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荷兰生活方式三普项目的有效性:一项随机对照试验。

The effectiveness of lifestyle triple P in the Netherlands: a randomized controlled trial.

作者信息

Gerards Sanne M P L, Dagnelie Pieter C, Gubbels Jessica S, van Buuren Stef, Hamers Femke J M, Jansen Maria W J, van der Goot Odilia H M, de Vries Nanne K, Sanders Matthew R, Kremers Stef P J

机构信息

Department of Health Promotion, and NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.

Department of Epidemiology, Maastricht University, Maastricht, the Netherlands; CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.

出版信息

PLoS One. 2015 Apr 7;10(4):e0122240. doi: 10.1371/journal.pone.0122240. eCollection 2015.

Abstract

INTRODUCTION

Lifestyle Triple P is a general parenting intervention which focuses on preventing further excessive weight gain in overweight and obese children. The objective of the current study was to assess the effectiveness of the Lifestyle Triple P intervention in the Netherlands.

METHOD

We used a parallel randomized controlled design to test the effectiveness of the intervention. In total, 86 child-parent triads (children 4-8 years old, overweight or obese) were recruited and randomly assigned (allocation ratio 1:1) to the Lifestyle Triple P intervention or the control condition. Parents in the intervention condition received a 14-week intervention consisting of ten 90-minute group sessions and four individual telephone sessions. Primary outcome measure was the children's body composition (BMI z-scores, waist circumference and skinfolds). The research assistant who performed the measurements was blinded for group assignment. Secondary outcome measures were the children's dietary behavior and physical activity level, parenting practices, parental feeding style, parenting style, and parental self-efficacy. Outcome measures were assessed at baseline and 4 months (short-term) and 12 months (long-term) after baseline. Multilevel multiple regression analyses were conducted to determine the effect of the intervention on primary and secondary outcome measures.

RESULTS

No intervention effects were found on children's body composition. Analyses of secondary outcomes showed positive short-term intervention effects on children's soft-drink consumption and parental responsibility regarding physical activity, encouragement to eat, psychological control, and efficacy and satisfaction with parenting. Longer-term intervention effects were found on parent's report of children's time spent on sedentary behavior and playing outside, parental monitoring food intake, and responsibility regarding nutrition.

CONCLUSION

Although the Lifestyle Triple P intervention showed positive effects on some parent reported child behaviors and parenting measures, no effects were visible on children's body composition or objectively measured physical activity. Several adjustments of the intervention content are recommended, for example including a booster session.

TRIAL REGISTRATION

Nederlands Trial Register NTR 2555.

摘要

引言

生活方式三重P干预是一项针对家长的综合干预措施,旨在防止超重和肥胖儿童进一步过度增重。本研究的目的是评估生活方式三重P干预在荷兰的效果。

方法

我们采用平行随机对照设计来测试该干预措施的效果。总共招募了86对儿童-家长三元组(儿童年龄在4至8岁之间,超重或肥胖),并将其随机分配(分配比例为1:1)至生活方式三重P干预组或对照组。干预组的家长接受为期14周的干预,包括十次90分钟的小组课程和四次个人电话辅导。主要结局指标是儿童的身体成分(BMI z评分、腰围和皮褶厚度)。进行测量的研究助理对分组情况不知情。次要结局指标包括儿童的饮食行为和身体活动水平、育儿方式、父母喂养方式、教养方式以及父母自我效能感。在基线、基线后4个月(短期)和12个月(长期)对结局指标进行评估。进行多水平多元回归分析以确定干预对主要和次要结局指标的影响。

结果

未发现干预对儿童身体成分有影响。对次要结局的分析表明,干预在短期内对儿童软饮料消费以及家长在身体活动、鼓励进食、心理控制、育儿效能感和满意度方面的责任产生了积极影响。在长期干预效果方面,发现家长报告的儿童久坐行为和户外玩耍时间、家长对食物摄入的监测以及营养方面的责任有所变化。

结论

尽管生活方式三重P干预对一些家长报告的儿童行为和育儿措施显示出积极影响,但对儿童身体成分或客观测量的身体活动没有明显影响。建议对干预内容进行若干调整,例如增加强化课程。

试验注册

荷兰试验注册编号NTR 2555 。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0217/4388496/a4b2004a339a/pone.0122240.g001.jpg

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