Benjamin Neelon Sara E, Namenek Brouwer Rebecca J, Østbye Truls, Evenson Kelly R, Neelon Brian, Martinie Annie, Bennett Gary
1Department of Community and Family Medicine, Duke University Medical Center, Duke University, Durham, NC.
2Duke Global Health Institute, Durham, NC.
Child Obes. 2015 Jun;11(3):297-303. doi: 10.1089/chi.2014.0130. Epub 2015 May 4.
Community-based interventions are promising approaches to obesity prevention, but few studies have prospectively evaluated them. The aim of this study was to evaluate a natural experiment—a community intervention designed to promote active living and decrease obesity within a small southern town.
In 2011, community leaders implemented the Mebane on the Move intervention—a community-wide effort to promote physical activity (PA) and decrease obesity among residents of Mebane, North Carolina. We measured child PA and BMI before and after the intervention, using a nearby town not implementing an intervention as the comparison. In total, we assessed 64 children from Mebane and 40 from the comparison community 6 months before, as well as 34 and 18 children 6 months after the intervention. We assessed PA with accelerometers worn for 7 days and calculated BMI z-scores using children's height and weight. We conducted multivariable linear regressions examining pre- to postintervention change in minutes of PA and BMI z-score, adjusting for confounders.
At follow-up, children in Mebane modestly increased their moderate-to-vigorous PA (1.3 minutes per hour; 95% confidence interval (CI): 0.2, 2.3; p=0.03) and vigorous activity (0.8 minutes per hour; 95% CI: 0.1, 1.5; p=0.04) more than comparison children. In intervention children, BMI z-scores decreased 0.5 units (kg/m(2); 95% CI: -0.9, -0.02; p=0.045), compared to children in the comparison community.
We observed positive effects on PA level and weight status of children in Mebane, despite high rates of attrition, suggesting that the community-based intervention may have been successful.
基于社区的干预措施是预防肥胖的有效方法，但前瞻性评估此类措施的研究较少。本研究旨在评估一项自然实验——在一个南方小镇开展的旨在促进积极生活方式并减少肥胖的社区干预措施。
2011年，社区领导人实施了“梅班动起来”干预措施——一项在北卡罗来纳州梅班社区范围内促进体育活动（PA）并减少居民肥胖的行动。我们在干预前后测量了儿童的PA和BMI，以附近未实施干预的城镇作为对照。总共，我们在干预前6个月评估了来自梅班的64名儿童和来自对照社区的40名儿童，以及在干预后6个月评估了34名和18名儿童。我们使用佩戴7天的加速度计评估PA，并根据儿童的身高和体重计算BMI z评分。我们进行了多变量线性回归分析，以研究干预前后PA分钟数和BMI z评分的变化，并对混杂因素进行了调整。
随访时，梅班的儿童比对照儿童适度增加了中等到剧烈PA（每小时增加1.3分钟；95%置信区间（CI）：0.2，2.3；p = 0.03）和剧烈活动（每小时增加0.8分钟；95%CI：0.1，1.5；p = 0.04）。与对照社区的儿童相比，干预组儿童的BMI z评分下降了0.5个单位（kg/m²；95%CI：-0.9，-0.02；p = 0.045）。
尽管失访率较高，但我们观察到梅班儿童的PA水平和体重状况有积极影响，这表明基于社区的干预措施可能是成功的。
