Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study).
Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study).
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DOI：
10.1136/bmj.k211
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发表时间：
2018-02-07
期刊：
影响因子：
--
通讯作者：
Cheng KK
中科院分区：
文献类型：
--
作者：
Adab P;Pallan MJ;Lancashire ER;Hemming K;Frew E;Barrett T;Bhopal R;Cade JE;Canaway A;Clarke JL;Daley A;Deeks JJ;Duda JL;Ekelund U;Gill P;Griffin T;McGee E;Hurley K;Martin J;Parry J;Passmore S;Cheng KK
评估以学校和家庭为基础的健康生活方式计划（WAVES干预）与常规做法相比在预防儿童肥胖方面的有效性。整群随机对照试验来自西米德兰兹郡的英国小学。从研究中心35英里范围内的所有公立小学中随机选择了200所学校（n=980），对少数民族人口较多的学校进行了过抽样。这些学校被随机排序，并依次邀请参加。教育署曾与144间合资格学校接触，以达到54间学校的目标。基线测量后，1467年1年级的学生年龄在5岁和6岁（对照：28所学校，778名学生）进行了随机化，使用块平衡算法。53所学校仍在试验中，第一次随访（15个月）和第二次随访（30个月）分别获得了1287名（87.7%）和1169名（79.7%）学生的数据。为期12个月的干预措施鼓励健康饮食和体育活动，包括每天增加30分钟的在校时间体育活动机会，与阿斯顿维拉足球俱乐部合作开展为期六周的互动技能计划，每六个月通过邮寄方式向当地家庭宣传体育活动机会，以及定期举办学校领导的健康烹饪技能家庭研讨会。方案定义的主要结局（对分配设盲评估）为15个月和30个月时体重指数（BMI）z评分的组间差异。次要结局是进一步的人体测量、饮食、身体活动和心理测量，以及39个月时一个子集中BMI z评分的差异。主要结果分析的数据为：基线，54所学校：1392名学生（732名对照）;第一次随访（基线后15个月），53所学校：1249名学生（675名对照）;第二次随访（基线后30个月），53所学校：1145名学生（621名对照）。15个月时，干预组的平均BMI z评分与对照组相比无显著性降低（基线校正模型中的平均差异为-0.075（95%置信区间为-0.183至0.033，P=0.18）。30个月时，平均差异为-0.027（-0.137至0.083，P=0.63）。其他人体测量、饮食、体力活动或心理测量（包括伤害评估）组间无统计学显著差异。初步分析表明，这种经验性的集中干预对BMI z评分或预防儿童肥胖没有统计学显著影响。如果没有多个部门和环境的广泛支持，学校不太可能通过采取这种干预措施来影响儿童肥胖症的流行。当前对照试验ISRCTN 97000586。
To assess the effectiveness of a school and family based healthy lifestyle programme (WAVES intervention) compared with usual practice, in preventing childhood obesity. Cluster randomised controlled trial. UK primary schools from the West Midlands. 200 schools were randomly selected from all state run primary schools within 35 miles of the study centre (n=980), oversampling those with high minority ethnic populations. These schools were randomly ordered and sequentially invited to participate. 144 eligible schools were approached to achieve the target recruitment of 54 schools. After baseline measurements 1467 year 1 pupils aged 5 and 6 years (control: 28 schools, 778 pupils) were randomised, using a blocked balancing algorithm. 53 schools remained in the trial and data on 1287 (87.7%) and 1169 (79.7%) pupils were available at first follow-up (15 month) and second follow-up (30 month), respectively. The 12 month intervention encouraged healthy eating and physical activity, including a daily additional 30 minute school time physical activity opportunity, a six week interactive skill based programme in conjunction with Aston Villa football club, signposting of local family physical activity opportunities through mail-outs every six months, and termly school led family workshops on healthy cooking skills. The protocol defined primary outcomes, assessed blind to allocation, were between arm difference in body mass index (BMI) z score at 15 and 30 months. Secondary outcomes were further anthropometric, dietary, physical activity, and psychological measurements, and difference in BMI z score at 39 months in a subset. Data for primary outcome analyses were: baseline, 54 schools: 1392 pupils (732 controls); first follow-up (15 months post-baseline), 53 schools: 1249 pupils (675 controls); second follow-up (30 months post-baseline), 53 schools: 1145 pupils (621 controls). The mean BMI z score was non-significantly lower in the intervention arm compared with the control arm at 15 months (mean difference −0.075 (95% confidence interval −0.183 to 0.033, P=0.18) in the baseline adjusted models. At 30 months the mean difference was −0.027 (−0.137 to 0.083, P=0.63). There was no statistically significant difference between groups for other anthropometric, dietary, physical activity, or psychological measurements (including assessment of harm). The primary analyses suggest that this experiential focused intervention had no statistically significant effect on BMI z score or on preventing childhood obesity. Schools are unlikely to impact on the childhood obesity epidemic by incorporating such interventions without wider support across multiple sectors and environments. Current Controlled Trials ISRCTN97000586.
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群集随机控制儿童肥胖预防试验的过程评估结果：WAVES研究。
影响因子：
4.5
作者：
Griffin TL;Clarke JL;Lancashire ER;Pallan MJ;Adab P;WAVES study trial investigators
通讯作者：
WAVES study trial investigators
影响因子：
5.2
作者：
Jackson LV;Thalange NK;Cole TJ
通讯作者：
Cole TJ
影响因子：
5.1
作者：
Pallan, Miranda;Parry, Jayne;Adab, Peymane
通讯作者：
Adab, Peymane
影响因子：
4.7
作者：
Christian, M. S.;Evans, C. E. L.;Cade, J. E.
通讯作者：
Cade, J. E.
影响因子：
4.5
作者：
Clarke JL;Griffin TL;Lancashire ER;Adab P;Parry JM;Pallan MJ;WAVES study trial investigators
通讯作者：
WAVES study trial investigators