Shape Up Somerville two-year results: A community-based environmental change intervention sustains weight reduction in children
Shape Up Somerville two-year results: A community-based environmental change intervention sustains weight reduction in children
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DOI：
10.1016/j.ypmed.2013.06.001
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发表时间：
2013-10-01
影响因子：
5.1
通讯作者：
Nelson, Miriam E.
中科院分区：
文献类型：
--
作者：
Economos, Christina D.;Hyatt, Raymond R.;Nelson, Miriam E.
目的：本研究的目的是验证以社区为基础的环境改变干预预防儿童体重增加的假设。方法：本研究采用的方法是一项为期两年的非随机对照试验（2003-2005），采用基于社区的参与式方法，在马萨诸塞州三个不同的城市进行：一个干预和两个社会人口统计学匹配的对照社区（汇总分析）。儿童1028例，平均年龄7.61 + 1.04岁。采取干预措施，通过增加体力活动选择和健康食品的可用性来改善能量平衡（第一年）。为了确保可持续发展，研究小组支持政策，并将干预工作转移给社区成员（二年级）。结果：通过多元回归评估体重指数z得分（bmi）的变化，考虑社区内的聚类并调整基线协变量。评估了性别特异性超重/肥胖的患病率、发病率和缓解情况。在两年的时间里，干预社区儿童的BMIz比对照组下降了0.06 [p = 0.005,95%可信区间：0.08 ~ 0.041]。与对照组相比，干预组男性（OR = 0.61, p = 0.01）和女性（OR = 0.78, p = 0.01）的超重/肥胖患病率下降，男性（OR 3.18, p = 0.03）和女性（OR 1.93,p = 0.03）的缓解率增加。结论：研究结果表明，采用可持续的多层次社区模式预防儿童肥胖是有希望的，并加强了广泛的环境和政策干预的必要性。(C) 2013出版的爱思唯尔公司。
Objective: The objective of this study was to test the hypothesis that community-based environmental change intervention prevents undesirable weight gain in children.Method: The method used in this study was a two-year, non-randomized, controlled trial (2003-2005) using community-based,participatory methodology in three diverse cities in Massachusetts: one intervention and two socio-demographically-matched control communities (pooled for analysis). Children (n = 1028), with a mean age = 7.61 + 1.04 years participated. Interventions were made to improve energy balance by increasing physical activity options and availability of healthful foods (Year 1). To firmly secure sustainability, the study team supported policies and shifted intervention work to community members (Year 2).Results: Change in body mass index z-score (BMIz) was assessed by multiple regression, accounting for clustering within communities and adjusting for baseline covariates. Sex-specific overweight/obesity prevalence, incidence and remission were assessed. Over the two-year period, BMIz of children in the intervention community decreased by 0.06 [p = 0.005,95% confidence interval: 0.08 to 0.041 compared to controls. Prevalence of overweight/obesity decreased in males (OR = 0.61, p = 0.01) and females (OR = 0.78, p = 0.01) and remission increased in males (OR 3.18, p = 0.03) and females (OR 1.93,p = 0.03) in intervention compared to controls.Conclusion: Results demonstrate promise for preventing childhood obesity using a sustainable multi-level community-based model and reinforce the need for wide-reaching environmental and policy interventions. (C) 2013 Published by Elsevier Inc.