Healthy apple program to support child care centers to alter nutrition and physical activity practices and improve child weight: a cluster randomized trial.
Healthy apple program to support child care centers to alter nutrition and physical activity practices and improve child weight: a cluster randomized trial.
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DOI：
10.1186/s12889-017-4951-y
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发表时间：
2017-12-19
影响因子：
4.5
通讯作者：
Arthur S
中科院分区：
文献类型：
--
作者：
Stookey JD;Evans J;Chan C;Tao-Lew L;Arana T;Arthur S
北卡罗来纳州儿童保育营养和身体活动自我评估（NAP SACC）资源改善儿童体重指数（BMI）时，由护士介绍给儿童保育提供者的资源，并提供讲习班和奖励。在旧金山弗朗西斯科，公共卫生和儿童保育机构合作，将国家行动方案的SACC资源纳入年度“健康苹果”质量改进方案。这项随机对照试验对HAP与护士一年两次的公共卫生筛查的整合进行了初步测试。2011-2012年参加弗朗西斯科儿童保健计划（CCHP）筛查的所有儿童保育中心在2012-2013年提供常规服务加HAP（CCHP + HAP，n = 19）或在2014-2015年提供延迟HAP的常规服务（CCHP + HAP延迟，n = 24）。意向治疗分析（稳健SE或混合模型）使用了来自12 - 17家CCHP + HAP和17 - 20家CCHP + HAP延迟中心的4年筛选数据，每年涉及791 - 945名2 - 5岁儿童。如果CCHP + HAP中心的儿童比CCHP + HAP延迟中心的儿童有更大的暴露于3个指数最佳实践的相对几率和更小的BMI百分位数和z分数的秋季至春季变化，则测试特定年份的儿童水平模型，控制年龄，性别和秋季状态。如果HAP支持儿童护理中心年度平均秋季至春季BMI变化的年度变化（2013-2014年和2014-2015年与2011-2012年），则对多年儿童护理中心水平模型进行测试。在2011-2012年，CCHP + HAP和CCHP + HAP延迟中心有类似的指数实践（<15%的儿童接触到体育活动课程，工作人员加入积极的游戏，饮用水投手）和年度BMI变化。2013-2014年：CCHP + HAP中心60%的儿童暴露于3种指数实践，CCHP + HAP延迟中心为19%; CCHP + HAP中心的平均（SE）儿童BMI百分位数（−2.6（0.9），p = 0.003）和z评分（−0.08（0.03），p = 0.007）下降幅度大于CCHP + HAP延迟中心。2014-2015年，在所有中心提供HAP后，所有中心的指数实践和BMI变化均比2011-2012年有所改善。HAP与现有公共卫生护理服务的整合与更多儿童接触最佳实践和改善儿童BMI变化相关。这些结果证明了继续将HAP纳入当地公共卫生基础设施的必要性。ISRCTN 18857356（24/04/2015）Retroperoxidase已注册。本文的在线版本（doi：10.1186/s12889-017-4951-y）包含补充材料，可供授权用户使用。
North Carolina Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) resources improve child body mass index (BMI) when the resources are introduced by nurses to child care providers, and offered with workshops and incentives. In San Francisco, public health and child care agencies partnered to adapt NAP SACC resources into an annual “Healthy Apple” quality improvement program (HAP). This cluster randomized controlled trial pilot-tested integration of the HAP with bi-annual public health screenings by nurses. All child care centers that participated in Child Care Health Program (CCHP) screenings in San Francisco in 2011–2012 were offered routine services plus HAP in 2012–2013 (CCHP + HAP, n = 19) or routine services with delayed HAP in 2014–2015 (CCHP + HAP Delayed, n = 24). Intention-to-treat analyses (robust SE or mixed models) used 4 years of screening data from 12 to 17 CCHP + HAP and 17 to 20 CCHP + HAP Delayed centers, regarding 791 to 945 children ages 2 to 5y, annually. Year-specific, child level models tested if children in CCHP + HAP centers had greater relative odds of exposure to 3 index best practices and smaller Autumn-to-Spring changes in BMI percentile and z-score than children in CCHP + HAP Delayed centers, controlling for age, sex, and Autumn status. Multi-year, child care center level models tested if HAP support modified year-to-year changes (2013–2014 and 2014–2015 vs 2011–2012) in child care center annual mean Autumn-to-Spring BMI changes. In 2011–2012, the CCHP + HAP and CCHP + HAP Delayed centers had similar index practices (<15% of children were exposed to a physical activity curriculum, staff joining in active play, and drinking water pitchers) and annual BMI changes. In 2013–2014: 60% of children in CCHP + HAP centers were exposed to the 3 index practices vs 19% in CCHP + HAP Delayed centers; Mean (SE) child BMI percentile (−2.6 (0.9), p = 0.003) and z-score (−0.08 (0.03), p = 0.007) decreased more in CCHP + HAP vs CCHP + HAP Delayed centers. In 2014–2015, after all centers were offered HAP, the index practices and BMI changes were improved for all centers vs 2011–2012. Integration of the HAP with existing public health nursing services was associated with significantly more children exposed to best practices and improvement in child BMI change. The results warrant continued integration of HAP into local public health infrastructure. ISRCTN18857356 (24/04/2015) Retrospectively registered. The online version of this article (doi:10.1186/s12889-017-4951-y) contains supplementary material, which is available to authorized users.
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DOI：
10.1136/bmj.h1258
发表时间：
2015-03-19
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moore GF;Audrey S;Barker M;Bond L;Bonell C;Hardeman W;Moore L;O'Cathain A;Tinati T;Wight D;Baird J
通讯作者：
Baird J
影响因子：
5.1
作者：
Battista, Rebecca A.;Oakley, Hillary;West, Stephanie T.
通讯作者：
West, Stephanie T.
影响因子：
1.9
作者：
Drummond, Rebecca L.;Staten, Lisa K.;Kaplan, Frances
通讯作者：
Kaplan, Frances
营养和体育活动随机对照试验在儿童保育中心进行了改善知识，政策和儿童体重指数。
影响因子：
4.5
作者：
Alkon A;Crowley AA;Neelon SE;Hill S;Pan Y;Nguyen V;Rose R;Savage E;Forestieri N;Shipman L;Kotch JB
通讯作者：
Kotch JB
影响因子：
8
作者：
Whitaker, RC;Pepe, MS;Dietz, WH
通讯作者：
Dietz, WH