Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55901, USA.
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
J Prim Prev. 2020 Apr;41(2):153-170. doi: 10.1007/s10935-020-00582-4.
Children and adolescents from minority and low income backgrounds face social and environmental challenges to engaging in physical activity and healthy eating to maintain a healthy weight. In this study, we present pilot work to develop and implement a multi-component physical activity and healthy eating intervention at a Boys & Girls Club (BGC) afterschool program. Using a community-based participatory approach, BGC staff and academic researchers developed intervention components informed by formative studies and based on a Social Ecological Theory framework. Components included healthy eating and physical activity policy implementation, staff training, a challenge and self-monitoring program for healthy behaviors, a peer-coaching program for healthy behaviors, and a social marketing campaign. We assessed pilot feasibility through a single group, pre-post study design with measures collected at baseline and 6 months. The sample included 61 children with a mean age of 10.4 years. Mean (SD) body mass index (BMI) percentile was 72.8 (28.9); 47.5% were in the healthy weight range for their age. We found statistically significant improvements of self-efficacy and motivation for physical activity. Self-efficacy and motivation for fruit and vegetable consumption, sugary beverage consumption, and screen time improved but were not statistically different from baseline. We found no improvements of perceived social support, objectively measured physical activity, or self-reported dietary quality. Though BMI did not improve overall, a dose effect was observed such that attendance in Club Fit specific programming was significantly correlated with decreased BMI z scores. Processes and products from this study may be helpful to other communities aiming to address childhood obesity prevention through afterschool programs.
儿童和青少年来自少数民族和低收入背景,他们在参与体育活动和健康饮食以维持健康体重方面面临着社会和环境挑战。在这项研究中,我们展示了在一家男孩女孩俱乐部(BGC)课后项目中开发和实施多组分体育活动和健康饮食干预的初步工作。使用基于社区的参与式方法,BGC 工作人员和学术研究人员根据形成性研究和社会生态理论框架制定了干预措施。这些措施包括实施健康饮食和体育活动政策、工作人员培训、健康行为挑战和自我监测计划、健康行为同伴指导计划以及社会营销活动。我们通过基线和 6 个月时收集的单一组、前后研究设计评估了试点可行性。样本包括 61 名平均年龄为 10.4 岁的儿童。平均(SD)体重指数(BMI)百分位数为 72.8(28.9);47.5%的儿童处于与其年龄相应的健康体重范围。我们发现,体育活动自我效能感和动机有了统计学上的显著提高。水果和蔬菜消费、含糖饮料消费和屏幕时间的自我效能感和动机有所改善,但与基线相比没有统计学差异。我们没有发现感知社会支持、客观测量的体育活动或自我报告的饮食质量有任何改善。尽管 BMI 总体没有改善,但我们观察到了一种剂量效应,即参加俱乐部健身特定项目的次数与 BMI z 分数的降低显著相关。本研究的过程和成果可能对其他旨在通过课后项目解决儿童肥胖问题的社区有帮助。