Division of Pediatric Emergency Medicine, New York University Langone Medical Center, New York, New York.
Department of General Pediatrics, New York University School of Medicine, Bellview Hospital Center, New York, New York.
Prev Chronic Dis. 2019 Nov 21;16:E154. doi: 10.5888/pcd16.190054.
The objective of our study was to strengthen wellness policy in Title 1 schools by implementing a mentored behavior-change model that extends the continuum of care from academic to community settings and mobilizes existing public resources in accordance with US Preventive Services Task Force screening guidelines for childhood obesity management.
Team Kid POWER! (KiPOW!) health mentors (students and trainees in medical and health-related fields) in 2 geographically and demographically distinct school districts, the District of Columbia and Orange County, California, delivered standardized health curricular modules to fifth grade classrooms, modeled healthy eating behaviors during school lunchtime, and engaged in active play at recess.
Initial interventions in the the District of Columbia and Orange County delivered 10 sessions in which all participants received the intervention. Two subsequent interventions in Orange County, for 5 weeks (Lite) and 10 weeks (Full), included controls. Pre-post measurements of body mass index (BMI) and blood pressure were documented in all participants. A mixed linear regression model, which included a random effect for each school, estimated differences between Full and Lite interventions compared with controls, adjusting for site, sex, and baseline status of the dependent variable.
KiPOW! Full, but not KiPOW! Lite, was associated with a modest reduction in BMI percentile compared with control (KiPOW! Full, P = .04; KiPOW! Lite, P = .41), especially in Orange County (P < .001). Systolic blood pressure improved in Full (P < .046) more than in Lite interventions (P = .11), and diastolic blood pressure improved in both Full (P = .02) and Lite (P = .03) interventions. Annual renewal of the school and volunteer commitment needed to maintain KiPOW! was found to be sustainable.
KiPOW! is a generalizable academic-community partnership promoting face-to-face contact between students and trusted health mentors to reinforce school wellness policies and foster youth confidence in decision-making about nutrition- and activity-related behaviors to achieve reduced BMI percentile and lowered blood pressure.
我们研究的目的是通过实施一个有导师指导的行为改变模式来加强 1 号法规下学校的健康政策，该模式将医疗保健从学术领域扩展到社区领域，并根据美国预防服务工作组（US Preventive Services Task Force）针对儿童肥胖管理的筛查指南，调动现有的公共资源。
在两个地理位置和人口结构不同的学区，即哥伦比亚特区和加利福尼亚州奥兰治县，“儿童力量”（Team Kid POWER!，KiPOW!）健康辅导员（医学和健康相关领域的学生和实习生）向五年级教室教授标准化的健康课程模块，在学校午餐时间树立健康饮食行为榜样，并在课间休息时进行积极的游戏。
在哥伦比亚特区和奥兰治县的初始干预中，共进行了 10 次干预，所有参与者都接受了干预。在奥兰治县的随后两次干预中，干预持续了 5 周（Lite）和 10 周（Full），并设置了对照组。所有参与者都记录了体重指数（BMI）和血压的前后测量值。一个混合线性回归模型，包括每个学校的随机效应，估计了 Full 和 Lite 干预与对照组相比的差异，调整了地点、性别和因变量的基线状态。
KiPOW! Full，但不是 KiPOW! Lite，与对照组相比，BMI 百分位数略有降低（KiPOW! Full，P =.04；KiPOW! Lite，P =.41），特别是在奥兰治县（P <.001）。Full 干预组的收缩压（P <.046）比 Lite 干预组（P =.11）有更大的改善，而 Full（P =.02）和 Lite（P =.03）干预组的舒张压都有改善。研究发现，学校和志愿者的年度续约可以维持 KiPOW! 的可持续性。
KiPOW! 是一种可推广的学术-社区伙伴关系，它促进了学生与值得信赖的健康辅导员之间的面对面接触，以加强学校的健康政策，并培养年轻人在营养和活动相关行为方面的决策信心，从而达到降低 BMI 百分位数和降低血压的目的。
