Lazorick Suzanne, Fang Xiangming, Crawford Yancey
1 Departments of Pediatrics and Public Health, East Carolina University , Greenville, NC.
2 Department of Biostatistics, College of Allied Health Sciences, East Carolina University , Greenville, NC.
Child Obes. 2016 Apr;12(2):103-12. doi: 10.1089/chi.2015.0073. Epub 2016 Jan 20.
Motivating Adolescents with Technology to CHOOSE Health™ (MATCH) has been provided for eight years in North Carolina middle schools with high obesity prevalence.
Seventh grade teachers in two schools delivered MATCH lessons in 2009, with one control school. In 2013 students were remeasured and completed a health behavior survey. Outcomes include BMI, BMI z-score (zBMI), weight category, and self-reported behaviors. Comparisons used t tests (continuous measures), Fisher's exact test (categorical measures), and linear mixed models (trend between groups).
Of original participants, 104/189 (55%) of MATCH and 117/173 (68%) of control were remeasured. In the control group, retained participants had lower baseline BMI and were higher percent white. Among all participants, zBMI decreased in MATCH (mean change -0.15 with SD = 0.60) and increased in control (mean change 0.04 with SD = 0.52); between groups p = 0.02. In mixed models for the all overweight subgroup, MATCH had a downward trend in zBMI over time that was significantly different from control (slope MATCH -0.0036 versus control 0.0009; p = 0.01). For shifts in weight category: incidence of obesity was lower in MATCH (13%) versus control (39%); remission of overweight to healthy weight was greater in MATCH (40%) versus control (26%). MATCH participants self-reported lower frequency of intake of sweetened beverages and snacks and hours of weekday TV time than control students.
MATCH participation can result in long-term prevention of obesity compared to control, with differences in self-reported health behavior changes to support an underlying mechanism for the observed BMI differences.
“利用技术激励青少年选择健康”（MATCH）项目已在北卡罗来纳州肥胖率较高的中学开展了八年。
2009年，两所学校的七年级教师开展了MATCH课程，另有一所对照学校。2013年，对学生进行了重新测量，并完成了一项健康行为调查。结果包括体重指数（BMI）、BMI z评分（zBMI）、体重类别和自我报告的行为。比较采用t检验（连续测量）、Fisher精确检验（分类测量）和线性混合模型（组间趋势）。
在最初的参与者中，重新测量了MATCH组的104/189名（55%）和对照组的117/173名（68%）。在对照组中，留存的参与者基线BMI较低，白人比例较高。在所有参与者中，MATCH组的zBMI下降（平均变化-0.15，标准差=0.60），而对照组增加（平均变化0.04，标准差=0.52）；组间p=0.02。在所有超重亚组的混合模型中，MATCH组的zBMI随时间呈下降趋势，与对照组有显著差异（MATCH组斜率为-0.0036，对照组为0.0009；p=0.01）。对于体重类别的变化：MATCH组的肥胖发生率（13%）低于对照组（39%）；MATCH组超重恢复到健康体重的比例（40%）高于对照组（26%）。MATCH组参与者自我报告的含糖饮料和零食摄入量以及工作日看电视时间的频率低于对照组学生。
与对照组相比，参与MATCH项目可长期预防肥胖，自我报告的健康行为变化存在差异，支持了观察到的BMI差异的潜在机制。
