Ling Jiying, Kao Tsui-Sui Annie, Robbins Lorraine B, Kerver Jean M, Zhang Nanhua, Shi Yan
Michigan State University College of Nursing, East Lansing, Michigan, USA
Michigan State University College of Nursing, East Lansing, Michigan, USA.
BMJ Open. 2024 Dec 5;14(12):e081578. doi: 10.1136/bmjopen-2023-081578.
This study aimed to examine the preliminary efficacy of the versus usual care control on improving parents' lifestyle behaviours (moderate to vigorous physical activity, screen time, fruit/vegetable and fibre intake, skin carotenoids), nutrition and physical activity knowledge, self-efficacy, support, parenting style, feeding practices, home environment, anthropometric outcomes (body mass index, % body fat) and blood pressure from baseline to postintervention after adjusting for random cluster effects.
A cluster randomised controlled trial with 10 Head Start daycare centres (five intervention, five control) was conducted using computer-generated randomisation after baseline data collection.
US Head Start daycare centres.
95 parent-child dyads (53 intervention, 42 control).
The 16-week, dyadic, intervention included: (1) a daycare-based child programme on healthy mindful eating and physical activity, (2) child letters to parents to connect school learning with home practice, (3) social media-based parent programme to assist parents to promote healthy eating and physical activity at home, (4) virtual group parent meetings via Zoom on topics related to healthy eating and physical activity and (5) weekly motivational messages to increase parental motivation to build a healthy home environment.
Mixed-effect models were used to examine intervention effects, adjusting for baseline outcome and cluster effects at the daycare and classroom levels. Intervention parents engaged in more moderate to vigorous physical activity (B=0.49, p=0.874) postintervention than controls, although not significantly. However, intervention parents showed significantly higher nutrition knowledge (B=0.87, p=0.009), physical activity knowledge (B=0.95, p=0.049), nutrition self-efficacy (B=0.74, p=0.025) and physical activity self-efficacy (B=0.86, p=0.013) compared with controls at postintervention. Fibre intake was also significantly higher (B=2.99, p=0.049), and intervention parents had lower % body fat (B=-2.56, p=0.005) and systolic blood pressure (B=-10.98, p=0.005) postintervention. No significant effects were found for fruits/vegetables intake, parental support for healthy behaviours, home physical activity environment or authoritative parenting style.
Future endeavours to proactively engage parents in a dyadic childhood obesity prevention approach such as the intervention are warranted to improve outcomes among both children and parents.
NCT04164277.
本研究旨在检验[干预措施名称]与常规护理对照相比，在调整随机整群效应后，从基线到干预后对改善父母生活方式行为（中度至剧烈身体活动、屏幕时间、水果/蔬菜和纤维摄入量、皮肤类胡萝卜素）、营养和身体活动知识、自我效能感、支持、育儿方式、喂养习惯、家庭环境、人体测量结果（体重指数、体脂百分比）和血压的初步疗效。
在收集基线数据后，使用计算机生成的随机化方法，对10个开端计划日托中心（5个干预组，5个对照组）进行整群随机对照试验。
美国开端计划日托中心。
95对亲子二元组（53个干预组，42个对照组）。
为期16周的二元[干预措施名称]干预包括：（1）基于日托中心的儿童健康正念饮食和身体活动计划，（2）儿童给父母的信件，将学校学习与家庭实践联系起来，（3）基于社交媒体的家长计划，协助家长在家中促进健康饮食和身体活动，（4）通过Zoom进行的虚拟小组家长会议，主题为健康饮食和身体活动，（5）每周的激励信息，以增加父母营造健康家庭环境的动力。
使用混合效应模型检验干预效果，调整日托中心和教室层面的基线结果和整群效应。干预组父母在干预后比对照组进行了更多的中度至剧烈身体活动（B = 0.49，p = 0.874），尽管不显著。然而，与对照组相比，干预组父母在干预后营养知识（B = 0.87，p = 0.009）、身体活动知识（B = 0.95，p = 0.049）、营养自我效能感（B = 0.74，p = 0.025）和身体活动自我效能感（B = 0.86，p = 0.013）显著更高。纤维摄入量也显著更高（B = 2.99，p = 0.049），干预组父母在干预后体脂百分比更低（B = -2.56，p = 0.005），收缩压更低（B = -10.98，p = 0.005）。在水果/蔬菜摄入量、父母对健康行为的支持、家庭身体活动环境或权威育儿方式方面未发现显著影响。
未来有必要积极促使父母参与二元儿童肥胖预防方法，如[干预措施名称]干预，以改善儿童和父母的结局。
NCT04164277。
