McSweeney Lorraine, Araújo-Soares Vera, Rapley Tim, Adamson Ashley
Institute of Health and Society and Human Nutrition Research Centre, Newcastle University, Framlington Place, Newcastle, NE2 4HH, UK.
Institute of Health & Society, Newcastle University, Richardson Road, Newcastle, NE2 4AX, UK.
BMC Public Health. 2017 Mar 11;17(1):248. doi: 10.1186/s12889-017-4167-1.
Around a fifth of children starting school in England are now overweight/obese. There is a paucity of interventions with the aim of obesity prevention in preschool-age children in the UK. Previous research has demonstrated some positive results in changing specific health behaviours, however, positive trends in overall obesity rates are lacking. Preschool settings may provide valuable opportunities to access children and their families not only for promoting healthy lifestyles, but also to develop and evaluate behaviour-change interventions.
This paper presents a cluster randomised feasibility study of a theory based behaviour-change preschool practitioner-led intervention tested in four preschool centres in the North East of England. The primary outcome measures were to test the acceptability and feasibility of the data collection measures and intervention. Secondary measures were collected and reported for extra information. At baseline and post intervention, children's anthropometric, dietary and physical activity measures as well as family 'active' time data were collected. The preschool practitioner-led intervention included family intervention tasks such as 'family goal-setting activities' and 'cooking challenges'. Preschool activities included increasing physical activity and providing activities with the potential to change behaviour with increased knowledge of and acceptance of healthy eating. The process evaluation was an on-going monthly process and was collected in multiple forms such as questionnaires, photographs and verbal feedback.
'Gatekeeper' permission and lower-hierarchal adherence were initially a problem for recruitment and methods acceptance. However, at intervention end the preschool teachers and parents stated they found most intervention methods and activities acceptable, and some positive changes in family health behaviours were reported. However, the preschool centres appeared to have difficulties with enforcing everyday school healthy eating policies.
The findings from the current study may have implications for nursery practitioners, nursery settings, Local Educational Authorities and policy makers, and contributes to the body of literature. However, further work with preschool practitioners is required to determine how personal attitudes and school policy application can be supported to implement successfully such an intervention.
ISRCTN12345678 (16/02/17) retrospectively registered.
目前在英国，约五分之一刚入学的儿童超重或肥胖。在英国，针对学龄前儿童预防肥胖的干预措施匮乏。先前的研究已证明在改变特定健康行为方面取得了一些积极成果，然而，总体肥胖率却缺乏积极趋势。学前教育机构不仅可为促进健康生活方式，还可为制定和评估行为改变干预措施提供接触儿童及其家庭的宝贵机会。
本文介绍了一项整群随机可行性研究，该研究在英格兰东北部的四个学前教育中心对一项由学前教育从业者主导的、基于理论的行为改变干预措施进行了测试。主要结局指标是检验数据收集措施和干预措施的可接受性和可行性。收集并报告次要指标以获取更多信息。在基线和干预后，收集了儿童的人体测量、饮食和身体活动指标以及家庭“活跃”时间数据。由学前教育从业者主导的干预措施包括家庭干预任务，如“家庭目标设定活动”和“烹饪挑战”。学前活动包括增加身体活动以及开展一些有可能随着对健康饮食的了解和接受程度提高而改变行为的活动。过程评估是一个持续的月度过程，通过问卷、照片和口头反馈等多种形式收集。
“把关人”的许可和较低层级的依从性最初是招募和方法接受方面的一个问题。然而，在干预结束时，学前教师和家长表示他们发现大多数干预方法和活动是可接受的，并且报告了家庭健康行为的一些积极变化。然而，学前教育中心在执行日常学校健康饮食政策方面似乎存在困难。
本研究的结果可能对幼儿园从业者、幼儿园环境、地方教育当局和政策制定者具有启示意义，并为文献做出贡献。然而，需要与学前教育从业者进一步合作，以确定如何支持个人态度和学校政策的应用，从而成功实施此类干预措施。
ISRCTN12345678（2017年2月16日）追溯注册。
