Alkon Abbey, Crowley Angela A, Neelon Sara E Benjamin, Hill Sherika, Pan Yi, Nguyen Viet, Rose Roberta, Savage Eric, Forestieri Nina, Shipman Linda, Kotch Jonathan B
Department of Maternal and Child Health, CB# 7445 Rosenau Hall, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7445, USA.
BMC Public Health. 2014 Mar 1;14:215. doi: 10.1186/1471-2458-14-215.
To address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children's body mass index (BMI).
A seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center's written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children's nutritional intake, physical activity, and height and weight pre- and post-intervention.
Hierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers' and parents' knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children's zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points.
The NAP SACC intervention, as delivered by trained child health professionals such as child care health consultants, increases provider knowledge, improves center policies, and lowers BMI for children in child care centers. More health professionals specifically trained in a nutrition and physical activity intervention in child care are needed to help reverse the obesity epidemic.
National Clinical Trials Number NCT01921842.
为应对超重和肥胖学龄前儿童的公共卫生危机，儿童保育营养与身体活动自我评估（NAP SACC）干预措施由儿童保育健康顾问护士实施，目的是提高儿童保育提供者和家长的营养与身体活动知识、中心层面的营养与身体活动政策及实践，以及儿童的体重指数（BMI）。
在加利福尼亚州、康涅狄格州和北卡罗来纳州的17家主要为低收入家庭服务的持牌儿童保育中心进行了一项为期七个月的随机对照试验，其中包括137名儿童保育提供者和552个家庭，这些家庭的孩子年龄在三至五岁，种族和民族多样。NAP SACC干预措施包括为儿童保育提供者和家长举办关于营养与身体活动的教育研讨会，以及由训练有素的儿童保育健康顾问护士进行咨询访问。提供者和家长完成了人口统计学特征以及研讨会前后的知识调查。不知情的研究助理审查了每个中心的书面健康与安全政策，并观察了营养与身体活动实践，还在干预前后测量了随机选择儿童的营养摄入量、身体活动情况以及身高和体重。
分层线性模型和多元回归模型评估了知识、政策、实践以及年龄和性别特异性标准化体重指数（zBMI）在个体和中心层面的变化，并对州、家长教育程度和贫困水平进行了控制。结果显示，基于干预中心和对照中心在干预前后两个时间点的209名儿童，提供者和家长在营养与身体活动知识方面有显著增加，中心层面的政策有所改善，儿童层面的zBMI也有变化。
由儿童保育健康顾问等训练有素的儿童健康专业人员实施的NAP SACC干预措施，增加了提供者的知识，改善了中心政策，并降低了儿童保育中心儿童的BMI。需要更多在儿童保育营养与身体活动干预方面经过专门培训的健康专业人员，以帮助扭转肥胖流行趋势。
国家临床试验编号NCT01921842。
