Healthy Living Cambridge Kids: A Community-based Participatory Effort to Promote Healthy Weight and Fitness
Healthy Living Cambridge Kids: A Community-based Participatory Effort to Promote Healthy Weight and Fitness
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DOI：
10.1038/oby.2009.431
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发表时间：
2010-02-10
期刊：
影响因子：
6.9
通讯作者：
Hacker, Karen A.
中科院分区：
文献类型：
--
作者：
Chomitz, Virginia R.;McGowan, Robert J.;Hacker, Karen A.
本研究的目的是评估以社区为基础的健康体重干预对儿童体重和健康的影响。自2000年以来，剑桥公立学校（CPS）每年都会监测BMI和健康状况。从2000年（37.0%）到2004年（39.1%），超重和肥胖的年增长率引发了一个由研究人员、教育工作者、卫生保健和公共卫生专业人员组成的多学科小组，以动员环境和政策干预。在社会生态模型和基于社区的参与性研究（CBPR）原则的指导下，该团队开发并实施了健康生活剑桥儿童（HLCK），这是一种针对社区，学校，家庭和个人的多成分干预措施。干预措施包括城市政策和社区宣传活动;体育（PE）增强，食品服务改革，农场到学校到家庭计划;家庭外展和“BMI和健身报告”。基线（2004年）到随访（2007年）的评估设计评估了儿童体重和健康状况的变化。一组1,858名K-5年级儿童参加了研究：37.3%黑人，14.0%西班牙裔，37.1%白色，10.2%亚洲人，1.7%其他种族; 43.3%收入较低。BMI z评分（0.67-0.63 P < 0.001）和肥胖比例（20.2-18.0% P < 0.05）下降，通过体能测试的平均次数（0-5）增加（3.7-3.9 P < 0.001）。与白色儿童（12.6%）和亚洲儿童（14.3%）相比，黑人和西班牙裔儿童在基线时更可能肥胖（分别为27.0%和28.5%），但所有种族/民族组的肥胖率均下降。与3年的社区干预同时，从基线到随访，CPS儿童的肥胖和健康状况略有改善。CBPR方法促进了在这个多样化社区中干预后的持续政策和计划要素。
The objective of this study was to assess the impact of a community-based healthy weight intervention on child weight and fitness. Cambridge Public Schools (CPS) have monitored BMI and fitness annually since 2000. Annual increases of overweight and obesity from 2000 (37.0%) to 2004 (39.1%), triggered a multidisciplinary team of researchers, educators, health care, and public health professionals to mobilize environmental and policy interventions. Guided by the social-ecological model and community-based participatory research (CBPR) principles, the team developed and implemented Healthy Living Cambridge Kids (HLCK), a multicomponent intervention targeting community, school, family, and individuals. The intervention included city policies and community awareness campaigns; physical education (PE) enhancements, food service reforms, farm-to-school-to-home programs; and family outreach and "BMI and fitness reports". Baseline (2004) to follow-up (2007) evaluation design assessed change in children's weight and fitness status. A cohort of 1,858 K-5th grade children participated: 37.3% black, 14.0% Hispanic, 37.1% white, 10.2% Asian, 1.7% other race; 43.3% were lower income. BMI z-score (0.67-0.63 P < 0.001) and proportion obese (20.2-18.0% P < 0.05) decreased, and mean number of fitness tests (0-5) passed increased (3.7-3.9 P < 0.001). Whereas black and Hispanic children were more likely to be obese at baseline (27.0 and 28.5%, respectively) compared with white (12.6%) and Asian (14.3%) children, obesity among all race/ethnicity groups declined. Concurrent with a 3-year community intervention, modest improvements in obesity and fitness were observed among CPS children from baseline to follow-up. The CBPR approach facilitated sustaining policies and program elements postintervention in this diverse community.