Dong Wenli, Wang Yimin, Xu Ke, Wang Miyuan, Xia Wenqi, Chen Fengyan, Tuerxun Paiziyeti, Jiang Yanfen, Wei Mengna, Zhou Jiameng, Zhang Jianduan
Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Key Laboratory of Environment & Health, Huazhong University of Science and Technology, Ministry of Education, Wuhan, Hubei, China.
Front Pediatr. 2025 Jul 23;13:1611282. doi: 10.3389/fped.2025.1611282. eCollection 2025.
Childhood obesity has surged in China, with preschool years being a critical window for intervention. Despite this, evidence-based randomized trials remain scarce, and traditional prevention strategies focusing on knowledge dissemination show limited long-term efficacy. The Wuhan Preschool Healthy Start (WPHS) project addresses this gap through a kindergarten-based trial integrating self-regulation strategies with energy balance-related behavior (EBRB) interventions.
This stratified randomized controlled trial enrolls children from 26 Wuhan kindergartens (13 intervention, 13 control) over 18 months. The multicomponent intervention targets diet, physical activity, sleep, sedentary behavior, and self-regulation, engaging children, families, and kindergarten environments. Control groups follow standard curricula. Primary outcome is the change in BMI z-score. Secondary outcomes assess behavioral factors (diet, sleep, activity), self-regulation skills, and other anthropometric indicators. Analyses adhere to intention-to-treat principles, using linear mixed models to evaluate intervention effects across strata while exploring potential effect modifiers including kindergarten level, child gender, and age.
This intervention hypothesizes that the integrated components of health knowledge, behavior, and self-regulation will not only support the adoption of targeted health behaviors but also ensure their long-term maintenance. This unique approach makes the WPHS project an innovative and holistic initiative to prevent childhood obesity, providing valuable insights into public health strategies for this critical population. We anticipate that incorporating self-regulation training will improve the sustainability of behavior changes, addressing a key gaps in current preschool obesity interventions.
Chinese Clinical Trial Registry ChiCTR2200058452.
中国儿童肥胖问题激增，学前阶段是进行干预的关键时期。尽管如此，基于证据的随机试验仍然很少，而专注于知识传播的传统预防策略显示出有限的长期效果。武汉学前健康启动（WPHS）项目通过一项基于幼儿园的试验来填补这一空白，该试验将自我调节策略与能量平衡相关行为（EBRB）干预相结合。
这项分层随机对照试验在18个月内招募了来自武汉26所幼儿园的儿童（13所干预幼儿园，13所对照幼儿园）。多组分干预针对饮食、身体活动、睡眠、久坐行为和自我调节，涉及儿童、家庭和幼儿园环境。对照组遵循标准课程。主要结局是BMI z评分的变化。次要结局评估行为因素（饮食、睡眠、活动）、自我调节技能和其他人体测量指标。分析遵循意向性分析原则，使用线性混合模型评估各层的干预效果，同时探索潜在的效应修饰因素，包括幼儿园水平、儿童性别和年龄。
这项干预假设健康知识、行为和自我调节的综合组成部分不仅将支持采用有针对性的健康行为，还将确保其长期维持。这种独特的方法使WPHS项目成为一项创新的、全面的预防儿童肥胖倡议，为这一关键人群的公共卫生策略提供了宝贵的见解。我们预计纳入自我调节训练将提高行为改变的可持续性，解决当前学前肥胖干预中的一个关键差距。
中国临床试验注册中心ChiCTR2200058452。
