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一个有效的基于证据的儿科体重管理干预措施的调整
R T Bartee1, K A Heelan2, C A Golden3
1Department of Biology, University of Nebraska at Kearney, Kearney, NE, USA. barteet2@unk.edu.
概括
这项研究适应了为服务不足的社区提供儿科体重管理计划,通过社区-学术伙伴关系和代程序修改,成功地将儿童的BMI z分数在六个月内平均降低了0.31.
科学领域:
- 公共卫生 公共卫生
- 儿科 儿科 儿科
- 行为科学 行为科学
背景情况:
- 现有的儿童肥胖干预措施往往无法达到医疗服务不足的人群或适应缺乏全面跨学科团队的环境.
- 社区-学术伙伴关系对于在不同环境中开发和实施有效的儿科体重管理干预措施 (PWMI) 是至关重要的.
研究的目的:
- 将爱斯坦的交通灯饮食 (TLD) 调整为一个以社区为基础的,以证据为基础的PWMI,称为建设健康的家庭 (BHF).
- 评估适应BHF计划在降低6-12岁肥胖儿童BMIz分数方面的有效性.
- 用"扩展的调整和修改报告框架" (Framework for Reporting Adaptations and Modifications-Expanded,简称FRAME) 来记录和分类对干预措施进行的调整.
主要方法:
- 一个社区-学术伙伴关系反复地将TLD适应到BHF计划中,为九个家族队伍提供服务.
- 框架指导了计划的,由利益相关者驱动的适应的文件,包括添加基于家庭的方法,删除卡路里计数和取代体育活动指标.
- 该研究评估了12周BHF计划完成的儿童在6个月的随访后BMI z分数的变化.
主要成果:
- 在9个队列中,在84个启动家庭中,69个家庭完成了为期12周的BHF计划,其中45个参加了6个月的随访.
- 在6个月后,BHF计划导致儿童的BMIz分数显著降低0.31±0.17.
- 适应的有效性各不相同,BMI z分数的降低在队列4的0.41到队列5的0.13之间.
结论:
- 代适应改善了BHF计划与其特定的社区环境和参与者的适应性.
- 适应的BHF计划代表了一个持续的,社区的PWMI,它保持了基于证据的核心原则.
- 监测适应及其对结果的影响对于社区干预的长期可持续性和有效性至关重要.
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