? Childhood overweight has reached epidemic proportions with a 45% increase in prevalence in the last decade. Approximately 16% of children aged 6-19 are overweight (BMI-for-age-and-gender > 95th percentile). Co-morbidities associated with overweight include type II diabetesTcardiac-and respiratory compromise, hypertension, hepatosteatosis, and orthopedic problems. Childhood overweight is costly from a quality of life and an economic perspective. The financial impact of overweight on the health care system is striking. Economic analysis of 1998 cost data indicated that 9.1 percent of total US medical expenses were used for treatment of overweight with costs estimated at $78.5 billion (CDC, 2003). Primary care providers (PCPs) have a unique opportunity to prevent and reduce the prevalence of childhood overweight. In their roles as health advisors and educators, PCPs are well positioned to influence parental decisions regarding child and family nutrition and physical activity levels. The long-term goal of this study is to develop an effective strategy for PCPs in the treatment and prevention of childhood overweight. This strategy focuses on parents and uses the Stages of Change approach to identify appropriate interventions for parents to address their children's nutritional and physical activity needs. The three specific aims of this study are: 1) Establish that home visiting in conjunction with PCP tailored educational interventions for parents is more effective than tailored interventions alone in improving child health outcomes, 2) Establish that tailored educational interventions with home visits are more effective than tailored interventions alone in moving parents through Stages of Change so they become more actively involved in managing their children's weight, and 3) Describe PCPs levels of satisfaction with the Stages of Change strategy and tailored educational interventions as effective and feasible tools in management of childhood overweight. This is an innovative project because it meets PCP needs in the clinical setting while providing tailored interventions to meet parents readiness to change and recognizing parents as agents of change for their children's health promotion. This project is responsive to the mission of NINR because it provides holistic approaches to prevention and intervention for childhood overweight using clinical and home/community strategies to improve health outcomes in minority children from underserved areas. ? ?
| O'Neil, Margaret E; Shewokis, Patricia A; Falkenstein, Kathleen K et al. (2010) Psychosocial factors and health perceptions in parents and children who are overweight or obese. Obesity (Silver Spring) 18:1558-65 |
