Reducing obesity via a school-based interdisciplinary intervention among youth - Planet health
Reducing obesity via a school-based interdisciplinary intervention among youth - Planet health
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DOI：
10.1001/archpedi.153.4.409
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发表时间：
1999-04-01
影响因子：
--
通讯作者：
Laird, N
中科院分区：
文献类型：
--
作者：
Gortmaker, SL;Peterson, K;Laird, N
目的：评估以学校为基础的健康行为干预措施对6至8年级男孩和女孩肥胖的影响。设计：随机对照现场试验，5所干预学校和5所对照学校。使用预干预（1995年秋季）和后续措施（1997年春季），包括患病率，发病率和缓解obesity.Participants：一组1295种族多样化的6年级和7年级的公立学校在4马萨诸塞州community.Intervention的学生参加了一个以学校为基础的跨学科干预超过2学年。地球健康课程已纳入现有的课程，由任课教师讲授4个主要科目和体育。会议集中在减少电视观看，减少高脂肪的洪水消费，增加水果和蔬菜的摄入量，并增加中度和剧烈的体力活动。主要结果Measures：肥胖被定义为一个复合指标的基础上，身体质量指数和三头肌皮褶值大于或等于年龄和性别特异性的第85届运动会。由于学校是随机的，而不是学生，广义估计方程方法被用来调整个人水平的协变量下集群随机化。结果在干预学校的女孩肥胖患病率降低与对照组相比，控制基线肥胖（比值比，0.47; 95%置信区间，0.24-0.93; P = 0.03），在男孩中没有发现差异。与对照组女孩相比，干预组女孩的肥胖缓解率更高（比值比，2.16; 95%置信区间，1.07-4.35; P = 0.04）。干预措施减少了女孩和男孩看电视的时间，增加了水果和蔬菜的消费，导致女孩总能量摄入量增幅较小。减少看电视可以预测肥胖的变化，并介导干预效果。在女孩中，每减少一个小时的电视观看预测减少肥胖患病率（比值比，0.85; 95%置信区间，0.75-0.97; P = 0.02）。结论：行星健康减少了女学生的肥胖，表明一个有前途的学校为基础的方法，以减少青年肥胖。
Objective: To evaluate the impact of a school-based health behavior intervention known as Planet Health on obesity among boys and girls in grades 6 to 8.Design: Randomized, controlled field trial with 5 intervention and 5 control schools. Outcomes were assessed using preintervention (fall 1995) and follow-up measures (spring 1997), including prevalence, incidence, and remission of obesity.Participants: A group of 1295 ethnically diverse grade 6 and 7 students from public schools in 4 Massachusetts communities.Intervention: Students participated in a school-based interdisciplinary intervention over 2 school years. Planet Health sessions were included within existing curricula using classroom teachers in 4 major subjects and physical education. Sessions focused on decreasing television viewing, decreasing consumption of high-fat floods, increasing fruit and vegetable intake, and increasing moderate and vigorous physical activity.Main Outcome Measures: Obesity was defined as a composite indicator based on both a body mass index and a triceps skinfold value greater than or equal to age- and sex-specific 85th percentiles. Because schools were randomized, rather than students, the generalized estimating equation method was used to adjust for individual-level covariates under cluster randomization.Results The prevalence of obesity among girls in intervention schools was reduced compared with controls, controlling for baseline obesity (odds ratio, 0.47; 95% confidence interval, 0.24-0.93; P = .03), with no differences found among boys. There was greater remission of obesity among intervention girls vs control girls (odds ratio, 2.16; 95% confidence interval, 1.07-4.35; P = .04). The intervention reduced television hours among both girls and boys, and increased fruit and vegetable consumption and resulted in a smaller increment in total energy intake among girls. Reductions in television viewing predicted obesity change and mediated the intervention effect. Among girls, each hour of reduction in television viewing predicted reduced obesity prevalence (odds ratio, 0.85; 95% confidence interval, 0.75-0.97; P = .02).Conclusion: Planet Health decreased obesity among female students, indicating a promising school-based approach to reducing obesity among youth.