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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Ethics of Implementing US Preventive Services Task Force Recommendations for Childhood Obesity
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Ethics of Implementing US Preventive Services Task Force Recommendations for Childhood Obesity

机译：实施美国预防措施的伦理工作队的儿童肥胖建议

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Childhood obesity represents a serious and growing concern for the United States. Its negative consequences for health and well-being can be far-reaching, devastating, and intergenerational. In 2017, the US Preventive Services Task Force (USPSTF) issued a grade B recommendation for screening children and adolescents for obesity and offering or referring to comprehensive, intensive behavioral interventions as indicated. However, many communities in the United States have limited access to such interventions. The USPSTF's mission is to review and grade research evidence for clinical preventive services and does not include cost or population-based operationalization and implementation logistics considerations for its recommendations. Yet implementing recommendations without considering cost and operationalization may lead to equity and access challenges. These are essential considerations, but oversight of the implementation of these recommendations is not standardized or assigned to any one agency or organization. As such, a central ethical feature inherent to the implementation of USPSTF recommendations calls for stakeholder collaborations to take on the next step beyond the establishment of evidence-based recommendations: to ensure the ethical application of such guidelines across diverse populations. Furthermore, the screening-intervention relationship inherent to this USPSTF recommendation raises ethical concerns regarding US societal norms surrounding obesity, particularly when contrasted against other screening-intervention modalities. More efforts, such as increased incentives or expansion of clinical services in low-resource areas, should be taken to facilitate this recommended intervention by expanding access to childhood obesity interventions to fulfill ethical responsibilities to equity and to ensure the right to open futures for children.
机译：儿童肥胖是美国日益严重的问题。它对健康和福祉的负面影响可能是深远的、毁灭性的和代际的。2017年，美国预防服务特别工作组（USPSTF）发布了一项B级建议，用于筛查儿童和青少年的肥胖症，并提供或参考全面、强化的行为干预措施，如图所示。然而，美国的许多社区获得此类干预的机会有限。USPSTF的任务是对临床预防服务的研究证据进行审查和分级，其建议不包括基于成本或人群的操作和实施后勤考虑。然而，在不考虑成本和可操作性的情况下实施建议可能会导致公平和准入方面的挑战。这些都是重要的考虑因素，但对这些建议的执行情况的监督没有标准化，也没有分配给任何一个机构或组织。因此，USPSTF建议的实施所固有的一个核心伦理特征要求利益相关者合作，在建立基于证据的建议之外，采取下一步行动：确保在不同人群中道德地应用此类指南。此外，USPSTF建议固有的筛查-干预关系引起了对美国肥胖社会规范的伦理担忧，尤其是与其他筛查-干预模式相比时。应采取更多努力，例如增加激励措施或扩大低资源领域的临床服务，通过扩大儿童肥胖干预的机会，促进这一建议的干预，以履行公平的道德责任，并确保为儿童开辟未来的权利。

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