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积极健康家庭:一项针对拉丁裔儿童的文化定制肥胖干预随机对照试验

Active and Healthy Families: A Randomized Controlled Trial of a Culturally Tailored Obesity Intervention for Latino Children.

作者信息

Falbe Jennifer, Cadiz Annabelle A, Tantoco Nicole K, Thompson Hannah R, Madsen Kristine A

机构信息

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.

出版信息

Acad Pediatr. 2015 Jul-Aug;15(4):386-95. doi: 10.1016/j.acap.2015.02.004. Epub 2015 Apr 28.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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