School of Public Health, University of California at Berkeley, Berkeley, CA, USA.
J Adolesc Health. 2010 Jul;47(1):74-82. doi: 10.1016/j.jadohealth.2009.12.014. Epub 2010 Feb 11.
The current epidemic of childhood overweight has launched a variety of school-based efforts to address the issue. This study reports on the first 2 years of a 3-year evaluation of one school district's comprehensive intervention to transform school foodservices and dining experiences, offer cooking and gardening programs, and integrate nutrition and food systems concepts into the academic curriculum.
This 3-year prospective study enrolled 327 4th and 5th graders in a mid-sized school district in California, and followed them into middle school. Intervention exposure was determined through interviews with school staff and student surveys. Student knowledge and attitudes were assessed annually by questionnaire, and student behavior was assessed annually by 3-day food diary. Household information was gathered by parent questionnaire. Changes in knowledge, attitudes, and behavior were compared by level of intervention exposure using analysis of covariance; pairwise differences were evaluated using Bonferroni's test at a procedure-wise error rate of 5%.
After controlling for family sociodemographic background, students most exposed to the intervention increased their consumption of fruits and vegetables by nearly 0.5 cups (one standard serving), whereas students least exposed decreased their consumption by 0.3 cups (p < .05). Students most exposed to the programming also showed a significantly greater increase in preference for fruit and green leafy vegetables, compared to students least exposed to the programming (p < .05).
Future research is needed to better understand the relative importance of the different components of such a program, and their cost-benefits as well as health impacts.
当前儿童超重的流行状况促使各种以学校为基础的措施纷纷出台，旨在解决这一问题。本研究报告了对一个学区为期 3 年的综合干预措施的前 2 年评估结果，该学区的综合干预措施包括改变学校餐饮服务和就餐体验、提供烹饪和园艺课程，以及将营养和食品系统概念融入学术课程。
这项为期 3 年的前瞻性研究纳入了加利福尼亚州一个中型学区的 327 名 4 年级和 5 年级学生，并跟踪他们进入中学。通过对学校工作人员的访谈和学生调查来确定干预措施的暴露情况。学生的知识和态度每年通过问卷调查进行评估，学生的行为每年通过 3 天的饮食日记进行评估。通过家长问卷收集家庭信息。使用协方差分析比较干预暴露水平的知识、态度和行为变化；使用 Bonferroni 检验评估两两差异，程序错误率为 5%。
在控制家庭社会人口统计学背景后，最暴露于干预措施的学生增加了近 0.5 杯（一份标准份量）的水果和蔬菜摄入量，而最不暴露于干预措施的学生则减少了 0.3 杯（p<0.05）。最暴露于该方案的学生在水果和绿叶蔬菜的偏好方面也表现出显著更大的增长，与最不暴露于该方案的学生相比（p<0.05）。
需要进一步研究以更好地了解该方案不同组成部分的相对重要性，以及它们的成本效益和健康影响。
