能力的儿童、至少一名高出勤率和自我调节能力的成人、在项目期间减肥并达到临床意义上体重减轻的母亲。充分条件（仅存在于高成功率的参与者中）包括自我调节得分>45%的母亲（范围 46.7%-98.2%），以及出勤率高（72%-100%）和自我调节得分≥45%（45%-92.7%）的儿童。项目实施者应继续专注于鼓励高出勤率，并强调在儿童和家长层面实施自我调节策略的必要性。
