Pigeot Iris, De Henauw Stefaan, Ahrens Wolfgang
Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS, Fachbereich 03: Mathematik und Informatik, Universität Bremen, Achterstr. 30, 28359, Bremen, Deutschland.
Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Gent, Belgien.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016 Nov;59(11):1385-1393. doi: 10.1007/s00103-016-2445-1.
Worldwide the prevalence of childhood overweight and obesity is strikingly high. Prevention programs are therefore of high priority at a national and international level. In the framework of the IDEFICS study a primary prevention program was developed, implemented and evaluated.
This paper investigates to what degree the IDEFICS intervention may serve as good practice example. For this purpose, the single modules are described and the achieved effects are discussed.
In eight European countries 16,228 children aged 2 to 9.9 years were recruited from kindergartens and schools. About half of them participated in a primary prevention program. In each country the intervention region was matched to a control region with a similar socio-demographic profile. All children participated in an extensive examination program at baseline, which was repeated two years later to assess the development of the children and the intervention effects. In addition, a further follow-up examination took place five years after the intervention in the framework of the I.Family study.
After two years the IDEFICS intervention showed only minor effects on an individual level, but sustainable effects on the community and the setting level. After five years a beneficial change in the consumption of sugar and water could be observed in the intervention families and children who were overweight and obese at baseline showed favorable weight trajectories.
The reasons for the weak intervention effects may be, among others, due to the limited penetration of intervention messages, an insufficient intensity of local intervention activities and our limited ability to induce structural changes of the obesogenic environment.
全球范围内儿童超重和肥胖的患病率极高。因此，预防计划在国家和国际层面都具有高度优先性。在IDEFICS研究框架内，制定、实施并评估了一项初级预防计划。
本文调查IDEFICS干预措施在多大程度上可作为良好实践范例。为此，描述了各个模块并讨论了所取得的效果。
在八个欧洲国家，从幼儿园和学校招募了16228名2至9.9岁的儿童。其中约一半儿童参加了初级预防计划。在每个国家，干预地区与社会人口统计学特征相似的对照地区相匹配。所有儿童在基线时都参加了一项全面的检查计划，两年后重复进行以评估儿童的发育情况和干预效果。此外，在I.Family研究框架内，在干预五年后进行了进一步的随访检查。
两年后，IDEFICS干预在个体层面仅显示出微小效果，但在社区和环境层面具有可持续效果。五年后，在干预家庭中观察到糖和水的消费有有益变化，且基线时超重和肥胖的儿童显示出有利的体重轨迹。
干预效果微弱的原因可能包括，除其他外，干预信息的渗透有限、当地干预活动强度不足以及我们在诱导致肥胖环境结构变化方面的能力有限。
