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“健康家庭”儿童肥胖治疗项目的两年随访

Two-year follow-up of the 'Families for Health' programme for the treatment of childhood obesity.

作者信息

Robertson W, Thorogood M, Inglis N, Grainger C, Stewart-Brown S

机构信息

Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, UK.

出版信息

Child Care Health Dev. 2012 Mar;38(2):229-36. doi: 10.1111/j.1365-2214.2011.01237.x. Epub 2011 Apr 4.

Abstract

BACKGROUND

The high prevalence of obesity in children in the UK warrants continuing public health attention. 'Families for Health' is a family-based group programme for the treatment of childhood obesity. Significant improvements in body mass index (BMI) z-score (-0.21, 95% CI: -0.35 to -0.07, P = 0.007) and other health outcomes were seen in children at a 9-month follow-up.

AIM

To undertake a 2-year follow-up of families who attended 'Families for Health' in Coventry, to assess long-term outcomes and costs.

METHODS

'Families for Health' is a 12-week programme with parallel groups for parents and children, addressing parenting skills, healthy lifestyles and emotional well-being. The intervention was delivered at a leisure centre in Coventry, England, with 27 overweight or obese children aged 7-13 years (18 girls, 9 boys) and their parents, from 21 families. A 'before-and-after' evaluation was completed with 19 (70%) children followed up at 2 years. The primary outcome was change in BMI z-score from baseline; secondary outcomes were children's quality of life, parent-child relationships, eating/activity habits and parents' mental health. Costs to deliver the intervention and to families were recorded.

RESULTS

Mean change in BMI z-score from baseline was -0.23 (95% CI: -0.42 to -0.03, P = 0.027) at the 2-year follow-up and eight (42%) children had a clinically significant reduction in BMI z-score. Significant improvements were seen in children's quality of life and eating habits in the home, while there were sustained reductions in unhealthy foods and sedentary behaviour. Fruit and vegetable consumption and parent's mental health were not significantly different at 2 years. Costs of the programme were £517 per family (£402 per child), equivalent to £2543 per unit reduction in BMI z-score.

CONCLUSIONS

Improvements in BMI z-score and certain other outcomes associated with the 'Families for Health' programme were sustained at the 2-year follow-up. 'Families for Health' is a promising new childhood obesity intervention, and a randomized controlled trial is now indicated.

摘要

背景

英国儿童肥胖的高患病率值得持续的公共卫生关注。“健康家庭”是一项基于家庭的儿童肥胖治疗团体项目。在9个月的随访中,儿童的体重指数(BMI)z评分有显著改善(-0.21,95%置信区间:-0.35至-0.07,P = 0.007)以及其他健康指标也有改善。

目的

对参加考文垂“健康家庭”项目的家庭进行为期2年的随访,以评估长期效果和成本。

方法

“健康家庭”是一个为期12周的项目,为家长和孩子设置了平行小组,涉及育儿技巧、健康生活方式和情绪健康。该干预措施在英国考文垂的一个休闲中心实施,有来自21个家庭的27名7至13岁超重或肥胖儿童(18名女孩,9名男孩)及其家长参与。对19名(70%)儿童进行了2年的随访并完成了“前后”评估。主要结局是BMI z评分相对于基线的变化;次要结局包括儿童的生活质量、亲子关系、饮食/活动习惯以及家长的心理健康。记录了实施干预措施的成本以及家庭成本。

结果

在2年随访时,BMI z评分相对于基线的平均变化为-0.23(95%置信区间:-0.42至-0.03,P = 0.027),8名(42%)儿童的BMI z评分有临床显著降低。儿童的生活质量和家庭饮食习惯有显著改善,不健康食品和久坐行为持续减少。2年后水果和蔬菜的摄入量以及家长的心理健康没有显著差异。该项目的成本为每个家庭517英镑(每个孩子402英镑),相当于每降低一个BMI z评分单位成本为2543英镑。

结论

在2年随访时,与“健康家庭”项目相关的BMI z评分及某些其他指标的改善得以持续。“健康家庭”是一项有前景的儿童肥胖新干预措施,现在需要进行一项随机对照试验。

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