Jiying Ling, PhD, MS, RN, is Assistant Professor, College of Nursing, Michigan State University, East Lansing. Nagwan R. Zahry, PhD, is Assistant Professor, Department of Communication, University of Tennessee at Chattanooga. Lorraine B. Robbins, PhD, RN, FAAN, is Associate Professor, College of Nursing, Michigan State University, East Lansing.
Nurs Res. 2019 Jul/Aug;68(4):329-335. doi: 10.1097/NNR.0000000000000345.
Understanding the dose-response relationship in behavioral interventions is critical to guide future research efforts. However, only few studies have fully examined the dose-response relationship especially among children.
The aim of the study was to examine the relationships between level of participation and intervention effects.
The study used data from 39 Head Start parent-preschooler dyads participating in a 10-week lifestyle intervention. The intervention included daily center-based preschooler program, preschooler weekly letters to parents, parent meetings, and weekly Facebook-based program. Height, weight, waist circumference (WC), moderate-to-vigorous physical activity (MVPA), screen time, and fruit/vegetable intake were assessed.
Preschooler program average daily attendance was 79%, and Facebook-based program average completion rate was 80%. About 49% attended all three parent meetings. Parent meeting attendance was significantly and positively related to preschoolers' vegetable intake (p = .023) and MVPA (p < .001) and parents' MVPA (p = .016). Preschooler letters were significantly and negatively related to preschoolers' screen time (p = .002) and parents' WC (p = .027) and positively correlated with parents' MVPA (p = .01). Preschooler program attendance was not significantly correlated with their body mass index (ρ = -.31) or WC (ρ = -.16).
The study provides important information for designing effective interventions among low-income families. The findings imply that (a) parent-only interventions and parent-child interventions may result in similar effects, (b) future behavioral interventions should focus on the bidirectional parent-child relationship, and (c) it is important to include face-to-face contacts in lifestyle interventions. In addition, it highlights the need to examine the dose-response relationship in multicomponent lifestyle interventions.
了解行为干预措施中的剂量反应关系对于指导未来的研究工作至关重要。然而，只有少数研究充分研究了剂量反应关系，特别是在儿童中。
本研究旨在检验参与程度与干预效果之间的关系。
本研究使用了 39 对参加为期 10 周生活方式干预的“先普”家长-学龄前儿童的数据。干预措施包括每天的学龄前儿童中心项目、每周给家长的信、家长会议和每周基于 Facebook 的项目。身高、体重、腰围（WC）、中高强度体力活动（MVPA）、屏幕时间和水果/蔬菜摄入量均进行了评估。
学龄前儿童项目的平均日出勤率为 79%，基于 Facebook 的项目的平均完成率为 80%。大约 49%的家长参加了全部三次家长会议。家长会议的出勤率与学龄前儿童的蔬菜摄入量（p =.023）和 MVPA（p <.001）以及家长的 MVPA（p =.016）呈显著正相关。学龄前儿童信件与学龄前儿童的屏幕时间（p =.002）和家长的 WC（p =.027）呈显著负相关，与家长的 MVPA 呈正相关（p =.01）。学龄前儿童项目的出勤率与他们的体重指数（ρ= -.31）或 WC（ρ= -.16）无显著相关性。
本研究为设计针对低收入家庭的有效干预措施提供了重要信息。研究结果表明：（a）仅家长参与的干预措施和家长-儿童共同参与的干预措施可能会产生类似的效果；（b）未来的行为干预措施应关注双向的亲子关系；（c）在生活方式干预中纳入面对面的接触非常重要。此外，本研究强调了在多成分生活方式干预中检验剂量反应关系的必要性。
