The effect of a behaviour change intervention on the diets and physical activity levels of women attending Sure Start Children's Centres: results from a complex public health intervention
The effect of a behaviour change intervention on the diets and physical activity levels of women attending Sure Start Children's Centres: results from a complex public health intervention
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DOI：
10.1136/bmjopen-2014-005290
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发表时间：
2014-01-01
期刊：
影响因子：
2.9
通讯作者：
Inskip, Hazel
中科院分区：
文献类型：
--
作者：
Baird, Janis;Jarman, Megan;Inskip, Hazel
目标：英国政府对肥胖流行病的反应呼吁社区采取行动，改善人们的健康行为。本研究评价了社区干预对弱势群体妇女的饮食质量和体力活动水平的影响。设计：对一项复杂的公共卫生干预的非随机对照评价。参与者：527名妇女参加南安普顿的“扎实起步儿童中心”（SSCC（干预）和戈斯波特和哈万特参加SSCC的495名妇女（对照）。干预：培训SSCC工作人员行为改变技能，使妇女能够改变其健康行为。结果：主要结果膳食质量和体力活动。中间结果自我效能感和控制感。结果：1年后的培训，干预人员使用的技能，以支持行为改变显着超过控制人员。在基线和随访之间，所有女性的饮食质量在统计学上显著降低了0.1 SD，自我效能和控制感降低。干预组女性自我效能和控制力的下降幅度明显小于对照组女性（自我效能和控制力的调整差异分别为0.26（95% CI 0.001至0.50）和0.35（0.05至0.65））。在干预组中，控制下降程度较低与女性暴露水平较高相关。干预组的身体活动有统计学显著改善，22.9%的妇女报告身体活动水平最高，而基线时为12.4%，对照组的改善较小。两组之间的身体活动水平的变化差异没有统计学意义（调整后的差异1.02（0.74至1.41））。结论：虽然干预措施没有改善妇女的饮食和身体活动水平，它有一个保护作用的中间因素控制和自我效能-这表明，更长时间的接触干预措施可能会改善健康行为。在更受控的环境中进行进一步评价是合理的。
Objectives: The UK government's response to the obesity epidemic calls for action in communities to improve people's health behaviour. This study evaluated the effects of a community intervention on dietary quality and levels of physical activity of women from disadvantaged backgrounds.Design: Non-randomised controlled evaluation of a complex public health intervention.Participants: 527 women attending Sure Start Children's Centres (SSCC) in Southampton (intervention) and 495 women attending SSCCs in Gosport and Havant (control).Intervention: Training SSCC staff in behaviour change skills that would empower women to change their health behaviours.Outcomes: Main outcomes dietary quality and physical activity. Intermediate outcomes self-efficacy and sense of control.Results: 1-year post-training, intervention staff used skills to support behaviour change significantly more than control staff. There were statistically significant reductions of 0.1 SD in the dietary quality of all women between baseline and follow-up and reductions in self-efficacy and sense of control. The decline in self-efficacy and control was significantly smaller in women in the intervention group than in women in the control group (adjusted differences in self-efficacy and control, respectively, 0.26 (95% CI 0.001 to 0.50) and 0.35 (0.05 to 0.65)). A lower decline in control was associated with higher levels of exposure in women in the intervention group. There was a statistically significant improvement in physical activity in the intervention group, with 22.9% of women reporting the highest level of physical activity compared with 12.4% at baseline, and a smaller improvement in the control group. The difference in change in physical activity level between the groups was not statistically significant (adjusted difference 1.02 (0.74 to 1.41)).Conclusions: While the intervention did not improve women's diets and physical activity levels, it had a protective effect on intermediate factors-control and self-efficacy-suggesting that a more prolonged exposure to the intervention might improve health behaviour. Further evaluation in a more controlled setting is justified.