Impact of a Fruit and Vegetable Prescription Program on Health Outcomes and Behaviors in Young Navajo Children
Impact of a Fruit and Vegetable Prescription Program on Health Outcomes and Behaviors in Young Navajo Children
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DOI：
10.1093/cdn/nzaa109
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发表时间：
2020-08-01
影响因子：
4.8
通讯作者：
Shin, Sonya S.
中科院分区：
文献类型：
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作者：
Jones, Leandra J.;VanWassenhove-Paetzold, Joan;Shin, Sonya S.
背景：美洲印第安人和阿拉斯加原住民的儿童肥胖率较高，食物不安全是与饮食相关的差异的主要原因。为了满足这一需求，当地医疗保健提供者和当地一家非营利组织在2015年启动了纳瓦霍水果和蔬菜处方(FVRx)计划。6岁以下的儿童和他们的照顾者由医疗保健提供者注册参加6个月的计划。参加FVRx计划的家庭每月参加健康指导会议，在那里他们可以获得参加FVRx计划的零售商兑换水果、蔬菜和健康传统食品的代金券。目标：我们评估了水果和蔬菜处方计划对参与计划的儿童的健康结果和行为的影响。方法：照顾者完成了自愿调查，以评估食品安全、水果和蔬菜的消费、睡眠时间和体育活动分钟；医疗保健提供者还在计划开始和完成时测量了儿童的身体质量指数[BMI(kg/m(2))]z评分。我们计算了项目结束时健康行为、BMI和食品安全方面的变化，并与基准值进行了比较。结果：2015年5月至2018年9月期间，共有243名纳瓦霍儿童在纳瓦霍FVRx注册。从项目开始到项目完成，水果和蔬菜的消费量显著增加，从每天5.2份增加到每天6.8份(P<；0.001)。报告粮食不安全的参与者家庭比例从82%大幅下降到65%(P<；0.001)。在基线被归类为超重或肥胖的儿童中，38%的儿童在计划完成时获得了健康的BMIz分数(P<；0.001)。65%的儿童被保留在该计划中。结论：纳瓦霍FVRx计划促进了幼儿水果和蔬菜的消费。肥胖或超重的儿童可能从该计划中受益最大。
Background: Rates of childhood obesity are higher in American Indian and Alaska Native populations, and food insecurity plays a major role in diet-related disparities. To address this need, local healthcare providers and a local nonprofit launched the Navajo Fruit and Vegetable Prescription (FVRx) Program in 2015. Children up to 6 y of age and their caregivers are enrolled in the 6-mo program by healthcare providers. Families attend monthly health coaching sessions where they receive vouchers redeemable for fruits, vegetables, and healthy traditional foods at retailers participating in the FVRx program.Objectives: We assessed the impact of a fruit and vegetable prescription program on the health outcomes and behaviors of participating children.Methods: Caregivers completed voluntary surveys to assess food security, fruit and vegetable consumption, hours of sleep, and minutes of physical activity; healthcare providers also measured children's body mass index [BMI (kg/m(2))] z score at initiation and completion of the program. We calculated changes in health behaviors, BMI, and food security at the end of the program, compared with baseline values.Results: A total of 243 Navajo children enrolled in Navajo FVRx between May 2015 and September 2018. Fruit and vegetable consumption significantly increased from 5.2 to 6.8 servings per day between initiation and program completion (P < 0.001). The proportion of participant households reporting food insecurity significantly decreased from 82% to 65% (P < 0.001). Among children classified as overweight or obese at baseline, 38% achieved a healthy BMI z score at program completion (P < 0.001). Sixty-five percent of children were retained in the program.Conclusions: The Navajo FVRx program improves fruit and vegetable consumption among young children. Children who are obese or overweight may benefit most from the program.