Larsen Andrew L, Liao Yue, Alberts Janel, Huh Jimi, Robertson Trina, Dunton Genevieve F
Department of Psychology, University of Southern California, SGM 501, 3620 South McClintock Ave, Los Angeles, CA 90089.
Department of Preventive Medicine, University of Southern California, 2001 North Soto Street, Los Angeles, CA 90032.
J Sch Health. 2017 Jan;87(1):36-46. doi: 10.1111/josh.12466.
Few nutrition interventions in kindergarten classes have been evaluated, and none has been tested for program effectiveness, implementation, and dissemination. Building a Healthy Me (BHM) is a nutrition intervention for kindergarteners that is classroom-based and includes a family component. This study evaluated the public health impact of BHM in California kindergarten classrooms using the RE-AIM (reach, efficacy, adoption, implementation, and maintenance) framework.
A quasi-experimental design assessed pre-to-post changes in nutrition knowledge, dietary consumption, and parent behaviors of 25 intervention classrooms (414 students, 264 parents); and postintervention differences in nutrition knowledge between the intervention classrooms and 4 control classrooms measured at postintervention only (103 students).
Intervention students improved in knowledge of food groups and healthy breakfast/snack options, and scored higher than control students in food group knowledge at postintervention (ps < .05). Parents of intervention group children increased their use of food labels, and intervention group children increased intake of several healthy foods and decreased intake of candy and fried potatoes (ps < .05). The BHM program reached 41% of kindergarteners attending public schools in California, and teachers implemented most lesson material.
The BHM program was effective, implemented with fidelity, and broadly disseminated, highlighting its potential public health impact for kindergarteners.
针对幼儿园班级的营养干预措施鲜有评估，且尚无任何一项措施经过项目效果、实施情况及推广情况的测试。“塑造健康的我”（BHM）是一项针对幼儿园儿童的营养干预措施，以课堂教学为基础，并包含家庭部分。本研究使用RE-AIM（覆盖范围、效果、采用率、实施情况及维持情况）框架评估了BHM在加利福尼亚州幼儿园课堂中的公共卫生影响。
采用准实验设计评估了25个干预班级（414名学生，264名家长）在营养知识、饮食消费及家长行为方面从干预前到干预后的变化；以及仅在干预后对干预班级和4个对照班级的营养知识进行的干预后差异评估（103名学生）。
干预组学生在食物类别及健康早餐/零食选择的知识方面有所提高，且在干预后食物类别知识得分高于对照组学生（p值<0.05）。干预组儿童的家长增加了食品标签的使用，干预组儿童增加了几种健康食品的摄入量，减少了糖果和炸土豆的摄入量（p值<0.05）。BHM项目覆盖了加利福尼亚州41%的公立幼儿园儿童，教师实施了大部分课程内容。
BHM项目有效，实施具有 fidelity，且广泛传播，凸显了其对幼儿园儿童潜在的公共卫生影响。 （注：原文中“fidelity”未给出准确释义，这里保留英文）
