Department of Nursing, Factor Building, Room 5-157, University of California, Los Angeles, 700 Tiverton Avenue, Los Angeles, CA 90095, USA.
Child Obes. 2012 Aug;8(4):347-56. doi: 10.1089/chi.2012.0045.
University–community partnerships through coordinated school health programs (CSHP) can play a key role in decreasing child obesity. The main objective of this study was to measure over a 1-year period whether a CSHP with parental, school, and home-based components to promote optimal nutrition will reduce BMI percentiles and z-scores and improve dietary behaviors in a sample of low-income, school-aged children.
The intervention included, Kids Nutrition and Fitness, a 6-week nutrition, physical activity educational after-school program, and school activities, including creation of an Advisory Committee that made wellness policies. A randomized controlled pilot study evaluated the effectiveness of the intervention that contrasts 251 (n = 251) predominantly Mexican-American 8 to 12 year olds from low-income Los Angeles–based schools. A mixed model of repeated measures analysis assessed changes in BMI percentiles and z-scores, dietary behaviors, food preferences, knowledge, and self-efficacy measured by a reliable/valid questionnaire. These data were collected at baseline and at 4 and 12 months postintervention. Process measures, collected via focus groups with parents, evaluated parent/community involvement.
At the 12-month follow-up, children in the intervention group decreased their BMI on average by 2.80 (p = 0.04) and BMI z-scores on average by 0.48 (p = 0.03) and they increased their daily dietary intake of vegetables on average by 1.51 (p = 0.03), fruit on average by 2.00 (P = 0.001), and 100% fruit juice by 1.12 (p = 0.05). An increase of 1.02 (p = 0.03) was seen in self-efficacy of healthy food choices (p = 0.03). Parent (P = 0.04) and community (p = 0.001) involvement significantly increased to 100% participation by the 12-month follow-up.
A CSHP using parent and community involvement was effective in reducing the risk of obesity in school-aged Mexican- American children attending low-income schools. The findings need to be examined in a larger, more diverse sample of children.
通过协调学校卫生计划（CSHP）建立的大学-社区伙伴关系可以在减少儿童肥胖方面发挥关键作用。本研究的主要目的是在一年的时间内测量一个 CSHP 的效果，该 CSHP 包括父母、学校和家庭为基础的成分，以促进最佳营养，减少 BMI 百分位和 z 分数，并改善低收入、学龄儿童的饮食行为。
该干预措施包括 Kids Nutrition and Fitness，这是一个为期 6 周的营养、体育教育课后计划，以及学校活动，包括成立一个咨询委员会制定健康政策。一项随机对照试点研究评估了该干预措施的有效性，该干预措施对比了来自洛杉矶低收入学校的 251 名（n=251）主要为墨西哥裔美国的 8 至 12 岁儿童。采用重复测量混合模型分析评估 BMI 百分位和 z 分数、饮食行为、食物偏好、知识和自我效能（通过可靠/有效的问卷测量）的变化。这些数据在基线和干预后 4 个月和 12 个月收集。通过与父母进行焦点小组收集的过程测量评估了父母/社区的参与情况。
在 12 个月的随访中，干预组的儿童平均 BMI 降低了 2.80（p=0.04），BMI z 分数平均降低了 0.48（p=0.03），他们平均每天的蔬菜摄入量增加了 1.51（p=0.03），水果摄入量增加了 2.00（P=0.001），100%果汁摄入量增加了 1.12（p=0.05）。健康食品选择的自我效能感增加了 1.02（p=0.03）。父母（P=0.04）和社区（p=0.001）的参与度显著增加，到 12 个月随访时达到 100%。
使用父母和社区参与的 CSHP 可有效降低低收入学校的墨西哥裔美国学龄儿童肥胖的风险。这一发现需要在更大、更多样化的儿童样本中进行检验。
