Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, Crosstown Center 4th floor, Boston, MA, 02118, USA.
Department of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA, 01655, USA.
Int J Behav Nutr Phys Act. 2019 Jul 30;16(1):58. doi: 10.1186/s12966-019-0819-0.
Efficacious strategies to reduce sugar-sweetened beverage (SSB) consumption among youth are needed. This pilot study assessed the feasibility and preliminary efficacy of a community-based youth empowerment intervention to reduce SSB consumption and obesity risk among a low-income, ethnically diverse sample of youth.
The HGO! intervention was pilot-tested in an afterschool setting (Boys and Girls Clubs (BGC)) in Massachusetts, USA. One site was randomized to receive the intervention; the other site received standard programming. Youth ages 9-12 years and their parents/caregivers were eligible to participate. A total of N = 110 parent-child pairs (N = 55 parent-child pairs per site) were recruited. The 6-week intervention consisted of group-based weekly sessions delivered by trained BGC staff and youth-led activities that engaged parents. Child outcomes included self-reported SSB and water intake and measured body mass index z scores (zBMI). Parent outcomes included self-reported SSB and water intake, SSB purchasing, and availability of SSBs at home. Outcomes were measured at baseline, 2 months, and 6 months. Generalized linear and logistic regression models were used to estimate intervention effects over time.
The final analytic study sample consisted of 100 child participants (38% Black, 20% Hispanic, 13% White, 12% Multiracial, 11% Asian) and 87 parent participants (78.2% female; 78.2% reporting eligibility for the free-or-reduced price lunch program). 6-month retention rates were ≥ 82%. Intervention attendance rates among intervention child participants (N = 51) averaged 78.1% (SD = 10.3). Over half (56.0%) of child participants were overweight or obese at baseline. Relative to the comparison site, intervention site child participants had decreased SSB intake (β = - 1.64; 95% CI: 2.52, - 0.76), increased water intake (β = 1.31; 95% CI: 0.38, 2.23), and decreased zBMI (- 0.23 units; 95% CI: - 0.31, - 0.14) over 6 months (p < 0.001). Intervention parent participants also reported decreased SSB intake (β = - 1.76; 95% CI: - 2.56, - 0.96) and increased water intake (β = 1.75; 95% CI: 1.11, 2.40) than comparison parent participants at 6 months (p < 0.001).
Findings demonstrate the potential of a youth empowerment intervention on reducing SSB intake and zBMI among a diverse sample. Findings will guide a larger cluster-randomized controlled trial to test intervention efficacy on preventing childhood obesity, as well as inform future interventions that aim to target additional diet and physical activity behaviors through youth empowerment.
ClinicalTrials.gov NCT02890056 . Registered 31 August 2016.
需要有效的策略来减少青少年含糖饮料（SSB）的消费。这项试点研究评估了基于社区的青年赋权干预措施的可行性和初步效果，该干预措施旨在减少低收入、种族多样化的青少年群体的 SSB 消费和肥胖风险。
HGO！干预措施在美国马萨诸塞州的课后（男孩和女孩俱乐部（BGC））进行了试点测试。一个地点被随机分配接受干预；另一个地点接受标准编程。9-12 岁的青少年及其父母/照顾者有资格参加。共招募了 110 对家长-孩子（每个地点 55 对家长-孩子）。为期 6 周的干预包括由经过培训的 BGC 工作人员进行的小组每周会议和青年主导的活动，这些活动使父母参与其中。儿童结果包括自我报告的 SSB 和水摄入量以及测量的体重指数 z 分数（zBMI）。父母的结果包括自我报告的 SSB 和水摄入量、SSB 购买量以及家中 SSB 的供应情况。在基线、2 个月和 6 个月时测量结果。使用广义线性和逻辑回归模型来估计随时间的干预效果。
最终分析研究样本包括 100 名儿童参与者（38%黑人，20%西班牙裔，13%白人，12%多种族，11%亚洲人）和 87 名家长参与者（78.2%女性；78.2%报告有资格获得免费或减价午餐计划）。6 个月的保留率≥82%。接受干预的儿童参与者（N=51）的干预出勤率平均为 78.1%（SD=10.3）。超过一半（56.0%）的儿童参与者在基线时超重或肥胖。与对照组相比，干预组儿童参与者的 SSB 摄入量减少（β=-1.64；95%CI：2.52，-0.76），水摄入量增加（β=1.31；95%CI：0.38，2.23），6 个月时 zBMI 减少（β=-0.23 个单位；95%CI：-0.31，-0.14）（p<0.001）。干预组家长参与者报告的 SSB 摄入量也减少（β=-1.76；95%CI：-2.56，-0.96），水摄入量增加（β=1.75；95%CI：1.11，2.40），比对照组家长参与者在 6 个月时（p<0.001）。
研究结果表明，在多样化的样本中，青少年赋权干预在减少 SSB 摄入和 zBMI 方面具有潜力。研究结果将指导更大的群组随机对照试验，以测试干预措施预防儿童肥胖的效果，并为旨在通过青少年赋权来针对其他饮食和身体活动行为的未来干预措施提供信息。
ClinicalTrials.gov NCT02890056。2016 年 8 月 31 日注册。
