School-based intervention to enable school children to act as change agents on weight, physical activity and diet of their mothers: a cluster randomized controlled trial.
School-based intervention to enable school children to act as change agents on weight, physical activity and diet of their mothers: a cluster randomized controlled trial.
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DOI：
10.1186/s12966-016-0369-7
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发表时间：
2016-04-06
期刊：
影响因子：
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通讯作者：
Samarasinghe D
中科院分区：
文献类型：
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作者：
Gunawardena N;Kurotani K;Indrawansa S;Nonaka D;Mizoue T;Samarasinghe D
学校健康促进已被证明可以改善学生的生活方式，但目前尚不清楚以学校为基础的项目是否能影响家庭健康。我们制定了一项创新方案，使在校儿童能够在促进母亲健康生活方式方面发挥变革推动者的作用。本研究的目的是检验儿童主动干预对母亲体重、身体活动和饮食习惯的影响。以学校为组，进行了为期12个月的随机分组试验。参与者是斯里兰卡霍马加马20所学校的8年级学生的母亲，年龄在13岁左右。干预组的学生接受了辅导员的培训，以获得评估家中非传染性疾病风险因素并采取行动解决这些风险因素的能力，而对照组的学生没有接受任何干预。在基线和干预后对母亲的体重、步数和生活方式进行评估。采用多级多变量线性回归和logistic回归分别评估干预对连续和二元结局的影响。308名研究参与者中，261人在12个月时完成了最终评估。干预组的体重明显下降，体力活动明显增加。干预组与对照组的体重平均（95%可信区间）差异为- 2.49(- 3.38至- 1.60)kg/m2，体重指数为- 0.99(- 1.40至- 0.58)kg/m2。干预组参与足够体育活动的几率是对照组的3.25倍（95%可信区间1.87 ~ 5.62），干预后干预组的步数多于对照组。干预组的家庭购买饼干和冰淇淋的数量明显减少。一个鼓励学生作为家庭生活方式的改变者的项目在减轻体重和增加母亲的体育活动方面是有效的。斯里兰卡临床试验登记处SLCTR/2013/011。本文的在线版本（doi:10.1186/s12966-016-0369-7）包含补充材料，可供授权用户使用。
School health promotion has been shown to improve the lifestyle of students, but it remains unclear whether school-based programs can influence family health. We developed an innovative program that enables school children to act as change agents in promoting healthy lifestyles of their mothers. The objective of this study was to examine the effect of the child-initiated intervention on weight, physical activity and dietary habit of their mothers. A 12-month cluster randomized trial was conducted, with school as a cluster. Participants were mothers with grade 8 students, aged around 13 years, of 20 schools in Homagama, Sri Lanka. Students of the intervention group were trained by facilitators to acquire the ability to assess noncommunicable disease risk factors in their homes and take action to address them, whereas those of the comparison group received no intervention. Body weight, step count and lifestyle of their mothers were assessed at baseline and post-intervention. Multi-level multivariable linear regression and logistic regression were used to assess the effects of intervention on continuous and binary outcomes, respectively. Of 308 study participants, 261 completed the final assessment at 12 month. There was a significantly greater decrease of weight and increase of physical activity in the intervention group. The mean (95 % confidence interval) difference comparing the intervention group with the control group was −2.49 (−3.38 to −1.60) kg for weight and −0.99 (−1.40 to −0.58) kg/m2 for body mass index. The intervention group had a 3.25 (95 % confidence interval 1.87–5.62) times higher odds of engaging in adequate physical activity than the control group, and the former showed a greater number of steps than the latter after intervention. The intervention group showed a greater reduction of household purchase of biscuits and ice cream. A program to motivate students to act as change agents of family’s lifestyle was effective in decreasing weight and increasing physical activity of their mothers. Sri Lanka Clinical Trials Registry SLCTR/2013/011. The online version of this article (doi:10.1186/s12966-016-0369-7) contains supplementary material, which is available to authorized users.