Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK.
Nutrition and Dietetics, Foodtalk CIC, London SE16 6SG, UK.
Nutrients. 2021 Oct 31;13(11):3912. doi: 10.3390/nu13113912.
Behavioural weight management interventions are recommended for the treatment of obesity in children. However, the evidence for these is limited and often generated under trial conditions with White, middle-class populations. Healthy Eagles is a behavioural weight management intervention designed to treat excess weight in children. It ran in the London Borough of Croydon from 2017 to 2020 and was delivered in both school and community settings, providing a natural experiment to compare outcomes. A total of 1560 participants started the Healthy Eagles programme; 347 were in the community setting and 703 in the school setting. Data were analysed for those who completed 70% of the programme. In the school setting, there was a small but significant reduction in BMI z-score (M = -0.04, 95% CI = -0.08, -0.01) for participants above a healthy weight, especially in those with severe obesity (M = -0.09, 95% CI = -0.15, -0.03); there was no significant change in any subgroup in the community setting. Linear regression analysis showed the school setting was associated with a 0.26 (95% CI = 0.13, 0.49) greater reduction in BMI z-score than the community setting after adjusting for ethnicity, deprivation, age and gender. Across both programmes, the effect was somewhat greater in participants from a Black (African/Caribbean/Other) ethnic background (M = -0.06, 95% CI = -0.09, -0.02) and from the two most deprived quintiles (M = -0.06, 95% CI = -0.11, -0.01). Data were limited, but minimal changes were measured in nutrition and physical activity behaviours regardless of setting. This evaluation provides indirect evidence of a small but significant benefit to running weight management interventions in a school versus community setting.
行为体重管理干预措施被推荐用于治疗儿童肥胖。然而，这些证据有限，而且往往是在针对白人和中产阶级人群的试验条件下产生的。健康老鹰（Healthy Eagles）是一种行为体重管理干预措施，旨在治疗儿童超重问题。该干预措施于 2017 年至 2020 年在伦敦克罗伊登区（Croydon）实施，在学校和社区环境中开展，提供了一个自然实验来比较结果。共有 1560 名参与者开始参与健康老鹰计划；347 人在社区环境中，703 人在学校环境中。对完成计划 70%的参与者进行了数据分析。在学校环境中，对于超重的参与者，BMI z 分数有一个较小但显著的降低（M = -0.04，95%置信区间 = -0.08，-0.01），特别是对于严重肥胖的参与者（M = -0.09，95%置信区间 = -0.15，-0.03）；在社区环境中，任何亚组都没有显著变化。线性回归分析表明，在校环境中，与社区环境相比，BMI z 分数的降低幅度更大，差值为 0.26（95%置信区间 = 0.13，0.49），在校环境中调整了种族、贫困程度、年龄和性别等因素后，这种差异仍然显著。在两个项目中，来自黑人（非洲/加勒比/其他）背景的参与者（M = -0.06，95%置信区间 = -0.09，-0.02）和来自两个最贫困五分位数的参与者（M = -0.06，95%置信区间 = -0.11，-0.01）的效果稍大。数据有限，但无论在何种环境下，营养和身体活动行为都只有很小的变化。这项评估提供了间接证据，表明在学校环境中开展体重管理干预措施比在社区环境中开展具有较小但显著的益处。
