干预措施可在 54 个月内增加南非青少年的身体活动和健康饮食：一项随机对照试验。
Intervention Increases Physical Activity and Healthful Diet Among South African Adolescents Over 54 Months: A Randomized Controlled Trial.
机构信息
Annenberg School for Communication and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Communication, University of California, Davis, California.
出版信息
J Adolesc Health. 2019 Jul;65(1):139-146. doi: 10.1016/j.jadohealth.2019.01.027. Epub 2019 Apr 23.
PURPOSE
Scant research has investigated whether health promotion interventions have sustained effects in increasing physical activity and healthful diet among adolescents in sub-Saharan Africa, which is experiencing an epidemiological transition from infectious diseases to noncommunicable diseases as leading causes of mortality. We examined whether an intervention increased adherence to 5-a-day diet and physical activity guidelines during a 54-month postintervention period among South African adolescents and whether its effects weakened at long-term (42 and 54 months postintervention) compared with short-term (3, 6, and 12 months postintervention) follow-up.
METHODS
We randomized 18 randomly selected schools serving grade 6 learners (mean age = 12.6) in a township and a semirural area in Eastern Cape Province, South Africa, to one of the two 12-hour interventions: health promotion, targeting healthful diet and physical activity; attention-matched control, targeting sexual risk behaviors. We tested the intervention's effects on adherence to 5-a-day diet and physical activity guidelines using generalized estimating equations logistic regression models adjusting for baseline behavior and clustering within schools.
RESULTS
Health promotion intervention participants had higher odds of meeting 5-a-day diet and physical activity guidelines than control participants. The effect on 5-a-day diet did not weaken at long-term compared with short-term follow-up, but the effect on physical activity guidelines was weaker at long-term follow-up, mainly because of a reduced effect on muscle-strengthening physical activity. The intervention also increased health promotion attitude and intention and health knowledge and reduced binge drinking compared with the control group.
CONCLUSIONS
A 12-hour intervention in grade 6 shows promise in increasing self-reported adherence to healthful diet and physical activity guidelines during a 4.5-year postintervention period among South African adolescents.
目的
在撒哈拉以南非洲，由于传染病向非传染性疾病转变，成为主要死亡原因，健康促进干预措施能否持续增加青少年的身体活动和健康饮食，这方面的研究很少。我们研究了一项干预措施是否能在南非青少年接受干预后 54 个月的随访期内增加他们遵守每日 5 份蔬果饮食和身体活动指南的依从性，以及与短期（干预后 3、6 和 12 个月）相比，其长期（干预后 42 和 54 个月）效果是否减弱。
方法
我们在南非东开普省的一个城镇和一个半农村地区，随机选择了 18 所服务于六年级学习者（平均年龄 12.6 岁）的学校，将它们随机分为两种 12 小时干预措施之一：健康促进，针对健康饮食和身体活动；注意力匹配对照，针对性行为风险。我们使用广义估计方程逻辑回归模型，根据基线行为和学校内聚类，测试干预对遵守每日 5 份蔬果饮食和身体活动指南的影响。
结果
健康促进干预组参与者符合每日 5 份蔬果饮食和身体活动指南的可能性高于对照组。与短期随访相比，对每日 5 份蔬果饮食的影响并没有随着时间的推移而减弱，但对身体活动指南的影响在长期随访中较弱，主要是因为对增强肌肉的身体活动的影响减少。与对照组相比，该干预措施还增加了健康促进态度和意向以及健康知识，减少了狂欢性饮酒。
结论
在南非六年级学生中进行 12 小时的干预，有望在 4.5 年的干预后随访期内增加自我报告的健康饮食和身体活动指南的依从性。
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