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动机性访谈对儿童肥胖治疗的影响:Obemat2.0 随机临床试验。

Impact of the motivational interviewing for childhood obesity treatment: The Obemat2.0 randomized clinical trial.

机构信息

Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, Tarragona, Spain.

Serra Hunter Fellow, Universitat Rovira i Virgili, Tarragona, Spain.

出版信息

Pediatr Obes. 2024 Jul;19(7):e13125. doi: 10.1111/ijpo.13125. Epub 2024 May 11.

Abstract

BACKGROUND AND OBJECTIVE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

Training primary care professionals on motivational interviewing supported by dietitians and educational materials, enhanced the efficacy of childhood obesity therapy.

摘要

背景与目的

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。

方法

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。

结果

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。

结论

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。

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