Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO; Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO; Department of Internal Medicine, University of Iowa, Iowa City, IA; Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO.
Department of Internal Medicine, University of Iowa, Iowa City, IA; Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA.
J Nutr Educ Behav. 2024 Sep;56(9):631-642. doi: 10.1016/j.jneb.2024.05.227. Epub 2024 Jun 19.
Test an obesity intervention for families with low incomes.
A total of 208 families were included (a parent with a body mass index [BMI] ≥ 30 and a child aged 6-12 years). A 12-month randomized controlled trial combining family health coaching (motivational interviewing) and connection to community resources. Comparison group: referrals for basic needs, written educational materials. Questionnaires, accelerometry, and anthropometrics. Intention-to-treat analysis of change in outcomes. Two-sided t test with multiple imputation.
Parents were 95% female, 31% Black, and 27% Hispanic. Children had a mean BMI-Z score of 1.15. Primary outcomes did not differ between groups at 12 months. Both groups significantly (P < 0.05) improved on the Family Nutrition and Physical Activity Scale for behaviors related to childhood obesity (mean ± SE: comparison, 2.8 ± 1.0; intervention, 2.2 ± 0.9), increased child sedentary activity (comparison, 32.5 ± 12.1; intervention, 39.9 ± 12.4 min/d), and decreased child moderate-vigorous physical activity (comparison, -9.6 ± 3.3; intervention -7.0 ± 3.0 min/d). Parents had no change in BMI.
We successfully embedded screening and referral to address social needs within an obesity intervention. The coaching intervention did not provide additional benefits. Future research could explore ways to make these interventions more accessible, valuable, and effective for families.
测试针对低收入家庭的肥胖干预措施。
共纳入 208 个家庭（父母 BMI≥30，子女年龄为 6-12 岁）。采用为期 12 个月的随机对照试验，结合家庭健康指导（动机访谈）和社区资源联系。对照组：基本需求转介，书面教育材料。问卷调查、加速度计和人体测量学。意向治疗分析结果变化。双侧 t 检验与多重插补。
父母中 95%为女性，31%为黑人，27%为西班牙裔。儿童的 BMI-Z 评分平均为 1.15。12 个月时两组主要结局无差异。两组均显著（P<0.05）改善了与儿童肥胖相关的家庭营养和体育活动量表的行为（对照组平均±SE：2.8±1.0；干预组 2.2±0.9），增加了儿童久坐活动（对照组 32.5±12.1；干预组 39.9±12.4 min/d），并减少了儿童中高强度体力活动（对照组-9.6±3.3；干预组-7.0±3.0 min/d）。父母的 BMI 没有变化。
我们成功地将筛查和转介以满足社会需求嵌入到肥胖干预措施中。指导干预并没有提供额外的益处。未来的研究可以探索使这些干预措施更易于获得、更有价值和对家庭更有效的方法。
