A Participatory Physical Activity Intervention in Preschools A Cluster Randomized Controlled Trial
A Participatory Physical Activity Intervention in Preschools A Cluster Randomized Controlled Trial
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DOI：
10.1016/j.amepre.2013.01.032
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发表时间：
2013-07-01
影响因子：
5.5
通讯作者：
Renz-Polster, Herbert
中科院分区：
文献类型：
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作者：
De Bock, Freia;Genser, Bernd;Renz-Polster, Herbert
背景：先前关于学龄前儿童体育活动干预的研究报道了有限的效果。以社区为基础的参与性方法有望提高干预效果，并以可持续的方式使家长作为主要利益攸关方参与进来。目的：评估以父母为中心的参与式方法是否能提高学前体育活动（PA）干预的效果。设计：以学龄前儿童为随机单位，以儿童为分析单位的双臂整群随机对照试验。背景/参与者：39所德国南部幼儿园申请现有的国家资助的PA项目，共有826名儿童（52%的男孩，5.0+/-0.2岁），其中441名分配到干预组。干预：对照幼儿园接受由国家资助的为期6个月、每周两次的体育课。在干预幼儿园，通过激励家长发展和实施他们自己的项目想法来促进儿童的PA，该计划得到了加强。主要结果测量：主要结果包括平均加速度计计数和中强度到高强度PA或久坐行为的时间。次要结果是BMI、体脂百分比、生活质量、睡眠质量和总体健康状况。在两个研究组（时间段：2008-2010年）的基线、6个月和12个月时测量结果。使用意向-治疗分析，线性多水平回归模型评估了随时间和跨研究组的变化，并对年龄、性别、季节和学龄前地点进行了调整。分析于2011年进行。结果：在15所干预幼儿园中，家长共实施了25个PA项目。与对照组相比，干预组儿童每天少坐11分钟（95% CI=5.39, 17.01, p=0.014）；平均加速度计计数显著增加（1.4次/15秒[95% CI=0.22, 2.54], p=0.019）；并在总体健康和生活质量方面显示出益处。所有其他结果在研究组之间没有差异。结论：以父母为行为改变媒介的参与式学前干预可能能够促进幼儿的PA并减少久坐行为。这些好处可能超出现有的非参与性干预措施的影响。
Background: Previous studies on physical activity interventions in preschools have reported limited effectiveness. Participatory community-based approaches hold promise for increasing intervention effectiveness and involving parents as key stakeholders in a sustainable way.Purpose: To assess whether a participatory parent-focused approach using parents as agents of behavioral change enhances the efficacy of a preschool physical activity (PA) intervention.Design: Two-armed, cluster-RCT with preschool as unit of randomization and children as unit of analysis.Setting/participants: 39 South German preschools applying for an existing state-sponsored PA program with 826 children (52% boys, aged 5.0+/-0.2 years), with 441 allocated to the intervention arm.Intervention: Control preschools received a state-sponsored program consisting of twice-weekly gym classes over 6 months. In intervention preschools, this program was augmented by motivating parents to develop and implement their own project ideas for promoting children's PA.Main outcome measures: Primary outcomes included mean accelerometry counts and time spent in moderate- to vigorous-intensity PA or sedentary behavior. Secondary outcomes were BMI, percentage body fat, quality of life, sleep quality, and general health. Outcomes were measured at baseline and at 6 and 12 months in both study arms (time period: 2008-2010). Using an intention-to-treat-analysis, linear multilevel regression models assessed change over time and across study arms, adjusted for age, gender, season, and preschool location. Analysis was conducted in 2011.Results: In 15 intervention preschools, parents implemented 25 PA projects. Compared with controls, intervention arm children were 11 minutes less sedentary per day (95% CI=5.39, 17.01, p=0.014); had significantly more mean accelerometry counts (1.4 counts/15 seconds [95% CI=0.22, 2.54], p=0.019); and showed benefits in perceived general health and quality of life. All other outcomes showed no difference between study arms.Conclusions: A participatory preschool intervention focusing on parents as agents of behavioral change may be able to promote PA and reduce sedentary behavior in preschoolers. These benefits may go beyond the effects of existing nonparticipatory interventions.