Kegler Michelle C, Alcantara Iris, Veluswamy J K, Haardörfer Regine, Hotz James A, Glanz Karen
Emory Prevention Research Center, Rollins School of Public Health, Emory University Research Center (EPRC), Cancer Coalition of South Georgia, USA.
Prog Community Health Partnersh. 2012 Fall;6(3):265-77. doi: 10.1353/cpr.2012.0042.
Ecological models of healthy eating and physical activity emphasize the influence of behavioral settings such as homes and worksites in shaping behavior. Research on home environments suggests that both social and physical aspects of the home may impact physical activity and healthy eating.
Using a community-based participatory research (CBPR) approach, the Emory Prevention Research Center (EPRC), Cancer Coalition of South Georgia, and the EPRC's Community Advisory Board (CAB) designed and tested a coach-based intervention to make the home environment more supportive of healthy eating and physical activity for rural adults.
The 6-week intervention consisted of a tailored home environment profile, goal-setting, and behavioral contracting delivered through two home visits and two telephone calls. The study used a quasi-experimental design with data collected via telephone interviews at baseline, 2 and 4 months post-baseline. Ninety households (n = 90) completed all three telephone interviews.
Multilevel models indicated that intervention households reported significant improvements in household food inventories, purchasing of fruit and vegetables, healthier meal preparation, meals with the TV off, and family support for healthy eating, relative to comparison households. Intervention households also reported increased exercise equipment and family support for physical activity relative to comparison households. Percent of fat intake decreased significantly, but no changes were observed for fruit and vegetable intake, physical activity, or weight among intervention relative to comparison households, although trends were generally in a positive direction.
Coaching combined with a focus on the home environment may be a promising strategy for weight gain prevention in adults.
健康饮食和体育活动的生态模型强调家庭和工作场所等行为环境对行为塑造的影响。对家庭环境的研究表明,家庭的社会和物理方面都可能影响体育活动和健康饮食。
埃默里预防研究中心(EPRC)、南佐治亚癌症联盟和EPRC社区咨询委员会(CAB)采用基于社区的参与性研究(CBPR)方法,设计并测试了一种基于指导的干预措施,以使家庭环境更支持农村成年人的健康饮食和体育活动。
为期6周的干预包括通过两次家访和两次电话提供的量身定制的家庭环境概况、目标设定和行为契约。该研究采用准实验设计,在基线、基线后2个月和4个月通过电话访谈收集数据。90户家庭(n = 90)完成了所有三次电话访谈。
多层次模型表明,与对照家庭相比,干预家庭在家庭食物库存、水果和蔬菜采购、更健康的膳食准备、关电视用餐以及家庭对健康饮食的支持方面有显著改善。与对照家庭相比,干预家庭还报告说运动器材增加,家庭对体育活动的支持增加。干预家庭的脂肪摄入量百分比显著下降,但与对照家庭相比,干预家庭的水果和蔬菜摄入量、体育活动或体重没有变化,尽管趋势总体呈积极方向。
指导结合对家庭环境的关注可能是预防成年人体重增加的一种有前景的策略。