Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Obesity (Silver Spring). 2010 Feb;18 Suppl 1:S84-90. doi: 10.1038/oby.2009.436.
Diet-related chronic diseases are at epidemic levels in low-income ethnic minority populations. The purpose of this study is to decrease risk for obesity in children by modifying the food environment and conducting point-of-purchase promotions that will lead to changes in psychosocial factors and behaviors associated with healthier food choices among low-income communities with a preponderance of Native Hawaiians and Pacific Islanders. We implemented an intervention trial over a 9-11-month period in five food stores in two low-income multiethnic communities in Hawaii, targeting both children and their adult caregivers. The Healthy Foods Hawaii (HFH) intervention consisted of an environmental component to increase store stocking of nutritious foods, point-of-purchase promotions, interactive sessions, and involved local producers and distributors. We evaluated the impact of the program on 116 child-caregiver dyads, sampled from two intervention and two comparison areas before and after intervention implementation. Program impacts were evaluated using multivariable linear regression. The HFH program had a significant impact on caregiver knowledge and the perception that healthy foods are convenient. Intervention children significantly increased their Healthy Eating Index (HEI) score for servings of grains, their total consumption of water, and showed an average 8.5 point (out of 90 total, eliminating the 10 points for variety, giving a 9.4% increase) increase in overall HEI score. A food store intervention was effective in improving healthy food knowledge and perception that healthy foods are convenient among caregivers, and increased the consumption of several targeted healthy foods by their children. Greater intensity, sustained food system change, and further targeting for children are needed to show greater and sustained change in food-related behaviors in low-income Native Hawaiian and Pacific Islander communities.
饮食相关的慢性病在低收入少数民族人群中流行。本研究的目的是通过改变食物环境和进行购买点促销活动，降低肥胖风险，从而改变与健康食物选择相关的心理社会因素和行为，这些行为在以夏威夷原住民和太平洋岛民为主的低收入社区中普遍存在。我们在夏威夷两个低收入多民族社区的五家食品店实施了为期 9-11 个月的干预试验，目标人群是儿童及其成年照顾者。健康食品夏威夷（HFH）干预措施包括增加营养食品的店内库存、购买点促销、互动环节，并涉及当地生产商和分销商，以改善环境。我们评估了该计划对 116 对儿童-照顾者的影响，这些参与者来自两个干预区和两个对照组，在干预实施前后进行了采样。使用多变量线性回归评估了该计划的影响。HFH 计划对照顾者的知识和对健康食品便利性的认知有显著影响。干预组儿童的谷物食用量、水总摄入量和整体健康饮食指数（HEI）得分显著增加，HEI 得分平均增加了 8.5 分（90 分总分中扣除了多样性的 10 分，增加了 9.4%）。食品店干预措施有效地提高了照顾者对健康食品的认识和便利性的认知，增加了他们的孩子对几种目标健康食品的消费。需要更大的强度、持续的食物系统变化和针对儿童的进一步目标，才能在低收入的夏威夷原住民和太平洋岛民社区中看到与食物相关的行为的更大和持续的变化。
