Department of Pediatrics, University of Hawai'i, John A. Burns School of Medicine, Honolulu, HI; and Community Pediatrics, Kapi'olani Medical Center for Women and Children, Honolulu, HI (MALS).
Hawaii Pacific Health Research Institute, Honolulu, HI (AMS).
Hawaii J Health Soc Welf. 2020 May 1;79(5 Suppl 1):24-31.
The high prevalence of childhood obesity highlights the need for effective weight management interventions. This study evaluated a family-based weight management program (Nutrition+Exercise+Weight Management; NEW Keiki) in overweight and obese children and their adult caregivers. Data were collected on overweight (body mass index, BMI = 85th-94th percentile) and obese (BMI > 95th percentile) children (n = 75, 5-14 years) and their adult caregivers (n = 104). Seventy-one percent of the enrolled children identified as Native Hawaiian, Pacific Islander, and/or Filipino (NHPI+F). Families participated weekly in a multidisciplinary lifestyle program for 8-9 weeks (intervention phase); follow-up visits occurred at 6-months and 12-months post-intervention. Long-term data (14-50 months post intervention) were collected by chart review for the children. Change in children's BMI z-score and adult BMI were analyzed. The effects of ethnicity, acceptance of government assistance, and program attendance were evaluated. Participants identifying as NHPI+F and/or receiving government assistance had higher baseline BMI z-scores and BMIs. In children, BMI z-score decreased from baseline at all evaluation visits (-0.05 at 2 months [ < .001], -0.07 at 6-month follow-up [ < .001], -0.04 at 12-month follow-up [ = .05], -0.06 at long-term follow-up [ = .01]). At the 2 month visit BMI decreased from baseline for adults (-0.39 [ < .001]). Decreases in BMI z-score and BMI were independent of program attendance, ethnicity, and acceptance of government assistance. This study, unique in its inclusion of both adults and overweight children, supports the effectiveness of a community-developed program to address weight management in an ethnically diverse population.
儿童肥胖症的高发率凸显出有效体重管理干预措施的必要性。本研究评估了针对超重和肥胖儿童及其成年照护者的基于家庭的体重管理计划(Nutrition+Exercise+Weight Management;NEW Keiki)。研究收集了超重(体重指数,BMI=85-94 百分位)和肥胖(BMI>95 百分位)儿童(n=75,5-14 岁)及其成年照护者(n=104)的数据。入组儿童中 71%为夏威夷原住民、太平洋岛民和/或菲律宾裔(NHPI+F)。家庭每周参加 8-9 周的多学科生活方式计划(干预阶段);干预后 6 个月和 12 个月进行随访。通过病历回顾收集儿童的长期数据(干预后 14-50 个月)。分析儿童 BMI z 评分和成年 BMI 的变化。评估了种族、接受政府援助和项目参与的影响。确定为 NHPI+F 和/或接受政府援助的参与者基线 BMI z 评分和 BMI 更高。在儿童中,BMI z 评分在所有评估访视中均从基线下降(2 个月时下降 0.05[<0.001],6 个月随访时下降 0.07[<0.001],12 个月随访时下降 0.04[=0.05],长期随访时下降 0.06[=0.01])。在 2 个月访视时,成年人的 BMI 从基线下降(-0.39[<0.001])。BMI z 评分和 BMI 的下降与项目参与、种族和接受政府援助无关。本研究的独特之处在于同时纳入了成年人和超重儿童,支持了针对不同种族人群进行体重管理的社区开发项目的有效性。