School of Nursing, College of Health and Human Services, George Mason University, Fairfax, VA, USA.
School of Nursing, University of Minnesota, Minneapolis, MN, USA.
Child Obes. 2021 Apr;17(3):185-195. doi: 10.1089/chi.2020.0321. Epub 2021 Feb 18.
The primary aim of this randomized controlled trial, conducted in Minneapolis/St. Paul, Minnesota (2014-2019), was to evaluate the effects of a school-based, school nurse-delivered, secondary obesity prevention intervention to reduce excess weight gain among preadolescent children with obesity or at risk of developing obesity. Parent/child dyads ( = 132) were randomized to the 9-month Students, Nurses, and Parents Seeking Healthy Options Together (SNAPSHOT) intervention (32.5 contact hours) or newsletter-only control group. Eligible children were 8 to 12 years old, proficient in English, and with a BMI ≥75th percentile, calculated using height/weight reported by a parent, school nurse, or clinician. The primary outcome was child BMI for sex/age -score (BMI) at postintervention (12 months) and follow-up (24 months). Among children, 63% were non-White, 51% were male, and 51% with obesity, including 21% with severe obesity. Among families, 59% received economic assistance and 30% reported food insecurity. The mean number of intervention contact hours received was 20 (range: 0-32.5). Among dyads ( = 54) receiving the intervention, parents were very satisfied/satisfied with SNAPSHOT and SNAPSHOT staff, 96% and 100%, respectively, and very likely/likely (97%) to recommend SNAPSHOT to others. Most (70%) children liked the kid group sessions "a lot." In an intent-to-treat analysis, there were no significant between-group differences in child BMI at 12 [0.04; 95% confidence interval (CI) -0.07 to 0.16] or 24 months (0.06; 95% CI -0.08 to 0.20), with participant retention of 92% and 93%, respectively. The SNAPSHOT intervention was well received, but did not improve BMI in a mostly diverse, low-income preadolescent population. Approaches to intervention delivery that are feasible, maximize accessibility, and optimize clinician and school nurse collaboration warrant consideration. Clinical trial registration identifier NCT02029976.
这项随机对照试验在明尼苏达州明尼阿波利斯/圣保罗进行（2014-2019 年），主要目的是评估一种基于学校、由学校护士实施的二级肥胖预防干预措施的效果，以减少肥胖或有肥胖风险的青春期前儿童的体重过度增加。父母/孩子对子（ = 132）被随机分配到为期 9 个月的学生、护士和家长一起寻求健康选择（SNAPSHOT）干预组（32.5 个接触小时）或仅接受通讯组。合格的儿童年龄在 8 至 12 岁之间，精通英语，且 BMI≥第 75 百分位数，使用父母、学校护士或临床医生报告的身高/体重计算得出。主要结果是儿童 BMI 性别/年龄评分（BMI）在干预后（12 个月）和随访（24 个月）时的变化。在儿童中，63%是非白人，51%是男性，51%患有肥胖症，包括 21%患有严重肥胖症。在家庭中，59%接受经济援助，30%报告存在粮食不安全问题。接受干预的儿童平均接受的干预接触小时数为 20 个（范围：0-32.5 个）。在接受干预的 54 对（ = ）父母中，分别有 96%和 100%的父母对 SNAPSHOT 及其工作人员非常满意/满意，97%的父母非常愿意/可能（97%）向他人推荐 SNAPSHOT。大多数（70%）孩子非常喜欢儿童小组课程。在意向治疗分析中，12 个月时儿童 BMI 无显著组间差异[0.04；95%置信区间（CI）-0.07 至 0.16]或 24 个月时[0.06；95%CI-0.08 至 0.20]，参与者的保留率分别为 92%和 93%。SNAPSHOT 干预措施受到好评，但并未改善以大多数不同种族、低收入的青春期前儿童为对象的 BMI。需要考虑那些可行、最大限度提高可及性并优化临床医生和学校护士合作的干预措施提供方式。临床试验注册号 NCT02029976。
