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美国家庭中低收入和少数族裔儿童蔬菜摄入量的饮食心理社会中介因素:德克萨斯州 Sprouts 干预研究结果。

Dietary Psychosocial Mediators of Vegetable Intake in Schoolchildren From Low-Income and Racial and Ethnic Minority US Families: Findings From the Texas Sprouts Intervention.

机构信息

Department of Medicine, New York University Grossman School of Medicine, New York, New York.

Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Austin, Texas.

出版信息

J Acad Nutr Diet. 2023 Aug;123(8):1187-1196.e1. doi: 10.1016/j.jand.2023.03.015. Epub 2023 Mar 28.

Abstract

BACKGROUND

Numerous school-based interventions have used cooking and gardening approaches to improve dietary intake; however, research is limited on the mediation effect of dietary psychosocial factors on the link between the intervention and increased vegetable intake, particularly in children from low-income and racial and ethnic minority US families.

OBJECTIVE

Our aim was to examine the effects of the Texas Sprouts intervention on dietary psychosocial factors related to intake of vegetables, and whether these psychosocial factors mediate the link between the intervention and increased intake of vegetables in schoolchildren from low-income and racial and ethnic minority US families.

DESIGN

This was an analysis of data on secondary outcomes from the Texas Sprouts program, a 1-year school-based gardening, nutrition, and cooking cluster randomized controlled trial consisting of elementary schools that were randomly assigned to either the Texas Sprouts intervention or to control.

PARTICIPANTS/SETTING: Participants were 2,414 third- through fifth-grade students from low-income and racial and ethnic minority US families from 16 schools (8 intervention and 8 control) in Austin, TX.

INTERVENTION

The intervention group received eighteen 60-minute gardening, nutrition, and cooking student lessons in an outdoor teaching garden and 9 monthly parent lessons throughout the academic year.

MAIN OUTCOME MEASURES

Child psychosocial and dietary measures were collected at baseline and post intervention via validated questionnaires.

STATISTICAL ANALYSES PERFORMED

Generalized linear mixed models assessed the intervention effects on dietary psychosocial factors. Mediation analyses examined whether these psychosocial factors mediated the link between the intervention and increased child vegetable intake.

RESULTS

Children in Texas Sprouts, compared with controls, showed significant increases in the mean scores of gardening attitudes, cooking self-efficacy, gardening self-efficacy, nutrition and gardening knowledge, and preferences for fruit and vegetables (all, P < .001). Each of the dietary psychosocial factors mediated the association between the Texas Sprouts intervention and child vegetable intake.

CONCLUSIONS

Besides targeting dietary behaviors, future school-based interventions should also focus on understanding the mechanisms through which teaching children to cook and garden influence dietary psychosocial factors as mediators of change in healthy eating behaviors.

摘要

背景

许多基于学校的干预措施都采用烹饪和园艺方法来改善饮食摄入;然而,关于饮食心理社会因素对干预与增加蔬菜摄入量之间关系的中介作用的研究有限,特别是在美国低收入和种族及少数民族家庭的儿童中。

目的

我们旨在检验德克萨斯州 Sprouts 干预措施对与蔬菜摄入量相关的饮食心理社会因素的影响,以及这些心理社会因素是否在低收入和种族及少数民族美国家庭的学童中作为干预与增加蔬菜摄入量之间关系的中介因素。

设计

这是对德克萨斯州 Sprouts 计划的次要结果数据的分析,该计划是一项为期 1 年的基于学校的园艺、营养和烹饪集群随机对照试验,由随机分配到德克萨斯州 Sprouts 干预组或对照组的小学组成。

参与者/设置:参与者是来自奥斯汀德克萨斯州 16 所学校(8 所干预组和 8 所对照组)的 2414 名三至五年级低收入和种族及少数民族美国家庭的学生。

干预措施

干预组在户外教学花园接受 18 节 60 分钟的园艺、营养和烹饪学生课程,以及整个学年每月 9 次家长课程。

主要观察指标

通过验证问卷在基线和干预后收集儿童心理社会和饮食措施。

统计分析

广义线性混合模型评估了干预措施对饮食心理社会因素的影响。中介分析检验了这些心理社会因素是否在干预措施与儿童蔬菜摄入量增加之间的关系中起中介作用。

结果

与对照组相比,德克萨斯州 Sprouts 的儿童在园艺态度、烹饪自我效能感、园艺自我效能感、营养和园艺知识以及对水果和蔬菜的偏好方面的平均得分均显著增加(均,P <.001)。饮食心理社会因素中的每一个都介导了德克萨斯州 Sprouts 干预措施与儿童蔬菜摄入量之间的关联。

结论

除了针对饮食行为外,未来的基于学校的干预措施还应注重了解教导儿童烹饪和园艺如何通过影响饮食心理社会因素作为健康饮食习惯变化的中介因素。

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