一项针对学龄前儿童肥胖风险的电话随机临床试验的有效性：COVID-19大流行期间的一项扩展研究。

Effectiveness of a telephone-based randomised clinical trial targeting obesity risk of preschool-aged children: An extension study during the COVID-19 pandemic.

作者信息

Wen Li Ming, Xu Huilan, Chen Zoe, Hayes Alison, Phongsavan Philayrath, Taki Sarah, Kerr Erin, Jawad Danielle, Simone Lisa, Rissel Chris, Baur Louise A

机构信息

Health Promotion Unit, Population Health Research & Evaluation Hub, Sydney Local Health District, Camperdown, NSW, Australia.

Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.

出版信息

Int J Obes (Lond). 2025 Aug 14. doi: 10.1038/s41366-025-01869-4.

DOI:10.1038/s41366-025-01869-4

PMID:40813489

Abstract

BACKGROUND

There is a great need for determining the effectiveness of telephone-based early obesity interventions targeting preschool-aged children. This was particularly important during the COVID-19 pandemic when most face-to-face health promotion programs were suspended. The aim of this study was to determine the effects of a two-year telephone-based intervention on body mass index (BMI), eating habits, active play, and screen time behaviours among preschool-aged children.

METHODS

We conducted an extension study to a randomised controlled trial (RCT) with 662 mother-child dyads at ages 2-3 years in 2019-20 in the Greater Sydney metropolitan area of New South Wales (NSW), Australia. In 2020-22, we extended the RCT for another two years, with one-year intervention (3-4 years) and one-year follow-up (4-5 years). Participants remained in the same group allocation as the original trial. The intervention comprised five nurse-led telephone support calls and SMS plus mailed intervention booklets to mothers to promote the health behaviours of their children from ages 2 to 4 years. The primary outcome was children's BMI, with weight and height measured at ages 3, 4, and 5 years. We conducted intention-to-treat analysis with a multiple imputation approach. Mixed linear models were built to compare the outcomes between intervention and control groups. Sub-group analysis by household income was also conducted.

RESULTS

Of the 662 mothers, 537 (81%), 491 (74%), and 405 (61%) completed the assessments when their children were 3, 4, and 5 years old. The intervention was significantly associated with a lower mean BMI: 15.90 (SE 0.08) vs. 16.20 (SE 0.08), difference -0.30 (95% CI: -0.59 to -0.01, P = 0.039). This association was stronger among low-income families, difference -0.57 (95% CI: -1.05 to -0.10, P = 0.018).

CONCLUSIONS

The two-year telephone-based intervention was associated with decreased mean BMI of preschool-aged children. Telephone-based support for mothers could reduce obesity risk in preschool-aged children, particularly among low-income families.

TRIAL REGISTRATION

The original RCT is registered with the Australian Clinical Trial Registry (ACTRN12618001571268).

摘要

背景

确定针对学龄前儿童的电话早期肥胖干预措施的有效性非常必要。在2019冠状病毒病大流行期间，这一点尤为重要，当时大多数面对面的健康促进项目都暂停了。本研究的目的是确定为期两年的电话干预对学龄前儿童体重指数（BMI）、饮食习惯、积极玩耍和屏幕时间行为的影响。

方法

我们对2019 - 2020年在澳大利亚新南威尔士州（NSW）大悉尼都会区进行的一项随机对照试验（RCT）进行了扩展研究，该试验涉及662对2 - 3岁的母婴。在2020 - 2022年，我们将RCT又延长了两年，包括一年的干预期（3 - 4岁）和一年的随访期（4 - 5岁）。参与者保持与原试验相同的分组。干预包括由护士主导的五次电话支持、短信以及向母亲邮寄干预手册，以促进她们2至4岁孩子的健康行为。主要结局是儿童的BMI，在3岁、4岁和5岁时测量体重和身高。我们采用多重填补法进行意向性分析。建立混合线性模型以比较干预组和对照组的结局。还按家庭收入进行了亚组分析。

结果

在662名母亲中，当孩子3岁、4岁和5岁时，分别有537名（81%）、491名（74%）和405名（61%）完成了评估。干预与较低的平均BMI显著相关：15.90（标准误0.08）对16.20（标准误0.08），差值为 - 0.30（95%置信区间： - 0.59至 - 0.01，P = 0.039）。这种关联在低收入家庭中更强，差值为 - 0.57（95%置信区间： - 1.05至 - 0.10，P = 0.018）。