Hull P C, Buchowski M, Canedo J R, Beech B M, Du L, Koyama T, Zoorob R
Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Division of Gastroenterology, Hepatology, & Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Pediatr Obes. 2018 Nov;13(11):686-696. doi: 10.1111/ijpo.12197. Epub 2016 Nov 24.
Obesity prevalence is disproportionately high among Hispanic children.
The Healthy Families Study assessed the efficacy of a culturally targeted, family-based weight gain prevention intervention for Hispanic immigrant families with children ages 5-7 years.
The study used a two-group, cluster randomized trial design, assigning 136 families (clusters) to the active intervention (weight gain prevention) and 136 families to attention control (oral health). The active intervention included a 4-month intensive phase (eight classes) and an 8-month reinforcement phase (monthly mail/telephone contact). Children's body mass index z-score (BMI-Z) was the primary outcome.
The BMI-Z growth rate of the active intervention group did not differ from the attention control group at short-term follow-up (median 6 months; 168 families, 206 children) or long-term follow-up (median 16 months; 142 families, 169 children). Dose response analyses indicated a slower increase in BMI-Z at short term among overweight/obese children who attended more intervention classes. Moderate physical activity on weekends increased at short term. Weekend screen time decreased at short term among those attending at least one class session.
Low class attendance likely impacted intention-to-treat results. Future interventions targeting this population should test innovative strategies to maximize intervention engagement to produce and sustain effects on weight gain prevention.
西班牙裔儿童中的肥胖患病率高得不成比例。
健康家庭研究评估了一项针对文化背景、以家庭为基础的体重增加预防干预措施对有5至7岁儿童的西班牙裔移民家庭的效果。
该研究采用两组整群随机试验设计,将136个家庭(群组)分配到积极干预组(预防体重增加),136个家庭分配到注意力控制组(口腔健康)。积极干预包括一个为期4个月的强化阶段(八节课)和一个为期8个月的强化阶段(每月邮件/电话联系)。儿童的体重指数z评分(BMI-Z)是主要结局指标。
在短期随访(中位数6个月;168个家庭,206名儿童)或长期随访(中位数16个月;142个家庭,169名儿童)中,积极干预组的BMI-Z增长率与注意力控制组没有差异。剂量反应分析表明,参加更多干预课程的超重/肥胖儿童在短期内BMI-Z的增加较慢。周末的适度身体活动在短期内有所增加。在至少参加一次课程的儿童中,周末的屏幕时间在短期内有所减少。
低课程参与率可能影响了意向性分析结果。未来针对该人群的干预措施应测试创新策略,以最大限度地提高干预参与度,从而对预防体重增加产生并维持效果。