Jansen Wilma, Raat Hein, Zwanenburg Evelien Joosten-van, Reuvers Ivo, van Walsem Ron, Brug Johannes
Department of Public Health, Erasmus MC, Rotterdam, The Netherlands.
BMC Public Health. 2008 Jul 25;8:257. doi: 10.1186/1471-2458-8-257.
Effective interventions to prevent overweight and obesity in children are urgently needed especially in inner-city neighbourhoods where prevalence of overweight and inactivity among primary school children is high. A school based intervention was developed aiming at the reduction of overweight and inactivity in these children by addressing both behavioural and environmental determinants.
METHODS/DESIGN: The main components of the intervention (Lekker Fit!) are the re-establishment of a professional physical education teacher; three (instead of two) PE classes per week; additional sport and play activities outside school hours; fitness testing; classroom education on healthy nutrition, active living and healthy lifestyle choices; and the involvement of parents. The effectiveness of the intervention is evaluated through a cluster randomized controlled trial in 20 primary schools among grades 3 through 8 (6-12 year olds). Primary outcome measures are BMI, waist circumference and fitness. Secondary outcome measures are assessed in a subgroup of grade 6-8 pupils (9-12 year olds) through classroom questionnaires and constitute of nutrition and physical activity behaviours and behavioural determinants. Multilevel regression analyses are used to study differences in outcomes between children in the intervention schools and in control schools, taking clustering of children within schools into account.
Hypotheses are that the intervention results in a lower prevalence of children being overweight and an improved mean fitness score, in comparison with a control group where the intervention is not implemented. The results of our study will contribute to the discussion on the role of physical education and physical activity in the school curriculum.
[ISRCTN84383524].
迫切需要有效的干预措施来预防儿童超重和肥胖，尤其是在市中心社区，那里小学生超重和缺乏运动的患病率很高。开展了一项基于学校的干预措施，旨在通过解决行为和环境决定因素来降低这些儿童的超重和缺乏运动情况。
方法/设计：干预措施（Lekker Fit!）的主要组成部分包括重新配备一名专业体育教师；每周安排三节（而非两节）体育课；在课余时间增加体育和游戏活动；进行体能测试；开展关于健康营养、积极生活方式和健康生活方式选择的课堂教育；以及让家长参与进来。通过在20所小学三至八年级（6至12岁）进行的整群随机对照试验来评估干预措施的效果。主要结局指标是体重指数、腰围和体能。次要结局指标通过课堂问卷在六年级至八年级学生（9至12岁）的一个亚组中进行评估，包括营养和身体活动行为以及行为决定因素。采用多水平回归分析来研究干预学校和对照学校儿童在结局方面的差异，同时考虑到学校内儿童的聚集情况。
假设与未实施干预措施的对照组相比，该干预措施能降低儿童超重的患病率，并提高平均体能得分。我们研究的结果将有助于讨论体育教育和体育活动在学校课程中的作用。
[ISRCTN84383524]
