Pathways: a school-based, randomized controlled trial for the prevention of obesity in American Indian schoolchildren
Pathways: a school-based, randomized controlled trial for the prevention of obesity in American Indian schoolchildren
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DOI：
10.1093/ajcn/78.5.1030
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发表时间：
2003-11-01
影响因子：
7.1
通讯作者：
Stevens, J
中科院分区：
文献类型：
--
作者：
Caballero, B;Clay, T;Stevens, J
背景：儿童肥胖是美国的一个主要公共卫生问题，特别是在美洲印第安社区。目的：目的是评估以学校为基础的多组分干预措施对降低美洲印第安学童体脂百分比的有效性。设计：本研究是一项随机、对照、基于学校的试验，涉及41所学校的1704名儿童，连续3年进行，从3年级到5年级，在亚利桑那州、新墨西哥州和南达科他州为美国印第安人社区服务的学校进行。干预有4个组成部分：1)饮食摄入量的改变，2)增加体育活动，3)注重健康饮食和生活方式的课堂课程，以及4)家庭参与计划。主要结果是体脂百分比；其他结果包括饮食摄入、身体活动、知识、态度和行为。结果：干预没有显著降低体脂百分比。然而，在干预学校中观察到脂肪能量百分比的显著降低。总能量摄入（通过24小时饮食回顾）在干预学校显著减少，但能量摄入（通过直接观察）没有。运动传感器数据显示，干预学校和控制学校的活动水平相似。通过干预，知识、态度和行为的几个组成部分也发生了积极而显著的变化。结论：这些结果证明了在美国印第安社区的小学实施多成分预防肥胖计划的可行性。该计划在脂肪摄入量、食物和健康相关知识和行为方面产生了显著的积极变化。可能需要更强烈或更长时间的干预来显著减少这一人群的肥胖。
Background: Childhood obesity is a major public health problem in the United States, particularly among American Indian communities.Objective: The objective was to evaluate the effectiveness of a school-based, multicomponent intervention for reducing percentage body fat in American Indian schoolchildren.Design: This study was a randomized, controlled, school-based trial involving 1704 children in 41 schools and was conducted over 3 consecutive years, from 3rd to 5th grades, in schools serving American Indian communities in Arizona, New Mexico, and South Dakota. The intervention had 4 components: 1) change in dietary intake, 2) increase in physical activity, 3) a classroom curriculum focused on healthy eating and lifestyle, and 4) a family-involvement program. The main outcome was percentage body fat; other outcomes included dietary intake, physical activity, and knowledge, attitudes, and behaviors.Results: The intervention resulted in no significant reduction in percentage body fat. However, a significant reduction in the percentage of energy from fat was observed in the intervention schools. Total energy intake (by 24-h dietary recall) was significantly reduced in the intervention schools but energy intake (by direct observation) was not. Motion sensor data showed similar activity levels in both the intervention and control schools. Several components of knowledge, attitudes, and behaviors were also positively and significantly changed by the intervention.Conclusions: These results document the feasibility of implementing a multicomponent program for obesity prevention in elementary schools serving American Indian communities. The program produced significant positive changes in fat intake and in food- and health-related knowledge and behaviors. More intense or longer interventions may be needed to significantly reduce adiposity in this population.