Long-term outcomes (2 and 3.5 years post-intervention) of the INFANT early childhood intervention to improve health behaviors and reduce obesity: cluster randomised controlled trial follow-up
Long-term outcomes (2 and 3.5 years post-intervention) of the INFANT early childhood intervention to improve health behaviors and reduce obesity: cluster randomised controlled trial follow-up
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DOI：
10.1186/s12966-020-00994-9
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发表时间：
2020-07-25
影响因子：
8.7
通讯作者：
Campbell, Karen J.
中科院分区：
文献类型：
--
作者：
Hesketh, Kylie D.;Salmon, Jo;Campbell, Karen J.
背景：从婴儿期开始的为数不多的健康行为干预已显示出良好的效果。需要对它们的长期利益有更深入的了解。本研究旨在评估墨尔本婴儿计划对5岁儿童的干预后对饮食、运动和肥胖的影响。方法对墨尔本婴儿计划中保留的参与者在干预结束时(儿童年龄接近19岁；2008-10年)进行为期2年和3.5年的干预后随访(2011-13年；分析完成2019年)。墨尔本婴儿计划是一项为期15个月、为期6个疗程的计划，由澳大利亚墨尔本4-19岁儿童的首次父母小组提供。该计划涉及帮助父母促进健康饮食、身体活动和减少婴儿久坐行为的战略。在本文报告的随访期内，未进行任何干预。研究人员测量了所有时间点的身高、体重和腰围，儿童佩戴Actigraph和Actigraph PAL加速计8天，母亲报告儿童看电视和使用医疗服务的情况。结果在计划结束时保留的儿童(18岁，n=480；89%)中，361个家庭(75%)参与了第一次随访(干预后2岁；年龄3.6岁)和337个家庭(保留了70%)在第二次随访(干预后3.5岁；年龄5岁)。干预组3.6岁儿童的水果(校正平均差为25.34g；CI 95：1.68、48.99)、蔬菜(MD=19.41；CI 95：3.15、35.67)和水摄入量(MD=113.33；CI 95：40.42、186.25)均高于对照组。5岁时非核心饮品摄入量较少(MD=-27.60；CI95：-54.58，-0.62)。干预儿童3.6岁(MD=-5.70；CI95：-9.75，-1.65)和5岁(MD=-6.84；CI95：-12.47，-1.21)的甜食摄入量较低。在两次随访中，干预组儿童每天看电视的时间比对照组少约10分钟，尽管可信区间为零(MD=-9.63；CI95：-30.79，11.53；MD=-11.34；CI95：-25.02，2.34)。结论在婴儿期实施的这种低剂量干预措施对一些有针对性的健康行为的影响在学校开始年龄之前仍然明显，但对肥胖没有影响。其中一些影响是在干预结束后才观察到的，这表明了对儿童早期提供的干预进行长期跟踪的重要性。
Background The few health behavior interventions commencing in infancy have shown promising effects. Greater insight into their longer-term benefits is required. This study aimed to assess post-intervention effects of the Melbourne INFANT Program to child age 5y on diet, movement and adiposity.Methods Two and 3.5y post-intervention follow-up (2011-13; analyses completed 2019) of participants retained in the Melbourne INFANT Program at its conclusion (child age similar to 19 m; 2008-10) was conducted. The Melbourne INFANT Program is a 15-month, six session program delivered within first-time parent groups in Melbourne, Australia, between child age 4-19 m. It involves strategies to help parents promote healthy diet, physical activity and reduced sedentary behavior in their infants. No intervention was delivered during the follow-up period reported in this paper. At all time points height, weight and waist circumference were measured by researchers, children wore Actigraph and activPAL accelerometers for 8-days, mothers reported children's television viewing and use of health services. Children's dietary intake was reported by mothers in three unscheduled telephone-administered 24-h recalls.Results Of those retained at program conclusion (child age 18 m,n = 480; 89%), 361 families (75% retention) participated in the first follow-up (2y post-intervention; age 3.6y) and 337 (70% retention) in the second follow-up (3.5y post-intervention; age 5y). At 3.6y children in the intervention group had higher fruit (adjusted mean difference [MD] = 25.34 g; CI95:1.68,48.99), vegetable (MD = 19.41; CI95:3.15,35.67) and water intake (MD = 113.33; CI95:40.42,186.25), than controls. At 5y they consumed less non-core drinks (MD = -27.60; CI95:-54.58,-0.62). Sweet snack intake was lower for intervention children at both 3.6y (MD = -5.70; CI95:-9.75,-1.65) and 5y (MD = -6.84; CI95:-12.47,-1.21). Intervention group children viewed approximately 10 min/day less television than controls at both follow-ups, although the confidence intervals spanned zero (MD = -9.63; CI95:-30.79,11.53; MD = -11.34; CI95:-25.02,2.34, respectively). There was no evidence for effect on zBMI, waist circumference z-score or physical activity.Conclusions The impact of this low-dose intervention delivered during infancy was still evident up to school commencement age for several targeted health behaviors but not adiposity. Some of these effects were only observed after the conclusion of the intervention, demonstrating the importance of long-term follow-up of interventions delivered during early childhood.