Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Int J Obes (Lond). 2009 Aug;33 Suppl 4(Suppl 4):S44-51. doi: 10.1038/ijo.2009.116.
HEALTHY was a multi-center primary prevention trial designed to reduce risk factors for type 2 diabetes in adolescents. Seven centers each recruited six middle schools that were randomized to either intervention or control. The HEALTHY intervention integrated multiple components in nutrition, physical education, behavior change and communications and promotion. The conceptual rationale as well as the design and development of the behavior intervention component are described. Pilot study data informed the development of the behavior intervention component. Principles of social learning and health-related behavior change were incorporated. One element of the behavior intervention component was a sequence of peer-led, teacher-facilitated learning activities known as FLASH (Fun Learning Activities for Student Health). Five FLASH modules were implemented over five semesters of the HEALTHY study, with the first module delivered in the second semester of the sixth grade and the last module in the second semester of the eighth grade. Each module contained sessions that were designed to be delivered on a weekly basis to foster self-awareness, knowledge, decision-making skills and peer involvement for health behavior change. FLASH behavioral practice incorporated individual and group self-monitoring challenges for eating and activity. Another element of the behavior intervention component was the family outreach strategy for extending changes in physical activity and healthy eating beyond the school day and for supporting the student's lifestyle change choices. Family outreach strategies included the delivery of newsletters and supplemental packages with materials to promote healthy behavior in the home environment during school summer and winter holiday breaks. In conclusion, the HEALTHY behavior intervention component, when integrated with total school food and physical education environmental changes enhanced by communications and promotional campaigns, is a feasible and acceptable mechanism for delivering age-appropriate social learning for healthy eating and physical activity among an ethnically diverse group of middle school students across the United States.
HEALTHY 是一项多中心一级预防试验，旨在减少青少年 2 型糖尿病的危险因素。七个中心各招募了六所中学，这些中学被随机分为干预组或对照组。HEALTHY 干预措施整合了营养、体育教育、行为改变以及沟通和推广等多个方面。本文描述了行为干预部分的概念原理、设计和开发。试点研究数据为行为干预部分的开发提供了信息。社会学习和与健康相关的行为改变原则被纳入其中。行为干预部分的一个元素是一系列由同伴主导、教师协助的学习活动，称为 FLASH（学生健康趣味学习活动）。在 HEALTHY 研究的五个学期中实施了五个 FLASH 模块，第一个模块在六年级的第二个学期进行，最后一个模块在八年级的第二个学期进行。每个模块都包含旨在每周进行一次的课程，以培养自我意识、知识、决策技能和同伴参与健康行为改变的能力。FLASH 行为实践包括个人和小组自我监测挑战，以促进饮食和活动的改变。行为干预部分的另一个元素是家庭外展策略，旨在将体育活动和健康饮食的改变扩展到课后，并支持学生的生活方式改变选择。家庭外展策略包括在学校暑假和寒假期间发放时事通讯和补充材料包，以促进家庭环境中的健康行为。总之，HEALTHY 行为干预部分与通过沟通和宣传活动增强的学校整体食品和体育教育环境变化相结合，是向美国不同种族背景的中学生提供适合年龄的社会学习，以促进健康饮食和体育活动的可行且可接受的机制。
