2013-08-012024-05-18https://scholars.lib.ntu.edu.tw/handle/123456789/707280摘要：背景: 兒童肥胖盛行率逐年上升，是全球性的公共衛生危機。隨著醫療科技及長期照護的進步，許多慢性疾病兒童會有肥胖的問題，其會對兒童身體健康，心理社會，醫療及經濟造成衝擊。慢性疾病兒童的健康生活型態如何?其可能的危險因子仍待探索。 目的: 本研究旨在了解慢性疾病肥胖學童的的健康生活型態，並發展出符合其需要的生活型態改變措施計畫，並評估其措施成效。 方法: 本研究將運用三年期複合式研究法探索慢性疾病兒童肥胖議題，第一年將藉質量合併方法由健康測量、健康生活型態調查及實地訪談觀察等，來確認慢性疾病兒童肥胖問題。第二年將藉由焦點團體、系統性文獻及統合分析方法來建構健康生活型態改變的措施內容及方案，進行初步試驗以為第三年措施研究的版本。第三年將進行前後測重複追蹤之實驗性研究，受試個案將隨機分派至實驗組及控制組，實驗組接受三次措施，其內容包括健康飲食、規律運動及行為調適等。二組均接受基準評估及後續每三個月一次的成效評值，包括身高、體重及腰圍測量、健康生活型態改變(含飲食紀錄、運動日誌、健康生活環境因素等)。考量檢力及流失率，第一及第三階段研究之樣本數分別估計為720 及 200。預期效益: 發展合於需求且有實證基礎的生活型態改變措施，以改善慢病兒童之健康。<br> Abstract: Background: Childhood obesity is a global “public health crisis” with increasing prevalence rate in all racial, ethnic and gender groups, as well as across socioeconomic strata. Research findings indicate that the prevalence of obesity and chronic conditions in children and youths has increased. Childhood obesity impacts physical, psychological and social well-being, and also impacts the economy as well. Purpose: The purpose of this study is to explore the healthy lifestyles, health outcomes among school-age children of chronic conditions who have BMI more than 85 percentile, then to examine the contextual factors affecting their healthy lifestyles in order to develop a tailored intervention for obese children of BMI more than 95 percentile by using mixed methods (MM) research approach. Methods: This study will be a three-year mixed methods study. By merging quantitative survey of physical measurement/ lifestyle and qualitative interview/observation to identify obesity issues among children with chronic conditions in phase I study. Focus groups, systematic review and meta-analysis will be conducted to develop and conduct a pilot of an intervention component and protocol in phase II study. The third phase is to undertake and assess the effects of an evidence-based intervention of lifestyle modification by experimental (pretest-posttest) design with repeated follow-ups. The research subjects will be randomaly assign to condition of receiving intervention or control; the measurement of the outcome across 4 observations, to assess both group differences (experimental comparison), and changes within groups. The interventions consist of healthy diet (X1), regular exercise (X2), and behavior change strategies (X3). The observations start from baseline (O1), then have three observations (O2,O3, O4) at 3-month interval respectively. Outcome indicators include height, body weight, waist circumference as well as healthy life style modification present by diet record, exercise diary, healthy life environment. The approximate sample size is estimated by power analysis and dropout rate, the eligible sample size will be 720 and 200 in phase I and III respectively. Expected outcomes: To have a tailored and evidence-based lifestyle modification to better health outcomes for children with chronic condition.