Haire-Joshu Debra, Elliott Michael B, Caito Nicole M, Hessler Kimberly, Nanney M S, Hale Nancy, Boehmer Tegan K, Kreuter Matthew, Brownson Ross C
Department of Community Health, School of Public Health, Saint Louis University, St. Louis, Missouri 63104, USA.
Prev Med. 2008 Jul;47(1):77-82. doi: 10.1016/j.ypmed.2008.03.016. Epub 2008 Apr 9.
The High 5 for Preschool Kids (H5-KIDS) program tested the effectiveness of a home based intervention to teach parents how to ensure a positive fruit-vegetable (FV) environment for their preschool child, and to examine whether changes in parent behavior were associated with improvements in child intake.
A group randomized nested cohort design was conducted (2001 to 2006) in rural, southeast Missouri with 1306 parents and their children participating in Parents As Teachers, a national parent education program.
When compared to control parents, H5-KIDS parents reported an increase in FV servings (MN=0.20, p=0.05), knowledge and availability of FV within the home (p=0.01), and decreased their use of noncoercive feeding practices (p=0.02). Among preschoolers, FV servings increased in normal weight (MN=0.35, p=0.02) but not overweight children (MN=-0.10, p=0.48), relative to controls. The parent's change in FV servings was a significant predictor of child's change in FV in the H5-KIDS group (p=0.001).
H5-KIDS suggests the need for, and promise of, early home intervention for childhood obesity prevention. It demonstrates the importance of participatory approaches in developing externally valid interventions, with the potential for dissemination across national parent education programs as a means for improving the intake of parents and young children.
“学前儿童健康五要素”(H5-KIDS)项目测试了一项以家庭为基础的干预措施的效果,该措施旨在教导家长如何为其学龄前儿童营造一个积极的果蔬环境,并研究家长行为的改变是否与孩子摄入量的改善相关。
2001年至2006年在密苏里州东南部农村地区进行了一项群组随机嵌套队列设计,1306名家长及其子女参与了“家长即教师”这一全国性家长教育项目。
与对照组家长相比,H5-KIDS项目组的家长报告称,家中的果蔬份数增加(中位数=0.20,p=0.05),对果蔬的知识和可得性提高(p=0.01),且减少了非强制性喂养行为的使用(p=0.02)。与对照组相比,在学龄前儿童中,正常体重儿童的果蔬份数增加(中位数=0.35,p=0.02),但超重儿童的果蔬份数未增加(中位数=-0.10,p=0.48)。在H5-KIDS组中,家长果蔬份数的变化是孩子果蔬摄入量变化的显著预测因素(p=0.001)。
H5-KIDS项目表明了早期家庭干预对于预防儿童肥胖的必要性和前景。它证明了参与式方法在制定具有外部效度的干预措施中的重要性,有可能在全国性家长教育项目中推广,作为改善家长和幼儿摄入量的一种手段。