Saelens Brian E, Rowland Maya G, Scholz Kelley, Wright Davene R, Ayala Guadalupe X, Simoni Jane M
Center for Child Health Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA.
Department of Pediatrics, University of Washington, Seattle, Washington, USA.
Obesity (Silver Spring). 2025 Mar;33(3):548-559. doi: 10.1002/oby.24220. Epub 2025 Feb 13.
This trial examined the noninferiority of family-based behavioral pediatric weight management treatment (FBT) delivered by peers relative to professionals.
Children (n = 127) aged 7 to 11 years with BMI > 85th percentile for age and sex and at least one parent with BMI > 25 kg/m were randomly assigned to receive FBT delivered by parents who had previously received FBT from professionals. Child and parent anthropometrics and child quality of life were measured prior to FBT, at treatment end, and at 12-month follow-up. Treatment fidelity, adherence, and costs were examined by delivery mode.
Peer FBT delivery was noninferior to professional FBT delivery (margin of 0.072 in child BMI z score change) at treatment end and at 12-month follow-up; however, superiority testing suggested that professional FBT delivery resulted in better child BMI z score change. No differential changes were observed in child quality of life or parental BMI by FBT delivery mode. Peer-delivered FBT was well received, with peers providing personal examples of behavior change success but less skills-focused content. Peer FBT delivery was about one-quarter the cost of professional FBT delivery.
This study informs new strategies for sustaining the delivery of pediatric obesity interventions by involving trained parents.
本试验检验了由同伴提供的家庭行为儿科体重管理治疗（FBT）相对于专业人员提供的FBT的非劣效性。
将年龄在7至11岁、BMI高于年龄和性别的第85百分位数且至少有一位父母BMI>25kg/m²的儿童（n = 127）随机分配，接受由之前从专业人员处接受过FBT的父母提供的FBT。在FBT之前、治疗结束时和12个月随访时测量儿童和父母的人体测量学指标以及儿童的生活质量。通过提供方式检查治疗保真度、依从性和成本。
在治疗结束时和12个月随访时，同伴提供FBT不劣于专业人员提供FBT（儿童BMI z评分变化的边际值为0.072）；然而，优效性检验表明专业人员提供FBT导致更好的儿童BMI z评分变化。通过FBT提供方式未观察到儿童生活质量或父母BMI的差异变化。同伴提供的FBT受到好评，同伴提供了行为改变成功的个人实例，但以技能为重点的内容较少。同伴提供FBT的成本约为专业人员提供FBT成本的四分之一。
本研究为通过让受过培训的父母参与来维持儿科肥胖干预措施的提供提供了新策略。
