Adaptations of an Effective Evidence-Based Pediatric Weight Management Intervention.

Autor: Bartee RT; Department of Biology, University of Nebraska at Kearney, Kearney, NE, USA. barteet2@unk.edu., Heelan KA; Department of Kinesiology and Sport Sciences, University of Nebraska at Kearney, Kearney, NE, USA., Golden CA; School of Medicine, Population Health Sciences, University of Utah, Salt Lake City, UT, USA., Hill JL; School of Medicine, Population Health Sciences, University of Utah, Salt Lake City, UT, USA., Porter GC; Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA., Abbey BA; Department of Kinesiology and Sport Sciences, University of Nebraska at Kearney, Kearney, NE, USA., George K; Department of Kinesiology and Sport Sciences, University of Nebraska at Kearney, Kearney, NE, USA., Foster N; Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA., Estabrooks PA; Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA.
Jazyk: angličtina
Zdroj: Prevention science : the official journal of the Society for Prevention Research [Prev Sci] 2024 Apr; Vol. 25 (Suppl 1), pp. 72-84. Date of Electronic Publication: 2023 Jul 21.
DOI: 10.1007/s11121-023-01557-7
Abstrakt: Current childhood obesity treatment programs do not address medically underserved populations or settings where all members of an interdisciplinary team may not exist-either within one organization or within the community. In this paper, we describe the use of a community-academic partnership to iteratively adapt Epstein's Traffic Light Diet (TLD), into Building Healthy Families (BHF), a community-placed evidence-based pediatric weight management intervention (PWMI) and evaluate its effectiveness in reducing BMI z scores. Nine cohorts of families completed BHF. Participants included children aged 6-12 years with obesity (M = 9.46, SD = 1.74). The Framework for Reporting Adaptations and Modifications-Expanded guided our classification of modifications across BHF cohorts. Using the FRAME reporting structure, the changes that were documented were (1) planned and occurred pre-implementation, (2) based on decisions from local stakeholders (e.g., school administrator, members of the implementation team), and (3) specific to changes in content and context-with a focus on implementation and potential for local scale-up. The nature of the adaptations included adding elements (whole of family approach), removing elements (calorie counting), and substituting elements (steps for minutes of physical activity). Across 9 cohorts, 84 families initiated the BHF program, 69 families successfully completed the 12-week program, and 45 families returned for 6-month follow-up assessments. Results indicated that the BMI z score in children was reduced by 0.31 ± 0.17 at 6 months across all cohorts. Reduction in BMI z score ranged from 0.41 in cohort 4 to 0.13 in cohort 5. Iterative adaptations to BHF were completed to improve the fit of BHF to the setting and participants and have contributed to a sustained community PWMI that adheres to the underlying principles and core elements of other evidence-based PWMIs. Monitoring adaptations and related changes to outcomes can play a role in long-term sustainability and effectiveness.
(© 2023. The Author(s).)
Databáze: MEDLINE
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