Health Promotion and Education, University of Cincinnati Faculty, Walden University, Cincinnati, OH 45221-0068, USA.
Adv Nutr. 2011 Mar;2(2):207S-16S. doi: 10.3945/an.111.000315. Epub 2011 Mar 10.
The purpose of this article was to review school based interventions designed to prevent childhood and adolescent obesity that focused on modifying dietary behavior and were published between 2000 and May 2009. A total of 25 interventions met the criteria. The grade range of these interventions was from K to 12; 13 studies exclusively targeted elementary school, 2 targeted both elementary and middle school, 9 exclusively targeted middle school, and 1 targeted high school. The majority of the interventions focused on both dietary and physical activity behaviors, whereas 8 interventions focused exclusively on dietary behaviors. Approximately one-half of the interventions were based on a behavioral theory. In terms of duration, 13 were longer than 6 mo, 4 were less than 1 mo, and 8 had a duration between 1 and 6 mo. The majority of the interventions were implemented by teachers. In terms of activities, almost all interventions had a curricular component except 2 that distributed free fruit or vegetables. Besides curricular instructions, parental and family involvement was also utilized by several interventions. Environmental and policy changes were used in 7 interventions. For evaluation, the 2 most popular designs were experimental design with random assignment at group level and quasi experimental design, both of which were used by 9 interventions each. In terms of impact on adiposity indices, only 14 interventions measured it and only 6 of those were able to demonstrate significant changes. Recommendations for enhancing the effectiveness of school based dietary education interventions for childhood obesity prevention are presented.
本文旨在回顾 2000 年至 2009 年 5 月期间以修改饮食行为为目的、针对儿童和青少年肥胖的学校为基础的干预措施。共有 25 项干预措施符合标准。这些干预措施的年级范围从 K 到 12 年级；13 项研究专门针对小学，2 项研究同时针对小学和初中，9 项研究专门针对初中，1 项研究针对高中。大多数干预措施同时关注饮食和体育活动行为，而 8 项干预措施则专门关注饮食行为。大约一半的干预措施基于行为理论。就持续时间而言，13 项干预措施持续时间超过 6 个月，4 项干预措施持续时间不到 1 个月，8 项干预措施持续时间在 1 至 6 个月之间。大多数干预措施由教师实施。就活动而言，除了 2 项分发免费水果或蔬菜的干预措施外，几乎所有干预措施都有课程组成部分。除了课程指导外，一些干预措施还利用了家长和家庭的参与。7 项干预措施使用了环境和政策变化。在评估方面，最受欢迎的两种设计是实验组随机分组设计和准实验设计，这两种设计都被 9 项干预措施采用。在评估肥胖指数的影响方面，只有 14 项干预措施进行了测量，其中只有 6 项能够显示出显著的变化。本文提出了增强学校为基础的儿童肥胖预防饮食教育干预措施有效性的建议。
