1 University of Alabama, Tuscaloosa, AL, USA.
Health Educ Behav. 2018 Apr;45(2):262-276. doi: 10.1177/1090198117732604. Epub 2017 Sep 27.
Childhood overweight and obesity is a public health epidemic with far-reaching medical, economic, and quality of life consequences. Brief, web-based interventions have received increased attention for their potential to combat childhood obesity. The purpose of our study was to evaluate a web-based, maternal-facilitated childhood obesity prevention intervention dubbed Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER), for its capacity to elicit sustained effects at the 2-year postintervention follow-up mark.
Two interventions were evaluated using a randomized controlled trial design. The experimental, EMPOWER arm received a social cognitive theory intervention ( n = 29) designed to improve four maternal-facilitated behaviors in children (fruit and vegetable consumption, physical activity, sugar-free beverage intake, screen time). The active control arm received a knowledge-based intervention dubbed Healthy Lifestyles ( n = 28), which also targeted the same four behaviors.
We identified a significant group-by-time interaction of small effect size for child fruit and vegetable consumption ( p = .033; Cohen's f = 0.139) in the EMPOWER group. The construct of maternal-facilitated environment was positively associated to improvements in child fruit and vegetable behavior. We also found significant main effects for child physical activity ( p = .024; Cohen's f = 0.124); sugar-free beverage intake ( p < .001; Cohen's f = 0.321); and screen time ( p < .001; Cohen's f = 0.303), suggesting both groups improved in these behaviors over time.
The EMPOWER arm of the trial resulted in an overall increase of 1.680 daily cups of fruits and vegetables consumed by children, relative to the comparison group ( p < .001, 95% confidence interval = [1.113, 2.248]). Web-based maternal-facilitated interventions can induce sustained effects on child behaviors.
儿童超重和肥胖是一种具有深远影响的公共卫生流行病，对医疗、经济和生活质量都有影响。简短的网络干预措施因其具有对抗儿童肥胖的潜力而受到越来越多的关注。我们的研究目的是评估一种基于网络的、由母亲促进的儿童肥胖预防干预措施，该措施被称为通过网络教育和相互决定论使母亲能够预防儿科肥胖（EMPOWER），以评估其在干预后 2 年的持续效果。
采用随机对照试验设计评估了两种干预措施。实验组，即 EMPOWER 组接受了基于社会认知理论的干预（n=29），旨在改善母亲促进的四项儿童行为（水果和蔬菜消费、身体活动、无糖饮料摄入、屏幕时间）。实验组接受了一项称为健康生活方式的基于知识的干预（n=28），该干预也针对相同的四项行为。
我们发现 EMPOWER 组儿童水果和蔬菜摄入量存在显著的小效应量的组间时间交互作用（p=0.033；Cohen's f=0.139）。母亲促进环境的构建与儿童水果和蔬菜行为的改善呈正相关。我们还发现儿童身体活动（p=0.024；Cohen's f=0.124）、无糖饮料摄入（p<0.001；Cohen's f=0.321）和屏幕时间（p<0.001；Cohen's f=0.303）存在显著的主效应，这表明两组在这些行为上都随着时间的推移而改善。
与对照组相比，试验中的 EMPOWER 组的儿童每天摄入的水果和蔬菜增加了 1.680 杯（p<0.001，95%置信区间=[1.113, 2.248]）。基于网络的母亲促进的干预措施可以对儿童行为产生持续的影响。
