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“健康家庭”试点项目:基于社区的肥胖家庭干预措施

Pilot of "Families for Health": community-based family intervention for obesity.

作者信息

Robertson W, Friede T, Blissett J, Rudolf M C J, Wallis M, Stewart-Brown S

机构信息

Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, UK.

出版信息

Arch Dis Child. 2008 Nov;93(11):921-6. doi: 10.1136/adc.2008.139162. Epub 2008 May 7.

Abstract

OBJECTIVE

To develop and evaluate "Families for Health", a new community based family intervention for childhood obesity.

DESIGN

Programme development, pilot study and evaluation using intention-to-treat analysis.

SETTING

Coventry, England.

PARTICIPANTS

27 overweight or obese children aged 7-13 years (18 girls, 9 boys) and their parents, from 21 families.

INTERVENTION

Families for Health is a 12-week programme with parallel groups for parents and children, addressing parenting, lifestyle change and social and emotional development.

MAIN OUTCOME MEASURES

Change in baseline BMI z score at the end of the programme (3 months) and 9-month follow-up. Attendance, drop-out, parents' perception of the programme, child's quality of life and self-esteem, parental mental health, parent-child relationships and lifestyle changes were also measured.

RESULTS

Attendance rate was 62%, with 18 of the 27 (67%) children completing the programme. For the 22 children with follow-up data (including four who dropped out), BMI z score was reduced by -0.18 (95% CI -0.30 to -0.05) at 3 months and -0.21 (-0.35 to -0.07) at 9 months. Statistically significant improvements were observed in children's quality of life and lifestyle (reduced sedentary behaviour, increased steps and reduced exposure to unhealthy foods), child-parent relationships and parents' mental health. Fruit and vegetable consumption, participation in moderate/vigorous exercise and children's self-esteem did not change significantly. Topics on parenting skills, activity and food were rated as helpful and used with confidence by most parents.

CONCLUSIONS

Families for Health is a promising new childhood obesity intervention. Definitive evaluation of its clinical effectiveness by randomised controlled trial is now required.

摘要

目的

开发并评估“健康家庭”这一针对儿童肥胖的新型社区家庭干预措施。

设计

采用意向性分析进行项目开发、试点研究及评估。

地点

英国考文垂。

参与者

来自21个家庭的27名7至13岁超重或肥胖儿童(18名女孩,9名男孩)及其父母。

干预措施

“健康家庭”是一项为期12周的项目,为家长和孩子设置了平行小组,涉及育儿、生活方式改变以及社会和情感发展等方面。

主要观察指标

项目结束时(3个月)及9个月随访时基线BMI z评分的变化。还测量了出勤率、退出率、家长对项目的看法、孩子的生活质量和自尊、家长的心理健康、亲子关系以及生活方式的改变。

结果

出勤率为62%,27名儿童中有18名(67%)完成了该项目。对于有随访数据的22名儿童(包括4名退出者),3个月时BMI z评分降低了-0.18(95%可信区间-0.30至-0.05),9个月时降低了-0.21(-0.35至-0.07)。在儿童的生活质量和生活方式(久坐行为减少、步数增加、接触不健康食品减少)、亲子关系和家长心理健康方面观察到了具有统计学意义的改善。水果和蔬菜摄入量、参与中度/剧烈运动以及儿童自尊没有显著变化。大多数家长认为关于育儿技巧、活动和饮食的主题很有帮助且使用时充满信心。

结论

“健康家庭”是一种有前景的新型儿童肥胖干预措施。现在需要通过随机对照试验对其临床效果进行确定性评估。

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