College of Osteopathic Medicine, Touro University California, Vallejo, CA, USA.
J Osteopath Med. 2021 Mar 23;121(5):513-520. doi: 10.1515/jom-2020-0143.
With pediatric obesity rates reaching epidemic scales across the United States, innovative research to identify key factors for successful implementation of obesity intervention programs is increasingly paramount. Project Healthy Attitudes Produces Positive Youth (HAPPY) is a family centered pediatric obesity prevention program targeting elementary age children and their families.
To determine whether Project HAPPY interventions emphasizing social networks were successful.
This was a small scale evaluation of the Project HAPPY pilot program, conducted after school at a public elementary campus in Solano County, California. From April 2018 to May 2018, first year medical students from Touro University California College of Osteopathic Medicine served as "family navigators," guiding participants through a 5 week curriculum of didactic lessons, cooking demonstrations, and physical exercises. Eligibility requirements for Project HAPPY included basic English proficiency, confirmed enrollment of at least one child at the elementary school, and willingness to attend all study sessions. The primary outcome evaluated was a shift in attitude toward individual health. Changes in body mass index (BMI) and health behaviors were assessed as secondary outcomes. Outcomes were assessed through surveys and measurements of BMI completed during Session 1, Session 10, and 4, 6, and 8 month follow up sessions.
Initial study participants included seven families, consisting of elementary school students with their siblings and parents (n=27). Only four families (n=13) completed the entire 5 week intervention. Over the course of the study, survey results of participants' attitudes regarding health suggested a positive trend toward self efficacy, while BMI appeared stable or increased. Participants demonstrated retention of successful health behaviors up to 8 months after the end of the intervention through qualitative reports of being "more conscious of meals and what (they) are eating," "valu[ing their] nutrition on a daily basis," "play[ing] a lot outside and inside on the weekends," "carry[ing] a water bottle," and "cook(ing) a lot." A higher percentage of respondents in the final session compared selected the option "strongly agree" to each of the following statements: "I can be healthier if my family works together" (87.5% final session vs. 84.6% first session), "Drinking water makes me healthy" (87.5% final session vs. 84.6% first session), "Moving my body makes me healthy" (87.5% final session vs. 76.9% first session), "I reach my goals even when things get in my way" (62.5% final session vs. 46.2% first session), "Eating fruits and veggies make me healthy" (100% final session vs. 92.3% first session), "I can be healthy and enjoy my favorite foods" (87.5% final session vs. 66.7% first session), and "I can create a healthy balanced meal" (87.0% final session vs. 75.0% first session). Concrete data analysis was severely complicated by loss of study participants to follow up and incomplete data collection.
Project HAPPY showed promising indications that should be further evaluated in studies of larger scale and longer duration.
在美国，儿科肥胖率达到了流行规模，因此，寻找成功实施肥胖干预计划的关键因素的创新性研究变得至关重要。“健康态度产生积极青年”（HAPPY）项目是一项针对小学年龄儿童及其家庭的以家庭为中心的儿科肥胖预防计划。
确定 HAPPY 项目强调社交网络的干预措施是否成功。
这是对 HAPPY 项目试点计划的小规模评估，在加利福尼亚州索拉诺县的一所公立小学放学后进行。从 2018 年 4 月到 2018 年 5 月，来自加州图罗大学骨科医学院的一年级医学生担任“家庭导航员”，指导参与者完成为期 5 周的课程，包括讲座、烹饪示范和体育锻炼。HAPPY 项目的入选标准包括基本英语水平、确认至少有一名小学生在小学就读，以及愿意参加所有学习课程。主要评估结果是个人健康态度的转变。次要评估结果包括体重指数（BMI）和健康行为的变化。通过在第 1 节课、第 10 节课以及 4 个月、6 个月和 8 个月的随访中完成的调查和 BMI 测量来评估结果。
最初的研究参与者包括七个家庭，由小学生及其兄弟姐妹和父母组成（n=27）。只有四个家庭（n=13）完成了整个 5 周的干预。在研究过程中，参与者对健康相关态度的调查结果表明，自我效能感呈积极趋势，而 BMI 似乎稳定或增加。通过定性报告表明，参与者保留了成功的健康行为，直至干预结束后 8 个月，包括“更注意饮食和所吃的食物”、“每天关注营养”、“周末内外多运动”、“携带水瓶”和“经常做饭”。与第一次会议相比，在最后一次会议中，更多的受访者选择“强烈同意”以下每一项陈述：“如果我的家人一起努力，我可以更健康”（87.5%的最后一次会议 vs. 84.6%的第一次会议）、“喝水使我健康”（87.5%的最后一次会议 vs. 84.6%的第一次会议）、“锻炼身体使我健康”（87.5%的最后一次会议 vs. 76.9%的第一次会议）、“即使遇到困难，我也能实现目标”（62.5%的最后一次会议 vs. 46.2%的第一次会议）、“吃水果和蔬菜使我健康”（100%的最后一次会议 vs. 92.3%的第一次会议）、“我可以健康并享受我最喜欢的食物”（87.5%的最后一次会议 vs. 66.7%的第一次会议）和“我可以制作健康均衡的膳食”（87.0%的最后一次会议 vs. 75.0%的第一次会议）。由于研究参与者失去随访和数据收集不完整，具体数据分析受到严重影响。
HAPPY 项目显示出有希望的迹象，应该在更大规模和更长时间的研究中进一步评估。
