Sleet Kaysha, Sisson Susan B, Dev Dipti A, Love Charlotte, Williams Mary B, Hoffman Leah A, Jernigan Valarie Blue Bird
Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Department of Child, Youth and Family Studies, College of Education and Human Sciences, University of Nebraska Lincoln, Lincoln, NE, USA.
Curr Dev Nutr. 2019 Sep 20;4(Suppl 1):23-32. doi: 10.1093/cdn/nzz105. eCollection 2020 Jan.
Establishing healthy eating habits early affects lifelong dietary intake, which has implications for many health outcomes. With children spending time in early care and education (ECE) programs, teachers establish the daytime meal environment through their feeding practices.
We aimed to determine the effect of a teacher-focused intervention to increase responsive feeding practices in 2 interventions, 1 focused exclusively on the teacher's feeding practices and the other focused on both the teacher's feeding practices and a nutrition classroom curriculum, in ECE teachers in a Native American (NA) community in Oklahoma.
Nine tribally affiliated ECE programs were randomly assigned to 1 of 2 interventions: ) a 1.5-h teacher-focused responsive feeding practice training (TEACHER; = 4) and ) TEACHER plus an additional 3-h training to implement a 15-wk classroom nutrition curriculum (TEACHER + CLASS; = 5). Feeding practice observations were conducted during lunch at 1 table in 1 classroom for 2- to 5-y-olds at each program before and 1 mo after the intervention. The Mealtime Observation in Child Care (MOCC) organizes teacher behaviors into 8 subsections. Descriptive statistics and the Shapiro-Wilk test for normality were calculated. Paired tests were calculated to determine change in each group.
A mean ± SD of 5.2 ± 2.0 (total = 47) children and 1.7 ± 0.5 (total = 14) teachers/center were observed at baseline, and 5.6 ± 1.7 (total = 50) children and 1.7 ± 0.7 teachers (total = 14) were observed/center postintervention. Total MOCC scores (max possible = 10) improved for TEACHER (6.1 ± 0.9 compared with 7.5 ± 0.3, = 4.12, = 0.026) but not for TEACHER + CLASS (6.5 ± 0.8 compared with 6.4 ± 1.0, = -0.11, = 0.915). No other changes were observed.
Teacher intervention-only programs demonstrated improvements in responsive feeding practices, whereas the programs receiving teacher and classroom training did not. Greater burden likely decreased capacity to make changes in multiple domains. We demonstrated the ability to implement interventions in NA ECE. Further research with larger communities is necessary. This trial was registered at clinicaltrials.gov as NCT03251950.
尽早养成健康的饮食习惯会影响终身饮食摄入，这对许多健康结果都有影响。由于儿童在早期护理和教育（ECE）项目中度过时光，教师通过其喂养行为营造白天的用餐环境。
我们旨在确定以教师为重点的干预措施对增加回应式喂养行为的效果，该干预措施有两种，一种仅专注于教师的喂养行为，另一种既专注于教师的喂养行为又专注于营养课堂课程，针对俄克拉荷马州一个美国原住民（NA）社区的ECE教师。
九个部落附属的ECE项目被随机分配到两种干预措施中的一种：）为期1.5小时的以教师为重点的回应式喂养行为培训（教师组； = 4）和）教师组加上额外3小时的培训以实施为期15周的课堂营养课程（教师 + 课堂组； = 5）。在干预前和干预后1个月，在每个项目中1间教室的1张桌子旁对2至5岁儿童的午餐时间进行喂养行为观察。儿童保育用餐时间观察（MOCC）将教师行为分为8个部分。计算描述性统计数据和用于正态性检验的夏皮罗 - 威尔克检验。计算配对 检验以确定每组的变化。
基线时观察到平均 ± 标准差为5.2 ± 2.0（共 = 47）名儿童和1.7 ± 0.5（共 = 14）名教师/中心，干预后观察到/中心为5.6 ± 1.7（共 = 50）名儿童和1.7 ± 0.7名教师（共 = 14）。教师组的MOCC总得分（最高可能 = 10）有所提高（从6.1 ± 0.9提高到7.5 ± 0.3， = 4.12， = 0.026），但教师 + 课堂组没有提高（从6.5 ± 0.8变为6.4 ± 1.0， = -0.11， = 0.915）。未观察到其他变化。
仅以教师为干预对象的项目在回应式喂养行为方面有改善，而接受教师和课堂培训的项目则没有。更大的负担可能降低了在多个领域做出改变的能力。我们证明了在NA ECE中实施干预措施的能力。有必要对更大的社区进行进一步研究。该试验在clinicaltrials.gov上注册为NCT03251950。
