Stubbs Joanne M, Achat Helen M
Sydney West Area Health Service, Sydney, NSW.
Med J Aust. 2009 Feb 2;190(3):140-2. doi: 10.5694/j.1326-5377.2009.tb02316.x.
Available evidence indicates that rates of childhood overweight and obesity have been increasing over the past two decades, but inconsistencies between study methods moderate the strength of this evidence. Concomitant health problems and associated costs make it imperative that primary prevention initiatives are introduced to combat the obesity epidemic. Fundamental to informed action is anthropometric monitoring, which if properly implemented will identify changes over time in specific populations to inform policies, practices and services aimed at prevention and treatment. Sample representativeness is essential for valid trend and prevalence data, but efforts to obtain population-based anthropometric data from school children with the required written parental consent have been thwarted by low participation rates. Notable improvements in participation rates when utilising opt-out consent, in which participation is assumed unless otherwise indicated, are evident from local as well as international studies. Opt-out consent can facilitate anthropometric monitoring, delivering a more informed, best-value-for-money response to the obesity epidemic. Health and education ethics committees need to acknowledge the benefits of opt-out consent for "low-risk" anthropometric measurement, which ultimately upholds the individual's rights.
现有证据表明，在过去二十年中，儿童超重和肥胖率一直在上升，但研究方法之间的不一致性削弱了这一证据的力度。随之而来的健康问题和相关成本使得必须采取一级预防措施来应对肥胖流行。人体测量监测是明智行动的基础，如果实施得当，它将识别特定人群随时间的变化，为旨在预防和治疗的政策、实践和服务提供信息。样本代表性对于有效的趋势和患病率数据至关重要，但由于参与率低，在获得有书面家长同意的在校儿童的基于人群的人体测量数据方面的努力受到了阻碍。从本地和国际研究中可以明显看出，采用退出同意书（即除非另有说明，否则假定参与）时，参与率有显著提高。退出同意书可以促进人体测量监测，为肥胖流行提供更明智、性价比更高的应对措施。健康和教育伦理委员会需要认识到退出同意书对“低风险”人体测量的益处，这最终维护了个人权利。
