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采用动机性访谈预防儿童肥胖:一项整群随机对照试验

Motivational Interviewing to Prevent Childhood Obesity: A Cluster RCT.

作者信息

Döring Nora, Ghaderi Ata, Bohman Benjamin, Heitmann Berit L, Larsson Christel, Berglind Daniel, Hansson Lena, Sundblom Elinor, Magnusson Margaretha, Blennow Margareta, Tynelius Per, Forsberg Lars, Rasmussen Finn

机构信息

Child and Adolescent Public Health Epidemiology, Department of Public Health Sciences, and.

Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;

出版信息

Pediatrics. 2016 May;137(5). doi: 10.1542/peds.2015-3104. Epub 2016 Apr 12.

Abstract

OBJECTIVE

The objective was to evaluate a manualized theory-driven primary preventive intervention aimed at early childhood obesity. The intervention was embedded in Swedish child health services, starting when eligible children were 9 to 10 months of age and continuing until the children reached age 4.

METHODS

Child health care centers in 8 Swedish counties were randomized into intervention and control units and included 1355 families with 1369 infants. Over ∼39 months, families in the intervention group participated in 1 group session and 8 individual sessions with a nurse trained in motivational interviewing, focusing on healthy food habits and physical activity. Families in the control group received care as usual. Primary outcomes were children's BMI, overweight prevalence, and waist circumference at age 4. Secondary outcomes were children's and mothers' food and physical activity habits and mothers' anthropometrics. Effects were assessed in linear and log-binominal regression models using generalized estimating equations.

RESULTS

There were no statistically significant differences in children's BMI (β = -0.11, 95% confidence interval [CI]: -0.31 to 0.08), waist circumference (β = -0.48, 95% CI: -0.99 to 0.04), and prevalence of overweight (relative risk = 0.95, 95% CI: 0.69 to 1.32). No significant intervention effects were observed in mothers' anthropometric data or regarding mothers' and children's physical activity habits. There was a small intervention effect in terms of healthier food habits among children and mothers.

CONCLUSIONS

There were no significant group differences in children's and mothers' anthropometric data and physical activity habits. There was, however, some evidence suggesting healthier food habits, but this should be interpreted with caution.

摘要

目的

本研究旨在评估一项以理论为导向的手动式初级预防干预措施,该措施旨在预防幼儿肥胖。该干预措施融入瑞典儿童健康服务体系,从符合条件的儿童9至10个月大时开始,持续至儿童满4岁。

方法

瑞典8个县的儿童保健中心被随机分为干预组和对照组,共纳入1355个家庭的1369名婴儿。在约39个月的时间里,干预组家庭与一名接受过动机性访谈培训的护士参加了1次小组会议和8次个人会议,重点关注健康的饮食习惯和身体活动。对照组家庭接受常规护理。主要结局指标为儿童4岁时的体重指数(BMI)、超重患病率和腰围。次要结局指标为儿童和母亲的饮食及身体活动习惯以及母亲的人体测量数据。使用广义估计方程在线性和对数二项回归模型中评估干预效果。

结果

儿童的BMI(β = -0.11,95%置信区间[CI]:-0.31至0.08)、腰围(β = -0.48,95%CI:-0.99至0.04)和超重患病率(相对风险 = 0.95,95%CI:0.69至1.32)均无统计学显著差异。在母亲的人体测量数据或母亲及儿童的身体活动习惯方面未观察到显著的干预效果。在儿童和母亲更健康的饮食习惯方面存在较小的干预效果。

结论

儿童和母亲的人体测量数据及身体活动习惯在组间无显著差异。然而,有一些证据表明饮食习惯更健康,但对此应谨慎解读。

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