儿童保健中心工作人员在儿童肥胖预防计划中的改变准备度。

Child Care Center Staff Readiness to Change in an Early Childhood Obesity Prevention Program.

机构信息

University of Miami, School of Nursing and Health Studies, Miami, Florida (Dr Lebron); University of Texas School of Public Health, Health Science Center at Houston, Dallas, Texas (Drs Atem and Messiah and Ms Rana); University of Miami Miller School of Medicine, Mailman Center for Child Development, Miami, Florida (Dr Natale); and Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, Dallas, Texas (Dr Messiah).

出版信息

J Public Health Manag Pract. 2024;30(4):526-534. doi: 10.1097/PHH.0000000000001850. Epub 2024 Jun 12.

DOI:10.1097/PHH.0000000000001850

PMID:38870370

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11178244/

Abstract

CONTEXT

The childcare center (CCC) setting has the potential to be a strong foundation that supports the introduction of sustainable healthy lifestyle behaviors to prevent childhood obesity. It is important to assess barriers and facilitators to healthy weight development initiatives via program evaluation, including measuring CCC staff readiness to change.

OBJECTIVE

The overall goal of this study was to assess the readiness level over 1 school year among CCC staff who participated in "Healthy Caregivers-Healthy Children" (HC2), a cluster randomized controlled trial that evaluated the effectiveness of a childhood obesity prevention program from 2015 to 2018 in 24 low-income, racially/ethnically diverse centers. A secondary outcome was to assess how a CCC's stage of readiness to change was associated with CCC nutrition and physical activity environment, measured via the Environment and Policy Assessment and Observation (EPAO) tool.

DESIGN

Mixed-models analysis with the CCC as the random effect assessed the impact of readiness to change over time on EPAO outcomes.

PARTICIPANTS

Eighty-eight CCC teachers and support staff completed the HC2 readiness to change survey in August 2015 and 68 in August 2016. Only teachers and staff randomized to the treatment arm of the trial were included.

MAIN OUTCOME

Readiness to change and the EPAO.

RESULTS

Results showed the majority of CCC staff in advanced stages of readiness to change at both time points. For every increase in readiness to change stage over 1 year (eg, precontemplation to contemplation), there was a 0.28 increase in EPAO nutrition scores (95% confidence interval [CI], 0.04-0.53; P = .02) and a 0.52 increase in PA score (95% CI, 0.09-0.95; P = .02).

CONCLUSIONS

This analysis highlights the importance between CCC staff readiness to change and the CCC environment to support healthy weight development. Future similar efforts can include consistent support for CCC staff who may not be ready for change to support successful outcomes.

摘要

背景

儿童保育中心（CCC）有可能成为一个强大的基础，支持引入可持续的健康生活方式行为，以预防儿童肥胖。通过项目评估，包括衡量 CCC 员工对变革的准备程度，评估健康体重发展计划的障碍和促进因素非常重要。

目的

本研究的总体目标是评估在参与“健康照顾者-健康儿童”（HC2）的 CCC 员工中，在一个学年内的准备水平，HC2 是一项从 2015 年到 2018 年进行的、评估儿童肥胖预防计划有效性的集群随机对照试验，该计划在 24 个低收入、种族/族裔多样化的中心实施。次要结果是评估 CCC 准备改变的阶段如何与 CCC 的营养和体育活动环境相关，这是通过环境和政策评估和观察（EPAO）工具来衡量的。

设计

混合模型分析以 CCC 为随机效应，评估随着时间的推移，准备改变对 EPAO 结果的影响。

参与者

88 名 CCC 教师和支持人员于 2015 年 8 月完成了 HC2 准备改变调查，68 名于 2016 年 8 月完成。仅包括试验治疗组随机分配的教师和工作人员。

主要结果

准备改变和 EPAO。

结果

结果显示，大多数 CCC 员工在两个时间点都处于准备改变的高级阶段。在一年内，准备改变阶段每增加一级（例如，从无考虑到考虑），EPAO 营养评分就会增加 0.28（95%置信区间 [CI]，0.04-0.53；P =.02），PA 评分增加 0.52（95% CI，0.09-0.95；P =.02）。