Parker Elizabeth A, Feinberg Termeh M, Lane Hannah G, Deitch Rachel, Zemanick Amy, Saksvig Brit I, Turner Lindsey, Hager Erin R
Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Veterans Affairs Healthcare Connecticut/Yale University School of Medicine, New Haven, CT, USA.
Prev Med Rep. 2020 Apr 2;18:101087. doi: 10.1016/j.pmedr.2020.101087. eCollection 2020 Jun.
Many schools have implemented policies and programs to address childhood obesity. However, few have evaluated obesity-related health behaviors among teachers, or how these behaviors may be associated with teachers' nutrition-related practices in the classroom setting. This cross-sectional study utilized data from teachers employed in 20 schools representing three public school districts in a mid-Atlantic state from 2017 to 2019 to examine associations between teachers' diet quality and their nutrition-related classroom practices (e.g. rewarding students with food; modeling healthy diet behaviors). Measures included: one 24-h dietary recall summarized via healthy eating index (HEI-2015; higher scores indicate better diet quality; Range: 0-100); demographics, self-reported height/weight (BMI; ≥25 kg/m = overweight/obese), and nutrition-related classroom practices (10 item survey; sum score range: 0-40; alpha = 0.65; higher score = more health-promoting practices). Associations between HEI and nutrition-related classroom practices were assessed in multilevel models, adjusting for covariates (gender, race/ethnicity, age, income, BMI, years teaching) and controlling for within-school effects. Of 331 teachers recruited, 116 (35.0%) completed both the optional dietary recall and incentivized survey (analytic sample: 89% female; 45% black; 79% overweight/obese; BMI = 30.5 ± 7.1; aged 41.1 ± 11.8 years). Means and standard deviations were calculated for HEI (52.2 ± 12.2) and nutrition-related classroom practices sum score (25.4 ± 5.9). For every one-unit increase in HEI, there was a 0.20 increase in nutrition-related classroom practices score (SE = 0.05; p < 0.001), which remained significant in the adjusted model. To better inform obesity prevention efforts, future studies should collect data among both students and teachers and explore the mechanisms through which teacher health behaviors may impact student health behaviors.
许多学校已实施相关政策和计划来应对儿童肥胖问题。然而，很少有学校评估教师中与肥胖相关的健康行为，或者这些行为在课堂环境中可能如何与教师的营养相关做法相关联。这项横断面研究利用了2017年至2019年在大西洋中部一个州的三个公立学区的20所学校任职的教师的数据，以研究教师的饮食质量与其营养相关的课堂做法（例如用食物奖励学生；示范健康饮食行为）之间的关联。测量指标包括：通过健康饮食指数（HEI-2015；分数越高表明饮食质量越好；范围：0-100）汇总的一次24小时饮食回忆；人口统计学特征、自我报告的身高/体重（BMI；≥25kg/m²=超重/肥胖）以及营养相关的课堂做法（10项调查问卷；总分范围：0-40；α=0.65；分数越高=促进健康的做法越多）。在多水平模型中评估了HEI与营养相关的课堂做法之间的关联，并对协变量（性别、种族/族裔、年龄、收入、BMI、教学年限）进行了调整，并控制了学校内部效应。在招募的331名教师中，116名（35.0%）完成了可选的饮食回忆和激励调查（分析样本：89%为女性；45%为黑人；79%超重/肥胖；BMI=30.5±7.1；年龄41.1±11.8岁）。计算了HEI（52.2±12.2）和营养相关的课堂做法总分（25.4±5.9）的均值和标准差。HEI每增加一个单位，营养相关课堂做法得分增加0.20（标准误=0.05；p<0.001），在调整后的模型中这一结果仍然显著。为了更好地为肥胖预防工作提供信息，未来的研究应该收集学生和教师的数据，并探索教师健康行为可能影响学生健康行为的机制。
