Cheng Erika R, Nelson Candace C, Leung-Strle Peggy, Colchamiro Rachel, Taveras Elsie M, Woo Baidal Jennifer A
Division of Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States of America.
Massachusetts Department of Public Health, Boston, MA, United States of America.
Prev Med Rep. 2019 Jan 25;13:289-292. doi: 10.1016/j.pmedr.2019.01.010. eCollection 2019 Mar.
The multi-sector, multi-level Massachusetts Childhood Obesity Research Demonstration (MA-CORD) study resulted in improvements in obesity risk factors among children age 2-4 years enrolled in the Special Supplemental Nutrition program for Women, Infants, and Children (WIC). The goal of this study was to examine whether the MA-CORD intervention increased WIC provider confidence in their ability to identify childhood obesity and obesity-related behaviors.
As part of the MA-CORD intervention conducted from 2012 to 2015, we implemented WIC practice changes focused on childhood obesity prevention within two Massachusetts communities. We examined changes in provider confidence to assess childhood obesity risk factors and practice frequency among WIC practices located in MA-CORD intervention communities over a 3-year period, compared to non-intervention sites. We measured provider confidence on a continuous scale using questions previously developed to assess provider and parent confidence to make weight-related behavior change (range 0 to 24).
There were 205 providers at baseline and 165 at follow-up. WIC providers at intervention sites reported greater confidence in their ability to identify childhood obesity and obesity-related behaviors compared to the usual care sites (β = 1.01, standard error = 0.13). These findings persisted after adjusting for provider gender, years in practice, highest education level, and WIC position.
The MA-CORD intervention was associated with increased WIC provider confidence to assess children's obesity risk. Interventions that increase confidence in assessing obesity-related behaviors may have salutary effects within WIC programs that serve low-income families.
多部门、多层次的马萨诸塞州儿童肥胖研究示范项目（MA-CORD）使参加妇女、婴儿和儿童特别补充营养计划（WIC）的2至4岁儿童的肥胖风险因素得到改善。本研究的目的是检验MA-CORD干预措施是否提高了WIC服务提供者识别儿童肥胖及与肥胖相关行为的信心。
作为2012年至2015年开展的MA-CORD干预措施的一部分，我们在马萨诸塞州的两个社区实施了以预防儿童肥胖为重点的WIC实践变革。我们考察了与非干预地点相比，MA-CORD干预社区内WIC机构在3年期间评估儿童肥胖风险因素的服务提供者信心及实践频率的变化。我们使用先前开发的用于评估服务提供者和家长进行与体重相关行为改变的信心的问题，在连续量表上测量服务提供者的信心（范围为0至24）。
基线时有205名服务提供者，随访时有165名。与常规护理地点相比，干预地点的WIC服务提供者报告称，他们在识别儿童肥胖及与肥胖相关行为方面更有信心（β = 1.01，标准误 = 0.13）。在对服务提供者的性别、从业年限、最高学历和WIC职位进行调整后，这些结果依然存在。
MA-CORD干预措施与WIC服务提供者评估儿童肥胖风险的信心增加有关。提高评估与肥胖相关行为信心的干预措施可能会对服务低收入家庭的WIC项目产生有益影响。
