Neumark-Sztainer D
Division of Epidemiology, University of Minnesota, School of Public Health, Minneapolis 55454-1015, USA.
J Sch Health. 1996 Feb;66(2):64-71. doi: 10.1111/j.1746-1561.1996.tb07912.x.
This paper describes a framework for involving schools in primary and secondary prevention of eating disturbances. The issues of why, what, who, and how are considered. Research on the prevalence and consequences of obesity, anorexia and bulimia nervosa, unhealthy dieting, and behaviors such as binge eating and purging indicates why prevention is necessary. Research on the etiology of eating disturbances also provided a basis for determining what factors need to be addressed. However, research has not adequately addressed the question of who should be targeted for prevention and how the topic of prevention should be approached. While different approaches to school-based prevention programs are possible, a comprehensive school-based program is recommended. Important components of a comprehensive program include staff training, classroom interventions, integration of relevant material into existing curriculum, individual counseling and small group work with high risk students, referral systems, opportunities for healthy eating, modifications within the physical education program, and outreach activities. This type of comprehensive program is based on an ecological model for health promotion and aims at the modification of both individual and environmental determinants of behavior.
本文描述了一个让学校参与饮食失调初级和二级预防的框架。文中探讨了为何、是什么、谁以及如何等问题。关于肥胖、神经性厌食症、神经性贪食症、不健康节食以及暴饮暴食和催吐等行为的患病率及后果的研究表明了预防的必要性。饮食失调病因的研究也为确定需要解决哪些因素提供了依据。然而，研究尚未充分解决预防应针对哪些人群以及应如何开展预防主题的问题。虽然基于学校的预防项目有不同的开展方式，但建议采用全面的基于学校的项目。一个全面项目的重要组成部分包括员工培训、课堂干预、将相关材料融入现有课程、针对高危学生的个别辅导和小组工作、转诊系统、健康饮食机会、体育课程内的调整以及外展活动。这种全面的项目基于健康促进的生态模型，旨在改变行为的个体和环境决定因素。
