The Ohio State University, College of Nursing, Columbus, OH, United States.
JMIR Mhealth Uhealth. 2016 Mar 14;4(1):e21. doi: 10.2196/mhealth.4398.
Children are 5 times more likely to be overweight at the age of 12 years if they are overweight during the preschool period.
The purpose of this study was to establish the feasibility, acceptability, and preliminary effects of a cognitive behavioral intervention (TEXT2COPE) synergized with tailored mobile technology (mHealth) on the healthy lifestyle behaviors of parents of overweight and obese preschoolers delivered in a primary care setting.
Fifteen preschooler-parent dyads recruited through primary care clinics completed a manualized 7-week cognitive behavioral skills building intervention. Beck's Cognitive Theory guided the TEXT2COPE intervention content and Fogg's Behavior Model guided the implementation. The intervention employed a combination of face-to-face clinic visits and ecological momentary interventions using text messaging (short message service, SMS). To enhance the intervention's relevance to the family's needs, parents dictated the wording of the text messages and also were able to adapt the frequency and timing of delivery throughout program implementation.
Self-reported findings indicate that the program is feasible and acceptable in this population. The intervention showed preliminary effects with significant improvements on parental knowledge about nutrition (P=.001) and physical activity (P=.012) for their children, parental beliefs (P=.001) toward healthy lifestyles, and parental behaviors (P=.040) toward engaging in healthy lifestyle choices for their children. Effect sizes were medium to large for all variables. The timing, frequency, and wording of the text messages were tailored to the individual families, with 69% of parents (9/13) increasing the frequency of the tailored SMS from being sent once weekly to as many as 5 times a week.
Utilizing a cognitive behavioral skills intervention with SMS has great potential for supporting clinical care of overweight and obese preschool children and their families. Further exploration of the potential effects on health and behavioral outcomes is warranted.
如果儿童在学龄前超重，那么他们在 12 岁时超重的可能性是其他儿童的 5 倍。
本研究旨在确定一种认知行为干预（TEXT2COPE）与定制移动技术（移动健康）相结合，在初级保健环境中为超重和肥胖学龄前儿童的父母提供健康生活方式行为的可行性、可接受性和初步效果。
通过初级保健诊所招募了 15 对学龄前儿童-父母进行了为期 7 周的认知行为技能培养干预。贝克认知理论指导 TEXT2COPE 干预内容，福格行为模型指导实施。该干预采用了面对面诊所就诊和使用短信（短消息服务，SMS）进行生态瞬间干预相结合的方式。为了增强干预对家庭需求的相关性，父母可以自行决定短信的措辞，也可以在整个项目实施过程中调整短信的发送频率和时间。
自我报告的研究结果表明，该方案在该人群中是可行且可接受的。该干预显示出初步效果，父母对儿童营养（P=.001）和体育活动（P=.012）的知识显著提高，对健康生活方式的信念（P=.001）以及对为孩子选择健康生活方式的行为（P=.040）也有所改善。所有变量的效应大小均为中到大。短信的时间、频率和措辞均根据每个家庭的情况进行了定制，有 69%的父母（9/13）将定制 SMS 的发送频率从每周一次增加到每周最多 5 次。
利用短信的认知行为技能干预为超重和肥胖学龄前儿童及其家庭的临床护理提供了巨大的潜力。需要进一步探索其对健康和行为结果的潜在影响。
