Little Beacons of Change: Targeting Preschool Children to Drive a Culture of Health.
Little Beacons of Change: Targeting Preschool Children to Drive a Culture of Health.
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变革的小灯塔：以学龄前儿童为目标，推动健康文化。
DOI：
10.1016/j.gheart.2016.10.023
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Fuster,Valentin
中科院分区：
文献类型：
--
作者：
Latina,Jacqueline;Bansilal,Sameer;Vedanthan,Rajesh;Fuster,Valentin
在世界范围内，最常见的死亡和残疾病因发生了重大转变，从传染性病因转向慢性疾病，缺血性心脏病和中风现在是死亡的主要原因。这些慢性疾病与不健康的生活方式选择密切相关。童年时期形成的不健康习惯已被证明会持续到成年期 [1, 2]。 Bogalusa 心脏研究表明，77% 的肥胖儿童成年后仍然肥胖，儿童超重可预测成人危险因素水平和心血管疾病 (CVD) 发病率 [2]。 CVD 的发生可能取决于肥胖等危险因素的累积效应；早期预防是预防晚年疾病不可或缺的一部分。为了向儿童介绍终生有益的行为，学校的健康教育以促进健康的饮食和身体活动习惯为目标至关重要[3]。针对 6 至 18 岁儿童的学校体育活动计划的 Cochrane 审查证明了健康促进干预措施的积极作用 [4]。这些发现引出了我们的问题：“如果干预措施能够在小学生身上取得成功，为什么不在更年轻的时候就开始建立健康的行为呢？”事实上，动脉粥样硬化的第一个迹象，即动脉壁上的黄色条纹，已在 3 岁时被记录[5]。当孩子们正在形成终生行为时，我们能否帮助他们并引导他们走向健康？如果可能的话，这可能会改变我们对健康社区和健康文化的追求。在过去的十年中，我们在三大洲对此类项目进行了随机评估。我们已经证明，以幼儿为目标可以为成年人的健康生活方式奠定基础。在哥伦比亚波哥大 Usaquen 的社会经济弱势社区，我们证明，旨在提高与健康饮食和积极生活方式相关的知识、态度和习惯的学前干预措施对于 3 至 5 岁的幼儿来说是可行且成功的[6]。设计并实施了一项长期的教学和交流研究计划，旨在制定有效的策略来改变学龄前儿童在健康饮食和积极生活方式方面的知识、态度和习惯（KAH）。该计划为期 5 个月，吸引了 1,200 多名儿童在课堂上参与教育和娱乐活动。它包括基于芝麻街的健康习惯课程，包括故事书、海报、视频、游戏和歌曲，以及健康的家庭日
Worldwide, there has been a major shift in the most common etiologies of death and disability from infectious etiologies to chronic diseases, with ischemic heart disease and stroke now the leading causes of mortality. These chronic illnesses are significantly related to unhealthy lifestyle choices. Unhealthy habits that develop during childhood have been shown to persist into adulthood [1, 2]. The Bogalusa Heart Study demonstrated that 77% of obese children remained obese as adults, and child overweight predicts adult risk factor levels and cardiovascular disease (CVD) morbidity [2]. The development of CVD may depend on the cumulative effects of risk factors such as obesity; early prevention is integral to the prevention of disease later in life.To introduce children to lifelong beneficial behaviors, it is critical for health education in schools to target the promotion of healthy dietary and physical activity habits [3]. A Cochrane Review of school-based physical activity programs for children 6 to 18 years of age demonstrated the positive effects of health promotion interventions [4]. These findings led us to the question,“If the intervention can be successful with elementary school children, why not start establishing healthy behaviors at an even younger age?” Indeed, the first signs of atherosclerosis in the form of yellow streaks in the arterial wall have been documented at 3 years of age [5]. Could we reach children when they are forming lifelong behaviors and channel them toward health? If possible, that could be transformative in our quest for healthy communities and a culture of health. Over the last decade, we have conducted randomized evaluations of such programs in 3 continents. We have shown that targeting very young children can form a foundation for a healthy lifestyle as adults. In the socioeconomically disadvantaged neighborhoods of Usaquen, Bogotá, Colombia, we demonstrated that a preschoolbased intervention aimed at improving knowledge, attitudes, and habits related to a healthy diet and an active lifestyle is feasible as well as successful in young children 3 to 5 years of age [6]. A long-term pedagogic and communication research program was designed and implemented, aimed at developing an effective strategy for modifying the knowledge, attitudes, and habits (KAH) of preschool children in regard to a healthy diet and active lifestyle. The program involved more than 1,200 children in educational and playful activities in the classroom over a 5-month period. It included a Sesame Streetebased curriculum in healthy habits and involves storybooks, posters, videos, games, and songs, as well as a healthy family day