Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.
JAMA Pediatr. 2013 Nov;167(11):1072-9. doi: 10.1001/jamapediatrics.2013.2356.
Racial/ethnic and socioeconomic disparities exist across risk factors for childhood obesity.
To examine the effectiveness of a home-based intervention to improve household routines known to be associated with childhood obesity among a sample of low-income, racial/ethnic minority families with young children.
Randomized trial.
The intervention was delivered in the families' homes.
The study involved 121 families with children aged 2 to 5 years who had a television (TV) in the room where he or she slept; 111 (92%) had 6-month outcome data (55 intervention and 56 control). The mean (SD) age of the children was 4.0 (1.1) years; 45% were overweight/obese. Fifty-two percent of the children were Hispanic, 34% were black, and 14% were white/other. Nearly 60% of the families had household incomes of $20,000 or less.
The 6-month intervention promoted 4 household routines, family meals, adequate sleep, limiting TV time, and removing the TV from the child's bedroom, using (1) motivational coaching at home and by phone, (2) mailed educational materials, and (3) text messages. Control subjects were mailed materials focused on child development.
Change in parent report of frequency of family meals (times/wk), child sleep duration (hours/d), child weekday and weekend day TV viewing (hours/d), and the presence of a TV in the room where the child slept from baseline to 6 months. A secondary outcome was change in age- and sex-adjusted body mass index (calculated as weight in kilograms divided by height in meters squared).
Compared with control subjects, intervention participants had increased sleep duration (0.75 hours/d; 95% CI, 0.06 to 1.44; P = .03), greater decreases in TV viewing on weekend days (-1.06 hours/d; 95% CI, -1.97 to -0.15; P = .02), and decreased body mass index (-0.40; 95% CI, -0.79 to 0.00; P = .05). No significant intervention effect was found for the presence of a TV in the room where the child slept or family meal frequency.
Our results suggest that promoting household routines, particularly increasing sleep duration and reducing TV viewing, may be an effective approach to reduce body mass index among low-income, racial/ethnic minority children. Longer-term studies are needed to determine maintenance of behavior change.
clinicaltrials.gov Identifier: NCT01565161.
在儿童肥胖的风险因素方面存在种族/民族和社会经济差异。
在一个有年幼子女的低收入、少数族裔家庭样本中，检查一种基于家庭的干预措施的有效性，该干预措施旨在改善与儿童肥胖相关的家庭常规。
随机试验。
干预措施在家庭中进行。
该研究涉及 121 名年龄在 2 至 5 岁之间、房间内有电视（TV）的儿童的家庭；111 名（92%）有 6 个月的结果数据（55 名干预组和 56 名对照组）。儿童的平均（SD）年龄为 4.0（1.1）岁；45%超重/肥胖。52%的儿童是西班牙裔，34%是黑人，14%是白人和其他族裔。近 60%的家庭收入在 20,000 美元或以下。
为期 6 个月的干预措施促进了 4 项家庭常规，包括家庭用餐、充足的睡眠、限制电视时间以及将电视从孩子的卧室中移除，使用（1）家庭和电话上的动机辅导，（2）邮寄教育材料，和（3）短信。对照组家庭收到了以儿童发展为重点的材料。
从基线到 6 个月时，父母报告的家庭用餐频率（每周次数）、儿童睡眠时间（每天小时数）、儿童工作日和周末日看电视时间（每天小时数）以及儿童卧室中是否有电视的变化。次要结果是年龄和性别调整后的体重指数（计算方法为体重（公斤）除以身高（米）的平方）的变化。
与对照组相比，干预组参与者的睡眠时间增加了 0.75 小时/天（95%置信区间，0.06 至 1.44；P =.03），周末看电视的时间减少了 1.06 小时/天（95%置信区间，-1.97 至 -0.15；P =.02），体重指数降低了 0.40（95%置信区间，-0.79 至 0.00；P =.05）。干预措施对儿童卧室中是否有电视或家庭用餐频率没有显著影响。
我们的结果表明，促进家庭常规，特别是增加睡眠时间和减少看电视时间，可能是一种有效减少低收入、少数族裔儿童体重指数的方法。需要进行更长期的研究以确定行为改变的维持情况。
clinicaltrials.gov 标识符：NCT01565161。
