Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, WC1E 6BT, London, UK.
BMC Public Health. 2012 Jun 6;12:404. doi: 10.1186/1471-2458-12-404.
Social marketing campaigns offer a promising approach to the prevention of childhood obesity. Change4Life (C4L) is a national obesity prevention campaign in England. It included mass media coverage aiming to reframe obesity into a health issue relevant to all and provided the opportunity for parents to complete a brief questionnaire ('How are the Kids') and receive personalised feedback about their children's eating and activity. Print and online C4L resources were available with guidance about healthy eating and physical activity. The study aims were to examine the impact of personalised feedback and print material from the C4L campaign on parents' attitudes and behaviours about their children's eating and activity in a community-based cluster-randomised controlled trial.
Parents of 5-11 year old children were recruited from 40 primary schools across England. Schools were randomised to intervention or control ('usual care'). Basic demographic data and brief information about their attitudes to their children's health were collected. Families in intervention schools were mailed the C4L print materials and the 'How are the Kids' questionnaire; those returning the questionnaire were sent personalised feedback and others received generic materials. Outcomes included awareness of C4L, attitudes to the behaviours recommended in C4L, parenting behaviours (monitoring and modelling), and child health behaviours (diet, physical activity and television viewing). Follow-up data were collected from parents by postal questionnaire after six months. Qualitative interviews were carried out with a subset of parents (n = 12).
3,774 families completed baseline questionnaires and follow-up data were obtained from 1,419 families (37.6%). Awareness was high in both groups at baseline (75%), but increased significantly in the intervention group by follow-up (96% vs. 87%). Few parents (5.2% of the intervention group) returned the questionnaire to get personalised feedback. There were few significant group differences in parental attitudes or parenting and child health behaviours at follow-up. Physical activity was rated as less important in the intervention group, but a significant group-by-socioeconomic status (SES) interaction indicated that this effect was confined to higher SES families. Similar interactions were also seen for physical activity monitoring and child television time; with adverse effects in higher SES families and no change in the lower SES families. Effects were little better in families that completed the questionnaire and received personalised feedback. At interview, acceptability of the intervention was modest, although higher in lower SES families.
The C4L campaign materials achieved increases in awareness of the campaign, but in this sample had little impact on attitudes or behaviour. Low engagement with the intervention appeared a key issue.
Current Controlled Trials ISRCTN00791709.
社会营销活动为预防儿童肥胖提供了一种很有前途的方法。Change4Life（C4L）是英格兰的一项国家肥胖预防运动。它包括旨在将肥胖重新定义为与所有人相关的健康问题的大众媒体报道，并为父母提供了完成简短问卷（“孩子们怎么样”）的机会，并收到有关孩子饮食和活动的个性化反馈。提供了印刷和在线 C4L 资源，其中包含有关健康饮食和体育活动的指导。该研究的目的是在一项基于社区的整群随机对照试验中，检查 C4L 运动的个性化反馈和印刷材料对父母对子女饮食和活动的态度和行为的影响。
从英格兰的 40 所小学招募了 5-11 岁儿童的父母。学校被随机分配到干预组或对照组（“常规护理”）。收集了基本的人口统计学数据和有关他们对孩子健康态度的简要信息。干预学校的家庭收到了 C4L 印刷材料和“孩子们怎么样”问卷；返回问卷的人收到了个性化反馈，其他人则收到了通用材料。结果包括对 C4L 的认识，对 C4L 推荐行为的态度，养育行为（监督和模仿）以及儿童健康行为（饮食，体育活动和看电视）。六个月后，通过邮政问卷从父母那里收集了随访数据。对一小部分父母（n=12）进行了定性访谈。
3774 个家庭完成了基线问卷，有 1419 个家庭（37.6％）获得了随访数据。两组在基线时的意识都很高（75％），但干预组在随访时显着增加（96％比87％）。很少有父母（干预组的 5.2％）返回问卷以获得个性化反馈。在随访时，父母的态度或养育和儿童健康行为很少有明显的组间差异。干预组认为体育活动不那么重要，但SES 之间的显着交互作用表明，这种影响仅限于 SES 较高的家庭。SES 较高的家庭中也出现了类似的物理活动监测和儿童电视时间交互作用，而 SES 较低的家庭则没有变化。在完成问卷并收到个性化反馈的家庭中，效果要好一些。在访谈中，尽管在 SES 较低的家庭中更高，但干预措施的可接受性适中。
C4L 运动材料提高了对运动的认识，但在本样本中，对态度或行为几乎没有影响。与干预措施的低参与度似乎是一个关键问题。
当前对照试验 ISRCTN00791709。
