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家庭日托环境中的肥胖预防:“蹦蹦跳跳”干预措施对儿童体育活动和健康饮食机会的影响。

Obesity prevention in the family day care setting: impact of the Romp & Chomp intervention on opportunities for children's physical activity and healthy eating.

作者信息

de Silva-Sanigorski A, Elea D, Bell C, Kremer P, Carpenter L, Nichols M, Smith M, Sharp S, Boak R, Swinburn B

机构信息

WHO Collaborating Centre for Obesity Prevention, Deakin University and McCaughey Centre and Melbourne School of Population Health, The University of Melbourne, Melbourne, Vic. Australia.

出版信息

Child Care Health Dev. 2011 May;37(3):385-93. doi: 10.1111/j.1365-2214.2010.01205.x. Epub 2011 Jan 31.

Abstract

BACKGROUND

The Romp & Chomp intervention reduced the prevalence of overweight/obesity in pre-school children in Geelong, Victoria, Australia through an intervention promoting healthy eating and active play in early childhood settings. This study aims to determine if the intervention successfully created more health promoting family day care (FDC) environments.

METHODS

The evaluation had a cross-sectional, quasi-experimental design with the intervention FDC service in Geelong and a comparison sample from 17 FDC services across Victoria. A 45-item questionnaire capturing nutrition- and physical activity-related aspects of the policy, socio-cultural and physical environments of the FDC service was completed by FDC care providers (in 2008) in the intervention (n= 28) and comparison (n= 223) samples.

RESULTS

Select results showed intervention children spent less time in screen-based activities (P= 0.03), organized active play (P < 0.001) and free inside play (P= 0.03) than comparison children. There were more rules related to healthy eating (P < 0.001), more care provider practices that supported children's positive meal experiences (P < 0.001), fewer unhealthy food items allowed (P= 0.05), higher odds of staff being trained in nutrition (P= 0.04) and physical activity (P < 0.001), lower odds of having set minimum times for outside (P < 0.001) and organized (P= 0.01) active play, and of rewarding children with food (P < 0.001).

CONCLUSIONS

Romp & Chomp improved the FDC service to one that discourages sedentary behaviours and promotes opportunities for children to eat nutritious foods. Ongoing investment to increase children's physical activity within the setting and improving the capacity and health literacy of care providers is required to extend and sustain the improvements.

摘要

背景

“蹦跳乐”干预措施通过在幼儿环境中促进健康饮食和积极玩耍,降低了澳大利亚维多利亚州吉朗地区学龄前儿童超重/肥胖的患病率。本研究旨在确定该干预措施是否成功营造了更有利于健康的家庭日托(FDC)环境。

方法

该评估采用横断面准实验设计,以吉朗地区的干预性家庭日托服务为研究对象,并选取了维多利亚州17个家庭日托服务机构作为对照样本。2008年,干预组(n = 28)和对照组(n = 223)的家庭日托服务提供者完成了一份包含45个项目的问卷,该问卷涵盖了家庭日托服务政策、社会文化和物理环境中与营养和身体活动相关的方面。

结果

部分结果显示,与对照组儿童相比,干预组儿童进行基于屏幕活动的时间更少(P = 0.03),有组织的积极玩耍时间更少(P < 0.001),室内自由玩耍时间更少(P = 0.03)。与健康饮食相关的规则更多(P < 0.001),照顾提供者支持儿童积极用餐体验的行为更多(P < 0.001),允许提供的不健康食品更少(P = 0.05),工作人员接受营养培训的几率更高(P = 0.04),接受身体活动培训的几率更高(P < 0.001),设定户外(P < 0.001)和有组织的(P = 0.01)积极玩耍最短时间的几率更低,用食物奖励儿童的几率更低(P < 0.001)。

结论

“蹦跳乐”改善了家庭日托服务,使其减少了久坐行为,并为儿童提供了食用营养食品的机会。需要持续投入,以增加儿童在该环境中的身体活动,并提高照顾提供者的能力和健康素养,从而扩大并维持这些改善成果。

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