Global Obesity Center (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
Child Obes. 2023 Jul;19(5):332-340. doi: 10.1089/chi.2022.0076. Epub 2022 Aug 5.
We investigated the effect of the Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHO STOPS) intervention on children's objectively measured physical activity and sedentary time (ST). We conducted a cluster randomized controlled trial with children in grades 4 (∼9-10 years old) and grade 6 (∼11-12 years old) from 10 communities in the Great South Coast region of Victoria, Australia. Communities were randomly allocated (1:1) to receive the WHO STOPS intervention in 2015. WHO STOPS was a whole of community systems-based approach to preventing childhood obesity. Outcome data were collected using a repeat cross-sectional design in 2015, 2017, and 2019. Children were asked to wear a hip-mounted accelerometer for 7 days. Age-specific Axis 1 activity counts were converted into duration (minutes/day) spent engaged in moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and ST. Linear mixed regression models were fitted to estimate the effects of the intervention on the three activity outcomes across the study period. Analyses were based on valid accelerometer data from 1406 children (intervention = 745; control = 661). Results for MVPA, LPA, and ST were nonsignificant. Between 2015 and 2017, there were positive, but nonsignificant, changes in mean MVPA favoring intervention boys [3.7 minutes/day; 95% confidence interval (CI): -5.7 to 13.1] and girls (5.5 minutes/day; 95% CI: -1.5 to 12.6). By 2019, these effects had attenuated. Although the WHO STOPS intervention did not significantly change activity levels, the magnitudes of the effects on MVPA suggest that further research with whole-of-community interventions in larger samples would be worthwhile. Clinical trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR.org.au) identifier 12616000980437.
我们研究了全系统试验预防儿童肥胖策略（WHO STOPS）干预对儿童客观测量的身体活动和久坐时间（ST）的影响。我们在澳大利亚维多利亚州大南岸地区的 10 个社区中，对 4 年级（约 9-10 岁）和 6 年级（约 11-12 岁）的儿童进行了一项集群随机对照试验。社区以 1:1 的比例随机分配（2015 年）接受 WHO STOPS 干预。WHO STOPS 是一种基于整个社区系统的预防儿童肥胖的方法。使用重复横断面设计在 2015 年、2017 年和 2019 年收集了结果数据。要求孩子们佩戴一个臀部佩戴的加速度计 7 天。特定年龄段的轴 1 活动计数被转换为进行中度到剧烈体力活动（MVPA）、轻度体力活动（LPA）和 ST 的分钟/天。线性混合回归模型用于估计干预对整个研究期间三项活动结果的影响。分析基于 1406 名儿童（干预组 = 745；对照组 = 661）的有效加速度计数据。MVPA、LPA 和 ST 的结果均不显著。2015 年至 2017 年间，干预男孩（3.7 分钟/天；95%置信区间（CI）：-5.7 至 13.1）和女孩（5.5 分钟/天；95%CI：-1.5 至 12.6）的平均 MVPA 有积极但不显著的变化。到 2019 年，这些影响已经减弱。尽管 WHO STOPS 干预没有显著改变活动水平，但 MVPA 的影响幅度表明，在更大的样本中进行全社区干预的进一步研究将是值得的。临床试验注册：澳大利亚新西兰临床试验注册中心（ANZCTR.org.au）标识符 12616000980437。
