Can the Healthy Primary School of the Future offer perspective in the ongoing obesity epidemic in young children? A Dutch quasi-experimental study
Can the Healthy Primary School of the Future offer perspective in the ongoing obesity epidemic in young children? A Dutch quasi-experimental study
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DOI：
10.1136/bmjopen-2019-030676
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发表时间：
2019-10-01
期刊：
影响因子：
2.9
通讯作者：
Jansen, Maria W. J.
中科院分区：
文献类型：
--
作者：
Bartelink, Nina H. M.;van Assema, Patricia;Jansen, Maria W. J.
学校在促进儿童健康行为方面发挥着重要作用，并可以为持续的肥胖流行提供视角。“未来健康小学"旨在通过加强学校健康宣传，改善儿童的健康和福祉。本研究旨在评估1年和2年随访后HPSF对儿童体重指数（BMI）z评分的影响，并调查HPSF是否对特定儿童亚组具有不同的影响。设计纵向准实验设计。设置四所干预学校和四所对照学校参与;位于低社会经济地位地区在荷兰。参与者1676名儿童（4-12岁）。干预HPSF使用上下文系统的方法，包括健康促进学校的变化。HPSF的核心是每天提供健康的午餐和有组织的身体活动。两所干预学校实施了这两项改革（完全HPSF），两所干预学校仅实施了身体活动的变化主要观察指标为BMI z评分，通过测量儿童基线时的身高和体重，在1年和2年后进行随访。结果在部分HPSF中，1年后的干预效果显著（标准化效应量（ES）=-0.05），在完整HPSF中不显著（ES=-0.04）。2年随访后，与对照学校的儿童相比，完全HPSF（ES=-0.08）和部分HPSF（ES=-0.07）的儿童的BMI z评分均显著降低，对照学校的儿童的平均BMI z评分从基线增加到2年。没有潜在的效果修饰符（性别，基线研究年，社会经济地位和基线体重状态）是显着的。结论HPSF是有效的1年和2年后的后续降低儿童的BMI Z分数。没有具体的儿童亚组可以确定谁受益更多的干预。
Objectives Schools play an important role in promoting healthy behaviours in children and can offer perspective in the ongoing obesity epidemic. The `Healthy Primary School of the Future' (HPSF) aims to improve children's health and well-being by enhancing school health promotion. The current study aims to assess the effect of HPSF on children's body mass index (BMI) z-score after 1 and 2 years follow-up and to investigate whether HPSF has different effects within specific subgroups of children.Design A longitudinal quasi-experimental design.Setting Four intervention and four control schools participated; located in a low socioeconomic status region in the Netherlands.Participants 1676 children (aged 4-12 years).Interventions HPSF uses a contextual systems approach and includes health-promoting changes in the school. Central to HPSF is the provision of a daily healthy lunch and structured physical activity sessions each day. Two intervention schools implemented both changes (full HPSF), two intervention schools implemented only the physical activity change (partial HPSF).Main outcome measures BMI z-score, determined by measurements of children's height and weight at baseline, after 1 and 2 years follow-up.Results The intervention effect was significant after 1-year follow-up in the partial HPSF (standardised effect size (ES)=-0.05), not significant in the full HPSF (ES=-0.04). After 2 years follow-up, BMI z-score had significantly decreased in children of both the full HPSF (ES=-0.08) and the partial HPSF (ES=-0.07) compared with children of the control schools, whose mean BMI z-score increased from baseline to 2 years. None of the potential effect modifiers (gender, baseline study year, socioeconomic status and baseline weight status) were significant.Conclusions HPSF was effective after 1 and 2 years follow-up in lowering children's BMI z-scores. No specific subgroups of children could be identified who benefitted more from the intervention.