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参与结构化编程可能有助于低收入社区学龄儿童在暑期避免体重不健康增长:NERF 夏令营研究的可行性、保真度和初步疗效发现。

Participation in structured programming may prevent unhealthy weight gain during the summer in school-aged children from low-income neighbourhoods: feasibility, fidelity and preliminary efficacy findings from the Camp NERF study.

机构信息

1Department of Human Sciences,The Ohio State University,313 Campbell Hall,1787 Neil Avenue,Columbus,OH 43210,USA.

3Department of Statistics,The Ohio State University,Columbus,OH,USA.

出版信息

Public Health Nutr. 2019 Apr;22(6):1100-1112. doi: 10.1017/S1368980018003403. Epub 2019 Jan 3.

Abstract

OBJECTIVE

Evaluate the feasibility, fidelity and preliminary efficacy of Camp NERF to prevent unhealthy weight gain and promote healthy behaviours in children during the summer.

DESIGN

Camp NERF was an 8-week, multicomponent, theory-based programme coupled with the US Department of Agriculture's Summer Food Service Program. Twelve eligible elementary-school sites were randomized to one of three treatment groups: (i) Active Control (non-nutrition, -physical activity (PA), -mental health); (ii) Standard Care (nutrition and PA); or (iii) Enhanced Care (nutrition and PA, plus cognitive behavioural techniques) programming. Efficacy was determined by assessing mean change by group in child outcomes using hierarchical linear regression models.

SETTING

Low-income, urban neighbourhoods in Columbus, OH, USA.ParticipantsEconomically disadvantaged, racial minority children of elementary school age (kindergarten-5th grade).

RESULTS

Eighty-seven child-caregiver dyads consented; eighty-one completed pre- and post-intervention assessments resulting in a 93·10 % retention rate. Delivery of the intended lesson occurred 79-90 % of the time. Of the children, 56·98 % (n 49) were female; 89·53 % (n 77) were Black. Overall mean change in BMI Z-score from baseline to post-intervention was -0·03 (se 0·05); change in BMI Z-score did not differ significantly between treatment group. Change in nutrition, PA, mental health or psychosocial outcomes did not differ between groups.

CONCLUSIONS

Results from the current study demonstrate feasibility and fidelity, yet no intervention effect of Camp NERF. Instead, findings suggest that participation in structured programming of any type (health behaviour-related or not) may prevent unhealthy summer weight gain. Additional studies are needed to confirm findings. Results have implications for child nutrition policy addressing the issue of summer health.

摘要

目的

评估 Camp NERF 在预防儿童夏季体重不健康增加和促进健康行为方面的可行性、保真度和初步疗效。

设计

Camp NERF 是一项为期 8 周的、多组分的、基于理论的计划,与美国农业部的夏季食品服务计划相结合。12 个符合条件的小学地点被随机分配到三个治疗组之一:(i)主动对照组(非营养、非体力活动(PA)、非心理健康);(ii)标准护理组(营养和 PA);或(iii)强化护理组(营养和 PA,外加认知行为技术)编程。使用分层线性回归模型,通过评估各组儿童结果的平均变化来确定疗效。

设置

美国俄亥俄州哥伦布市的低收入、城市社区。

参与者

经济贫困、少数族裔的小学生(幼儿园-5 年级)及其照顾者。

结果

87 对儿童-照顾者同意;81 对完成了干预前和干预后的评估,保留率为 93.10%。预期课程的交付时间为 79-90%。在这些儿童中,56.98%(n=49)为女性;89.53%(n=77)为黑人。从基线到干预后的 BMI Z 分数的总体平均变化为-0.03(se 0.05);治疗组之间的 BMI Z 分数变化没有显著差异。营养、PA、心理健康或心理社会结果的变化在组间没有差异。

结论

当前研究的结果表明该计划具有可行性和保真度,但 Camp NERF 没有干预效果。相反,研究结果表明,参加任何类型的结构化计划(与健康行为相关或不相关)都可能预防夏季体重不健康增加。需要进一步的研究来证实这些发现。研究结果对解决夏季健康问题的儿童营养政策具有重要意义。

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