孟菲斯女孩健康促进多地点研究（GEMS）：一项针对非裔美国女孩的为期两年的肥胖预防计划的效果评估。
The Memphis Girls' health Enrichment Multi-site Studies (GEMS): an evaluation of the efficacy of a 2-year obesity prevention program in African American girls.
作者信息
Klesges Robert C, Obarzanek Eva, Kumanyika Shiriki, Murray David M, Klesges Lisa M, Relyea George E, Stockton Michelle B, Lanctot Jennifer Q, Beech Bettina M, McClanahan Barbara S, Sherrill-Mittleman Deborah, Slawson Deborah L
机构信息
Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline Street, Memphis, TN 38105, USA.
出版信息
Arch Pediatr Adolesc Med. 2010 Nov;164(11):1007-14. doi: 10.1001/archpediatrics.2010.196.
OBJECTIVE
To determine the efficacy of a 2-year obesity prevention program in African American girls.
DESIGN
Memphis GEMS (Girls' health Enrichment Multi-site Studies) was a controlled trial in which girls were randomly assigned to an obesity prevention program or alternative intervention.
SETTING
Local community centers and YWCAs (Young Women's Christian Associations) in Memphis, Tennessee.
PARTICIPANTS
Girls aged 8 to 10 years (N = 303) who were identified by a parent or guardian as African American and who had a body mass index (BMI) at or higher than the 25th percentile for age or 1 parent with a BMI of 25 or higher.
INTERVENTIONS
Group behavioral counseling to promote healthy eating and increased physical activity (obesity prevention program) or self-esteem and social efficacy (alternative intervention).
MAIN OUTCOME MEASURE
The BMI at 2 years.
RESULTS
The BMI increased in all girls with no treatment effect (obesity prevention minus alternative intervention) at 2 years (mean, 0.09; 95% confidence interval [CI], -0.40 to 0.58). Two-year treatment effects in the expected direction were observed for servings per day of sweetened beverages (mean, -0.19; 95% CI, -0.39 to 0.09), water (mean, 0.21; 95% CI, 0.03 to 0.40), and vegetables (mean, 0.15; 95% CI,-0.02 to 0.30), but there were no effects on physical activity. Post hoc analyses suggested a treatment effect in younger girls (P for interaction = .08). The mean BMI difference at 2 years was -2.41 (95% CI, -4.83 to 0.02) in girls initially aged 8 years and -1.02 (95% CI, -2.31 to 0.27) in those initially aged 10 years.
CONCLUSIONS
The lack of significant BMI change at 2 years indicates that this intervention alone is insufficient for obesity prevention. Effectiveness may require more explicit behavior change goals and a stronger physical activity component as well as supportive changes in environmental contexts.
目的
确定一项为期两年的肥胖预防计划对非裔美国女孩的效果。
设计
孟菲斯GEMS（女孩健康强化多地点研究）是一项对照试验，女孩们被随机分配到肥胖预防计划或替代干预组。
地点
田纳西州孟菲斯的当地社区中心和基督教女青年会。
参与者
年龄在8至10岁的女孩（N = 303），其父母或监护人认定为非裔美国人，且其体重指数（BMI）处于或高于其年龄对应的第25百分位数，或父母中有一人BMI为25或更高。
干预措施
通过小组行为咨询促进健康饮食和增加身体活动（肥胖预防计划），或提升自尊和社交效能（替代干预）。
主要结局指标
2年后的BMI。
结果
所有女孩的BMI均有所增加，2年后无治疗效果（肥胖预防组减去替代干预组）（均值为0.09；95%置信区间[CI]为-0.40至0.58）。在每天饮用的含糖饮料份数（均值为-0.19；95%CI为-0.39至0.09）、水（均值为0.21；95%CI为0.03至0.40）和蔬菜（均值为0.15；95%CI为-0.02至0.30）方面观察到了预期方向的两年治疗效果，但对身体活动没有影响。事后分析表明，在较年幼女孩中有治疗效果（交互作用P值 = 0.08）。最初年龄为8岁的女孩2年后的平均BMI差值为-2.41（95%CI为-4.83至0.02），最初年龄为10岁的女孩为-1.02（95%CI为-2.31至0.27）。
结论
2年后BMI无显著变化表明，仅靠这种干预不足以预防肥胖。有效性可能需要更明确的行为改变目标、更强的身体活动组成部分以及环境背景方面的支持性改变。
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