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家庭访视育儿计划与儿童肥胖:一项随机试验。

A Home Visiting Parenting Program and Child Obesity: A Randomized Trial.

机构信息

School of Nursing, Yale University, Orange, Connecticut;

School of Nursing, Yale University, Orange, Connecticut.

出版信息

Pediatrics. 2018 Feb;141(2). doi: 10.1542/peds.2017-1076. Epub 2018 Jan 16.

Abstract

BACKGROUND

Young children living in historically marginalized families are at risk for becoming adolescents with obesity and subsequently adults with increased obesity-related morbidities. These risks are particularly acute for Hispanic children. We hypothesized that the prevention-focused, socioecological approach of the "Minding the Baby" (MTB) home visiting program might decrease the rate of childhood overweight and obesity early in life.

METHODS

This study is a prospective longitudinal cohort study in which we include data collected during 2 phases of the MTB randomized controlled trial. First-time, young mothers who lived in medically underserved communities were invited to participate in the MTB program. Data were collected on demographics, maternal mental health, and anthropometrics of 158 children from birth to 2 years.

RESULTS

More children in the intervention group had a healthy BMI at 2 years. The rate of obesity was significantly higher ( < .01) in the control group (19.7%) compared with the intervention group (3.3%) at this age. Among Hispanic families, children in the MTB intervention were less likely to have overweight or obesity (odds ratio = 0.32; 95% confidence interval: 0.13-0.78).

CONCLUSIONS

Using the MTB program, we significantly lowered the rate of obesity among 2-year-old children living in low-socioeconomic-status communities. In addition, children of Hispanic mothers were less likely to have overweight or obesity at 2 years. Given the high and disproportionate national prevalence of Hispanic young children with overweight and obesity and the increased costs of obesity-related morbidities, these findings have important clinical, research, and policy implications.

摘要

背景

生活在历史上处于边缘地位家庭中的幼儿有成为肥胖青少年并随后成为肥胖相关发病率增加的成年人的风险。这些风险对西班牙裔儿童尤为严重。我们假设,以预防为重点、关注社会生态的“关注婴儿”(MTB)家访计划可能会降低儿童在生命早期超重和肥胖的发生率。

方法

这是一项前瞻性纵向队列研究,我们纳入了 MTB 随机对照试验的两个阶段的数据。首次邀请居住在医疗服务不足社区的年轻母亲参加 MTB 计划。从出生到 2 岁,收集了 158 名儿童的人口统计学、产妇心理健康和人体测量数据。

结果

干预组更多的儿童在 2 岁时具有健康的 BMI。在这个年龄,对照组(19.7%)的肥胖率明显高于干预组(3.3%)(<0.01)。在西班牙裔家庭中,MTB 干预组的儿童超重或肥胖的可能性较低(比值比=0.32;95%置信区间:0.13-0.78)。

结论

通过使用 MTB 计划,我们显著降低了生活在低社会经济地位社区的 2 岁儿童肥胖率。此外,西班牙裔母亲的孩子在 2 岁时超重或肥胖的可能性较低。鉴于西班牙裔幼儿超重和肥胖的全国患病率较高且不成比例,以及肥胖相关发病率增加的成本,这些发现具有重要的临床、研究和政策意义。

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