参与或不参与针对超重儿童家庭的电话干预计划的原因。
Reasons for (non)participating in a telephone-based intervention program for families with overweight children.
机构信息
Department of Women and Child Health, Hospital for Children and Adolescents, University Hospital of Leipzig, Leipzig, Germany.
出版信息
PLoS One. 2012;7(4):e34580. doi: 10.1371/journal.pone.0034580. Epub 2012 Apr 3.
OBJECTIVE
Willingness to participate in obesity prevention programs is low; underlying reasons are poorly understood. We evaluated reasons for (non)participating in a novel telephone-based obesity prevention program for overweight children and their families.
METHOD
Overweight children and adolescents (BMI>90(th) percentile) aged 3.5-17.4 years were screened via the CrescNet database, a representative cohort of German children, and program participation (repetitive computer aided telephone counseling) was offered by their local pediatrician. Identical questionnaires to collect baseline data on anthropometrics, lifestyle, eating habits, sociodemographic and psychosocial parameters were analyzed from 433 families (241 participants, 192 nonparticipants). Univariate analyses and binary logistic regression were used to identify factors associated with nonparticipation.
RESULTS
The number of overweight children (BMI>90(th) percentile) was higher in nonparticipants than participants (62% vs. 41.1%,p<0.001), whereas the number of obese children (BMI>97(th) percentile) was higher in participants (58.9% vs.38%,p<0.001). Participating girls were younger than boys (8.8 vs.10.4 years, p<0.001). 87.3% and 40% of participants, but only 72.2% and 24.7% of nonparticipants, respectively, reported to have regular breakfasts (p = 0.008) and 5 regular daily meals (p = 0.003). Nonparticipants had a lower household-net-income (p<0.001), but higher subjective physical wellbeing than participants (p = 0.018) and believed that changes in lifestyle can be made easily (p = 0.05).
CONCLUSION
An important reason for nonparticipation was non-awareness of their child's weight status by parents. Nonparticipants, who were often low-income families, believed that they already perform a healthy lifestyle and had a higher subjective wellbeing. We hypothesize that even a low-threshold intervention program does not reach the families who really need it.
目的
参与肥胖预防计划的意愿较低；其潜在原因尚未得到充分理解。我们评估了超重儿童及其家庭参与一种新型基于电话的肥胖预防计划的原因（参与或不参与）。
方法
通过德国儿童代表性队列 CrescNet 数据库对超重儿童和青少年（BMI>第 90 百分位数）进行筛查，并由其当地儿科医生提供参与该计划的机会（重复计算机辅助电话咨询）。从 433 个家庭（241 名参与者，192 名非参与者）中收集与人体测量学、生活方式、饮食习惯、社会人口学和心理社会参数相关的基线数据的相同问卷进行分析。使用单变量分析和二元逻辑回归来确定与不参与相关的因素。
结果
与参与者（62%）相比，非参与者中超重儿童（BMI>第 90 百分位数）的数量更多（41.1%，p<0.001），而参与者中肥胖儿童（BMI>第 97 百分位数）的数量更多（58.9%）与非参与者（38%，p<0.001）相比。参与的女孩比男孩年轻（8.8 岁比 10.4 岁，p<0.001）。87.3%和 40%的参与者，但只有 72.2%和 24.7%的非参与者，分别报告有规律的早餐（p=0.008）和 5 份日常餐（p=0.003）。非参与者的家庭净收入较低（p<0.001），但主观身体健康状况优于参与者（p=0.018），并认为生活方式的改变可以轻松实现（p=0.05）。
结论
父母对孩子体重状况缺乏认识是不参与的一个重要原因。非参与者通常是低收入家庭，他们认为自己已经过着健康的生活方式，主观幸福感更高。我们假设，即使是一个低门槛的干预计划也无法覆盖真正需要的家庭。
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