Effects of the Youth Fit 4 Life physical activity/nutrition protocol on body mass index, fitness and targeted social cognitive theory variables in 9-to 12-year-olds during after-school care
Effects of the Youth Fit 4 Life physical activity/nutrition protocol on body mass index, fitness and targeted social cognitive theory variables in 9-to 12-year-olds during after-school care
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DOI：
10.1111/jpc.13447
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发表时间：
2017-04-01
影响因子：
1.7
通讯作者：
Unruh-Rewkowski, Jennifer L.
中科院分区：
文献类型：
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作者：
Annesi, James J.;Walsh, Stephanie M.;Unruh-Rewkowski, Jennifer L.
在工业化国家，儿童超重和肥胖的比例高得令人无法接受。以学校为基础的干预在很大程度上是理论性的和无效的。本研究旨在测试一种新的基于理论的协议，其对健康和体重指数（BMI）测量的影响，以及其提出的心理社会介质，在小学课后（校外时间）照顾。方法将美国东南部基督教青青会（ymca）的12岁至12岁学生随机分为青年健康4生活（YF4L）试验组（n = 86）和典型护理组（n = 55），每天45分钟。YF4L以社会认知理论为基础，强调掌握身体活动和发展自我管理/自我调节技能，以支持健康的行为。生理和社会心理变量在9个月的小学学年中被评估。结果在整个样本中，28%的人在基线时超重或肥胖。在3个月和9个月的时间里，YF4L与BMI、自我调节、情绪、自我效能、心血管耐力和力量的显著改善有关。自我调节、情绪和自我效能的变化在治疗3个月（R-2 = 0.12, P = 0.002）和9个月（R-2 = 0.13, P = 0.001）期间显著介导了治疗类型与bmi的关系，其中自我调节的变化是一个显著的独立中介。身体质量指数和自我调节的变化相互加强。性别并不是这些关系的重要调节因素。结论YF4L治疗减轻了9 ~ 12岁儿童的BMI升高。该疗法的社会认知理论基础得到了支持。由于其积极影响和利用现有工作人员的能力，在充分复制之后，有必要大规模应用。
AimChildhood overweight and obesity is unacceptably high in industrialised nations. School-based interventions have largely been atheoretical and ineffective. This study aimed to test a new theory-based protocol for its effects on measures of fitness and body mass index (BMI), and its proposed psychosocial mediators, during elementary after-school (out-of-school hours) care.MethodsNine- to 12-year-old participants of YMCA-based after-school care in the southeastern Unites States were randomised into either the experimental Youth Fit 4 Life (YF4L) treatment group (n = 86) or a typical care group (n = 55) for 45 min/day. YF4L is based on social cognitive theory, emphasising mastery over physical activities and the development of self-management/self-regulatory skills to support healthy behaviours. Physiological and psychosocial variables were assessed over a 9-month elementary school year.ResultsOf the overall sample, 28% were overweight or obese at baseline. YF4L was associated with significantly greater improvements in BMI, and measures of self-regulation, mood, self-efficacy, cardiovascular endurance and strength over both 3 and 9 months. Changes in self-regulation, mood and self-efficacy significantly mediated the treatment type-BMI relationship over both 3 months (R-2 = 0.12, P = 0.002) and 9 months (R-2 = 0.13, P = 0.001), with change in self-regulation being a significant independent mediator. Changes in BMI and self-regulation reciprocally reinforced one another. Gender was not a significant moderator of those relationships.ConclusionsThe YF4L treatment mitigated rise in BMI in 9- to 12-year-old enrollees of after-school care. The treatment's basis in social cognitive theory was supported. Because of its positive effects and ability to utilise existing staff, large-scale application is warranted after sufficient replication.