社会生态模型层面在太平洋地区年轻儿童的含糖饮料和水摄入量中的作用：儿童健康生活干预。

Role of social ecological model level on young Pacific children's sugar-sweetened beverage and water intakes: Children's Healthy Living intervention.

机构信息

Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA02111, USA.

College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, HI96822, USA.

出版信息

Public Health Nutr. 2021 Jun;24(8):2318-2323. doi: 10.1017/S1368980020004796. Epub 2020 Nov 25.

DOI:10.1017/S1368980020004796

PMID:33234187

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10195608/

Abstract

OBJECTIVE

To examine children's sugar-sweetened beverage (SSB) and water intakes in relation to implemented intervention activities across the social ecological model (SEM) during a multilevel community trial.

DESIGN

Children's Healthy Living was a multilevel, multicomponent community trial that reduced young child obesity (2013-2015). Baseline and 24-month cross-sectional data were analysed from nine intervention arm communities. Implemented intervention activities targeting reduced SSB and increased water consumption were coded by SEM level (child, caregiver, organisation, community and policy). Child SSB and water intakes were assessed by caregiver-completed 2-day dietary records. Multilevel linear regression models examined associations of changes in beverage intakes with activity frequencies at each SEM level.

SETTING

US-Affiliated Pacific region.

PARTICIPANTS

Children aged 2-8 years (baseline: n 1343; 24 months: n 1158).

RESULTS

On average (± sd), communities implemented 74 ± 39 SSB and 72 ± 40 water activities. More than 90 % of activities targeted both beverages together. Community-level activities (e.g. social marketing campaign) were most common (61 % of total activities), and child-level activities (e.g. sugar counting game) were least common (4 %). SSB activities across SEM levels were not associated with SSB intake changes. Additional community-level water activities were associated with increased water intake (0·62 ml/d/activity; 95 % CI: 0·09, 1·15) and water-for-SSB substitution (operationalised as SSB minus water: -0·88 ml/d/activity; 95 % CI: -1·72, -0·03). Activities implemented at the organization level (e.g. strengthening preschool wellness guidelines) and policy level (e.g. SSB tax advocacy) also suggested greater water-for-SSB substitution (P < 0·10).

CONCLUSIONS

Community-level intervention activities were associated with increased water intake, alone and relative to SSB intake, among young children in the Pacific region.

摘要

目的

在一项多层次社区试验中，根据社会生态模型 (SEM) 中实施的干预活动，研究儿童的含糖饮料 (SSB) 和水摄入量。

设计

儿童健康生活是一项多层次、多成分的社区试验，旨在减少幼儿肥胖症（2013-2015 年）。从 9 个干预组社区分析了基线和 24 个月的横断面数据。针对减少 SSB 和增加水消耗的实施干预活动按 SEM 水平（儿童、照顾者、组织、社区和政策）进行编码。儿童 SSB 和水摄入量由照顾者完成的 2 天饮食记录评估。多水平线性回归模型检验了每个 SEM 水平的饮料摄入量变化与活动频率之间的关联。

设置

美属太平洋地区。

参与者

年龄 2-8 岁的儿童（基线：n=1343；24 个月：n=1158）。

结果

平均而言（±标准差），社区实施了 74±39 项 SSB 和 72±40 项水活动。超过 90%的活动同时针对两种饮料。社区层面的活动（如社会营销活动）最为常见（总活动的 61%），而儿童层面的活动（如糖计数游戏）最为少见（4%）。SEM 各层次的 SSB 活动与 SSB 摄入量变化无关。更多的社区层面水活动与水摄入量增加相关（0·62 ml/d/活动；95%CI：0·09，1·15）和 SSB 替代水（操作定义为 SSB 减去水：-0·88 ml/d/活动；95%CI：-1·72，-0·03）。组织层面（如加强学前保健准则）和政策层面（如 SSB 税宣传）实施的活动也表明了更大的 SSB 替代水（P<0·10）。