Shin Ahyoung, Surkan Pamela J, Coutinho Anastasia J, Suratkar Sonali R, Campbell Rebecca K, Rowan Megan, Sharma Sangita, Dennisuk Lauren A, Karlsen Micaela, Gass Anthony, Gittelsohn Joel
Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
University of Alberta, Edmonton, Alberta, Canada.
Health Educ Behav. 2015 Apr;42(1 Suppl):97S-105S. doi: 10.1177/1090198115571362.
This study assessed the impact of a youth-targeted multilevel nutrition intervention in Baltimore City. The study used a clustered randomized design in which 7 recreation centers and 21 corner stores received interventions and 7 additional recreation centers served as comparison. The 8-month intervention aimed to increase availability and selection of healthful foods through nutrition promotion and education using point-of purchase materials such as posters and flyers in stores and interactive sessions such as taste test and cooking demonstrations. Two hundred forty-two youth-caregiver dyads residing in low-income areas of Baltimore City recruited from recreation centers were surveyed at baseline using detailed instruments that contained questions about food-related psychosocial indicators (behavioral intentions, self-efficacy, outcome expectancies, and knowledge), healthful food purchasing and preparation methods, and anthropometric measures (height and weight). The Baltimore Healthy Eating Zones intervention was associated with reductions in youth body mass index percentile (p = .04). In subgroup analyses among overweight and obese girls, body mass index for age percentile decreased significantly in girls assigned to the intervention group (p = .03) and in girls with high exposure to the intervention (p = .013), as opposed to those in comparison or lower exposure groups. Intervention youth significantly improved food-related outcome expectancies (p = .02) and knowledge (p < .001). The study results suggest that the Baltimore Healthy Eating Zones multilevel intervention had a modest impact in reducing overweight or obesity among already overweight low-income African American youth living in an environment where healthful foods are less available. Additional studies are needed to determine the relative impact of health communications and environmental interventions in this population, both alone and in combination.
本研究评估了针对巴尔的摩市青少年的多层次营养干预措施的影响。该研究采用整群随机设计，其中7个娱乐中心和21家街角商店接受了干预措施，另外7个娱乐中心作为对照。为期8个月的干预旨在通过营养推广和教育来增加健康食品的可及性和选择，在商店中使用海报和传单等购买点材料，并开展味觉测试和烹饪示范等互动活动。从娱乐中心招募的居住在巴尔的摩市低收入地区的242对青少年-照顾者二元组在基线时使用详细的工具进行了调查，这些工具包含有关与食物相关的心理社会指标（行为意图、自我效能感、结果期望和知识）、健康食品购买和制备方法以及人体测量指标（身高和体重）的问题。巴尔的摩健康饮食区干预措施与青少年体重指数百分位数的降低相关（p = 0.04）。在超重和肥胖女孩的亚组分析中，与对照组或低暴露组的女孩相比，分配到干预组的女孩（p = 0.03）和高暴露于干预措施的女孩（p = 0.013）的年龄别体重指数百分位数显著下降。干预组青少年在与食物相关的结果期望（p = 0.02）和知识（p < 0.001）方面有显著改善。研究结果表明，巴尔的摩健康饮食区多层次干预措施对生活在健康食品供应较少环境中的超重低收入非裔美国青少年减少超重或肥胖有一定影响。需要进一步的研究来确定健康传播和环境干预措施单独及联合对该人群的相对影响。
