¡Míranos! 对低收入拉丁裔学龄前儿童家长报告的家庭健康能量平衡相关行为的影响：一项聚类随机对照试验。
Impact of ¡Míranos! on parent-reported home-based healthy energy balance-related behaviors in low-income Latino preschool children: a clustered randomized controlled trial.
机构信息
College for Health, Community and Policy, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, USA.
Latino Research Institute, University of Texas at Austin, 210 W. 24th Street, GWB 1.102, Austin, TX, 78712, USA.
出版信息
Int J Behav Nutr Phys Act. 2023 Mar 21;20(1):33. doi: 10.1186/s12966-023-01427-z.
BACKGROUND
Widespread establishment of home-based healthy energy balance-related behaviors (EBRBs), like diet, physical activity, sedentary behavior, screen time, and sleep, among low-income preschool-aged children could curb the childhood obesity epidemic. We examined the effect of an 8-month multicomponent intervention on changes in EBRBs among preschool children enrolled in 12 Head Start centers.
METHODS
The Head Start (HS) centers were randomly assigned to one of three treatment arms: center-based intervention group (CBI), center-based plus home-based intervention group (CBI + HBI), or control. Before and following the intervention, parents of 3-year-olds enrolled in participating HS centers completed questionnaires about their child's at-home EBRBs. Adult-facilitated physical activity (PA) was measured by an index based on questions assessing the child's level of PA participation at home, with or facilitated by an adult. Fruit, vegetable, and added sugar intake were measured via a short food frequency questionnaire, and sleep time and screen time were measured using 7-day logs. A linear mixed effects model examined the intervention's effect on post-intervention changes in PA, intake of fruit, vegetable, and added sugar, sleep time, and screen time from baseline to post-intervention.
RESULTS
A total of 325 parents participated in the study (CBI n = 101; CBI + HBI n = 101; and control n = 123). Compared to control children, CBI and CBI + HBI parents reported decreases in children's intake of added sugar from sugar-sweetened beverages. Both CBI and CBI + HBI parents also reported smaller increases in children's average weekday screen time relative to controls. In addition, CBI + HBI parents reported CBI + HBI parents reported increases in children's adult-facilitated PA, fruit and vegetable intake, and daily sleep time during weekdays (excluding weekends) and the total week from baseline to post-intervention, while children in the CBI increased sleep time over the total week compared to the children in the control group.
CONCLUSIONS
Parent engagement strengthened the improvement in parent-reported EBRBs at home in young children participating in an evidence-based obesity prevention program in a childcare setting. Future studies should investigate equity-related contextual factors that influence the impact of obesity prevention in health-disparity populations.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT03590834. Registered July 18, 2018, https://clinicaltrials.gov/ct2/show/NCT03590834.
背景
在低收入学龄前儿童中广泛建立以家庭为基础的健康能量平衡相关行为（EBRBs），如饮食、身体活动、久坐行为、屏幕时间和睡眠，可以遏制儿童肥胖症的流行。我们研究了为期 8 个月的多组分干预措施对参与 12 个“提前开端计划”（Head Start）中心的学龄前儿童 EBRBs 变化的影响。
方法
“提前开端计划”中心被随机分配到以下三个治疗组之一：以中心为基础的干预组（CBI）、以中心为基础加家庭为基础的干预组（CBI+HBI）或对照组。在干预之前和之后，参加参与的“提前开端计划”中心的 3 岁儿童的父母完成了关于他们孩子在家中 EBRBs 的调查问卷。成人促进的身体活动（PA）通过一个指数来衡量，该指数基于评估儿童在家中参与 PA 程度的问题，以及是否有成年人的帮助。水果、蔬菜和添加糖的摄入量通过简短的食物频率问卷进行测量，睡眠时间和屏幕时间通过 7 天的记录进行测量。线性混合效应模型检查了干预对从基线到干预后 PA、水果、蔬菜和添加糖摄入量、睡眠时间和屏幕时间的变化的影响。
结果
共有 325 名家长参与了这项研究（CBI 组 n=101；CBI+HBI 组 n=101；对照组 n=123）。与对照组儿童相比，CBI 和 CBI+HBI 组的儿童摄入来自含糖饮料的添加糖量有所减少。CBI 和 CBI+HBI 组的父母还报告说，与对照组相比，儿童平均工作日屏幕时间的增加幅度较小。此外，CBI+HBI 组的父母报告说，与对照组相比，CBI+HBI 组的儿童在工作日（不包括周末）和整周的成人促进的 PA、水果和蔬菜摄入量以及每日睡眠时间有所增加，而 CBI 组的儿童在整周的睡眠时间有所增加。
结论
家长的参与加强了在儿童保育环境中参与基于证据的肥胖预防计划的幼儿在家中报告的 EBRBs 的改善。未来的研究应调查影响健康差异人群肥胖预防效果的与公平相关的背景因素。
试验注册
ClinicalTrials.gov，NCT03590834。2018 年 7 月 18 日注册，https://clinicaltrials.gov/ct2/show/NCT03590834。
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