Falbe Jennifer, Cadiz Annabelle A, Tantoco Nicole K, Thompson Hannah R, Madsen Kristine A
Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, Calif.
Contra Costa Public Health, Contra Costa Health Services, Martinez, Calif.
Acad Pediatr. 2015 Jul-Aug;15(4):386-95. doi: 10.1016/j.acap.2015.02.004. Epub 2015 Apr 28.
There is a critical need for culturally relevant interventions to address obesity among Latino children, who have a greater risk of obesity and diabetes than non-Hispanic white children. To test the impact of a family-centered, culturally tailored obesity intervention delivered through group medical appointments on body mass index (BMI) and other measures of cardiovascular risk among Latino children.
In a randomized controlled trial, 55 parent-child dyads were assigned to Active and Healthy Families (AHF) or a usual care wait-list control condition. Dyads were eligible if they spoke Spanish and if the child received care in a federally qualified health center, was aged 5 to 12 years, had a BMI in the 85th percentile or higher, and had not participated in AHF. The 10-week AHF intervention included biweekly group sessions delivered by a registered dietitian, physician, and promotora triad. Sessions covered topics such as parenting, screen time, healthy beverages, physical activity, and stress due to immigration.
Child BMI (kg/m(2)) decreased (-0.50) in the AHF group and increased (+0.32) in the control group, yielding an adjusted difference in change of -0.78 (95% confidence interval [CI] -1.28, -0.27). Children assigned to AHF also exhibited relative improvements over controls in BMI z score (-0.10; 95% CI -0.19, -0.02) and triglycerides (-26.8 mg/dL; 95% CI -50.1, -3.6), but no significant between-group differences were observed for blood pressure or other fasting blood measures.
AHF resulted in reductions in child BMI, BMI z score, and triglycerides. AHF, which was designed for low-income Latino families, has potential to reduce health disparities, but future studies are needed to determine long-term impact.
迫切需要开展与文化相关的干预措施来解决拉丁裔儿童的肥胖问题,这些儿童比非西班牙裔白人儿童患肥胖症和糖尿病的风险更高。旨在测试通过集体医疗预约提供的以家庭为中心、针对文化定制的肥胖干预措施对拉丁裔儿童体重指数(BMI)和其他心血管风险指标的影响。
在一项随机对照试验中,55对亲子被分配到积极健康家庭(AHF)组或常规护理等待名单对照组。如果他们说西班牙语,并且孩子在联邦合格的健康中心接受护理,年龄在5至12岁之间,BMI处于第85百分位或更高,且未参加过AHF,则该亲子对符合条件。为期10周的AHF干预包括由注册营养师、医生和健康促进员三人小组每两周进行一次的集体课程。课程涵盖了育儿、屏幕使用时间、健康饮品、体育活动以及移民带来的压力等主题。
AHF组儿童的BMI(kg/m²)下降了(-0.50),而对照组则上升了(+0.32),调整后的变化差异为-0.78(95%置信区间[CI] -1.28,-0.27)。被分配到AHF组的儿童在BMI z评分(-0.10;95% CI -0.19,-0.02)和甘油三酯(-26.8 mg/dL;95% CI -50.1,-3.6)方面也相对于对照组有相对改善,但在血压或其他空腹血液指标方面未观察到显著的组间差异。
AHF导致儿童BMI、BMI z评分和甘油三酯降低。AHF是为低收入拉丁裔家庭设计的,有潜力减少健康差距,但需要未来的研究来确定其长期影响。