Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, Tarragona, Spain.
Serra Hunter Fellow, Universitat Rovira i Virgili, Tarragona, Spain.
Pediatr Obes. 2024 Jul;19(7):e13125. doi: 10.1111/ijpo.13125. Epub 2024 May 11.
The aim was assessing a short training for healthcare providers on patient-focused counselling to treat childhood obesity in primary care, along with dietitian-led workshops and educational materials.
Randomized clustered trial conducted with paediatrician-nurse pairs (Basic Care Units [BCU]) in primary care centres from Tarragona (Spain). BCUs were randomized to intervention (MI) (motivational interview, dietitian-led education, and educational materials) or control group (SC, standard care). Participants were 8-14-year-old children with obesity, undergoing 1-11 monthly treatment visits during 1 year at primary care centres. The primary outcome was BMI z-score reduction.
The study included 44 clusters (23 MI). Out of 303 allocated children, 201 (n = 106 MI) completed baseline, final visits, and at least one treatment visit and were included in the analysis. BMI z-score reduction was -0.27 (±0.31) in SC, versus -0.36 (±0.35) in MI (p = 0.036). Mixed models with centres as random effects showed greater reductions in BMI in MI than SC; differences were B = -0.11 (95% CI: -0.20, -0.01, p = 0.025) for BMI z-score, and B = -2.06 (95% CI: -3.89, -0.23, p = 0.028) for BMI %. No severe adverse events related to the study were notified.
Training primary care professionals on motivational interviewing supported by dietitians and educational materials, enhanced the efficacy of childhood obesity therapy.
本研究旨在评估针对初级保健医护人员的以患者为中心的咨询培训,联合营养师主导的研讨会和教育材料,以治疗儿童肥胖。
在西班牙塔拉戈纳的初级保健中心,开展了一项儿科医生-护士配对(基础保健单位 [BCU])的随机聚类试验。BCU 被随机分为干预组(MI)(动机性访谈、营养师主导的教育和教育材料)或对照组(SC,标准护理)。参与者为 8-14 岁的肥胖儿童,在初级保健中心接受为期 1 年的 1-11 次每月治疗就诊。主要结局为 BMI z 评分降低。
该研究共纳入 44 个聚类(23 个 MI)。在 303 名分配的儿童中,有 201 名(n=106 MI)完成了基线、最终就诊和至少一次治疗就诊,并纳入分析。SC 组 BMI z 评分降低 0.27(±0.31),MI 组降低 0.36(±0.35)(p=0.036)。以中心为随机效应的混合模型显示,MI 组的 BMI 降低幅度大于 SC 组;差异为 BMI z 评分的 B 值=-0.11(95%CI:-0.20,-0.01,p=0.025),BMI%的 B 值=-2.06(95%CI:-3.89,-0.23,p=0.028)。未报告与研究相关的严重不良事件。
培训初级保健专业人员进行动机性访谈,并辅以营养师和教育材料,可增强儿童肥胖治疗的疗效。