Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children - Eat well and keep moving
Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children - Eat well and keep moving
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DOI：
10.1001/archpedi.153.9.975
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发表时间：
1999-09-01
影响因子：
--
通讯作者：
Laird, N
中科院分区：
文献类型：
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作者：
Gortmaker, SL;Cheung, LWY;Laird, N
目的：评价以学校为基础的跨学科健康行为干预对四、五年级儿童饮食和身体活动的影响。设计：6所干预学校和8所匹配对照学校的准实验现场试验。采用干预前（1995年秋季）和随访（1997年春季）对结果进行纵向评估，学生调查的食物频率和活动测量以及随访的24小时饮食和活动回忆测量。从1995年到1997年，每年对所有五年级学生进行重复的横断面调查，以评估变化。参与者：纵向数据从马里兰州巴尔的摩市公立学校的479名四年级学生中收集；91%是非洲裔美国人。1997年对336名学生随机抽样进行了24小时重复召回。横断面调查收集1995年、1996年和1997年所有五年级学生的数据（n = 2103）。干预：“健康饮食并保持运动”计划是由数学、科学、语言艺术和社会研究班的老师讲授两年多的课程。材料提供了与学校食品供应商和家庭的联系，并为教师和其他工作人员提供了培训和健康计划。干预材料侧重于减少总脂肪和饱和脂肪含量高的食物的摄入，增加水果和蔬菜的摄入量，以及减少看电视和增加体育活动。主要结局指标：通过重复24小时回忆测量的饮食摄入量和身体活动是主要终点，还有额外的食物频率和活动测量。结果：24小时回忆测量表明，在控制基线协变量后，与对照学校相比，干预学校的学生脂肪和饱和脂肪总能量的百分比降低了（-1.4%；95%可信区间[CI]， -2.8至-0.04;P = 0.04和-0.60%;95% CI, -1.2至-0.01;P = 0.05）。水果和蔬菜摄入量增加（0.36份/4184千焦；95% CI, 0.10-0.62; P = 0.01），维生素C摄入量增加（8.8毫克/4184千焦；95% CI, 2.0-16; P = 0.01），纤维摄入量增加（0.7克/4184千焦；95% CI, 0.0-1.4; P = 0.05）。电视观看时间略有减少（-0.55小时/天；95% CI, -1.04至0.04;P = 0.06）。纵向和重复的横断面食物频率数据分析表明，脂肪和饱和脂肪的总能量百分比也有类似的显著下降。结论：对“健康饮食持续运动”项目的评估表明，该项目在改善学生饮食摄入和减少看电视方面是有效的。
Objective: To evaluate the impact of a school-based interdisciplinary health behavior intervention on diet and physical activity among children in grades 4 and 5.Design: A quasiexperimental field trial with 6 intervention and 8 matched control schools. Outcomes were assessed longitudinally using preintervention (fall 1995) and follow-up (spring 1997) student survey food frequency and activity measures and follow-up 24-hour recall measures of diet and activity. Change was also assessed using yearly repeated cross-sectional surveys of all grade 5 students from 1995 through 1997.Participants: Longitudinal data were collected from 479 students initially in grade 4 in Baltimore, Md, public schools; 91% were African American. Repeated 24-hour recall measures in 1997 were collected for a random subsample of 336 students. Cross-sectional survey data were collected from all grade 5 students in 1995, 1996, and 1997 (n = 2103).Intervention: The Eat Well and Keep Moving Program was taught by classroom teachers over 2 years in math, science, language arts, and social studies classes. Materials provided links to school food sen ices and families and provided training and wellness programs for teachers and other staff members. intervention materials focused on decreasing consumption of foods high in total and saturated fat and increasing fruit and vegetable intake, as well as reducing television viewing and increasing physical activity.Main Outcome Measures: Dietary intake and physical activity measured via repeated 24-hour recall were primary end points, with additional food frequency and activity measures.Results: The 24-hour recall measures indicated that, after controlling for baseline covariates, the percentages of total energy from fat and saturated fat were reduced among students in intervention compared with control schools (-1.4%; 95% confidence interval [CI], -2.8 to -0.04; P = .04 and -0.60%; 95% CI, -1.2 to -0.01; P = .05). There was an increase in fruit and vegetable intake (0.36 servings/4184 kJ; 95% CI, 0.10-0.62; P = .01), in vitamin C intake (8.8 mg/4184 kJ; 95% CI, 2.0-16; P = .01), and in fiber consumption (0.7 g/4184 kJ; 95% CI, 0.0-1.4; P = .05). Television viewing was marginally reduced (-0.55 h/d; 95% CI, -1.04 to 0.04; P = .06). Analysis of longitudinal and repeated cross-sectional food frequency data indicated similar significant decreases in the percentages of total energy from fat and saturated fat.Conclusion: Evaluation of the Eat Well and Keep Moving Program indicates effectiveness in improving dietary intake of students and reducing television viewing.