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一个基于小儿初级保健实践的肥胖干预措施来支持家庭:一个集群随机临床试验
Lori Pbert1, Sue Druker1, Sybil Crawford2
1Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
电话辅导和邮寄的工作簿适度地改善了儿童的BMI百分比. 在20.8%的参与者中,电话辅导导致了临床显著的BMIz得分改善,这表明它对儿科体重管理的潜力.
科学领域:
- 儿科初级护理专业的儿童初级护理
- 预防肥胖 预防肥胖
- 公共卫生干预措施 公共卫生干预措施
背景情况:
- 儿童肥胖症是一个日益关注的问题,在初级保健机构的提供者时间和治疗机会有限.
- 美国儿科学会建议改变生活方式以改善儿童的体重指数 (BMI).
- 需要有效的,可扩展的干预措施来支持家庭在初级保健中管理儿科BMI.
研究的目的:
- 为了比较两种基于儿科实践的转诊干预措施降低儿童BMI的有效性.
- 为了评估电话辅导与邮寄工作簿干预,用于儿科体重管理.
- 评估这些干预措施对8-12岁儿童的BMI百分位数和z分数的影响.
主要方法:
- 一个集群随机临床试验,涉及20个儿科初级保健实践.
- 随机选择电话辅导 (Fitline辅导) 或邮寄的工作簿 (Fitline工作簿).
- 对501名儿童 (8-12岁) 的评估,BMI在基线,6个月和12个月时等于或超过第85个百分位.
主要成果:
- 这两项干预都显示了BMI百分位数的适度改善.
- 在12个月后,在任何一组中都没有观察到连续BMIz得分的统计学上显著下降.
- 电话辅导导致20.8%的参与者BMIz分数临床显著降低 (≥0.25),而工作簿组的12.4% (p=0.0415).
结论:
- 两种低强度干预都被发现是可以接受的,并且在BMI百分位数中产生了适度的改善.
- 电话辅导在儿童中显示出更高的临床意义上的BMIz得分改善率.
- 需要进行进一步的研究,以确定这种方案是否适用于常规儿科初级保健实践.
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