DeVault Norma, Kennedy Tay, Hermann Janice, Mwavita Mwarumba, Rask Pam, Jaworsky Amber
Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA.
J Am Diet Assoc. 2009 Apr;109(4):680-7. doi: 10.1016/j.jada.2008.12.021.
In response to the increased incidence of child overweight, a school-based program, It's All About Kids, was designed by the Tulsa Health Department, Tulsa Public Schools, and community partners to improve food choices and increase physical activity of students in first through fifth grade. The nutrition component consisted of six weekly 30-minute experiential, age-appropriate classroom lessons, including healthful-eating food games, taste-testing foods, whole-grain bread baking, information on portion sizes, and food demonstrations. Documenting and evaluating school-based intervention programs is critical for setting evidence-based health policy, justifying funding, and achieving broader implementation of successful interventions. To evaluate the effectiveness of the It's All About Kids nutrition component in fourth-grade children, we conducted a controlled trial from 20 fourth-grade classes in five intervention and five comparison Title I public schools. Evaluation included 140 fourth-grade students, including 69 in the comparison group and 71 in the intervention group. Outcomes were measured by pre-, post-, and follow-up tests using a modified version of the Pathways Knowledge, Attitudes, and Behaviors questionnaire and the Child and Adolescent Trial of Cardiovascular Health (CATCH) Food Checklist. Data were analyzed using repeated measures analysis of variance over time controlling for sex, paired samples t tests, and independent samples t tests. Intervention students had significant improvements in knowledge of which food had more fat (P<0.043). Intervention students' behavioral intent scale scores for food choice intentions improved significantly (P<0.014). Self-reported consumption of saturated fat and sodium improved considerably in both intervention and comparison students. We conclude that results support a broader program implementation. More reinforcement over time may be needed to sustain the level of improvement.
为应对儿童超重发病率上升的情况，塔尔萨市卫生部门、塔尔萨公立学校及社区合作伙伴共同设计了一项名为“一切为了孩子”的校本项目，旨在改善食物选择并增加一至五年级学生的身体活动量。营养部分包括每周六节时长30分钟、适合各年龄段的体验式课堂课程，内容有健康饮食食物游戏、食物品尝测试、全麦面包烘焙、食物分量信息以及食物演示。记录和评估校本干预项目对于制定循证健康政策、证明资金合理性以及推动成功干预措施的更广泛实施至关重要。为评估“一切为了孩子”营养部分对四年级儿童的效果，我们在五所参与干预的第一类公立学校和五所对照公立学校的20个四年级班级中进行了一项对照试验。评估对象包括140名四年级学生，其中对照组69名，干预组71名。通过使用经修改的《途径知识、态度和行为问卷》以及《儿童和青少年心血管健康试验（CATCH）食物清单》进行前测、后测和随访测试来衡量结果。使用重复测量方差分析对数据进行分析，同时控制性别因素，还进行了配对样本t检验和独立样本t检验。干预组学生在了解哪种食物脂肪含量更高方面有显著改善（P<0.043）。干预组学生在食物选择意图的行为意向量表得分有显著提高（P<0.014）。干预组和对照组学生自我报告的饱和脂肪和钠的摄入量均有相当程度的改善。我们得出结论，结果支持更广泛地实施该项目。可能需要随着时间的推移给予更多强化措施来维持改善水平。
