The impact of a multilevel childhood obesity prevention intervention on healthful food acquisition, preparation, and fruit and vegetable consumption on African-American adult caregivers.
The impact of a multilevel childhood obesity prevention intervention on healthful food acquisition, preparation, and fruit and vegetable consumption on African-American adult caregivers.
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多层次儿童肥胖预防干预措施对健康食品获取、准备以及水果和蔬菜消费对非裔美国成年护理人员的影响。
DOI：
10.1017/s1368980018003038
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发表时间：
2019
影响因子：
3.2
通讯作者：
Gittelsohn,Joel
中科院分区：
文献类型：
--
作者：
Trude,AngelaCb;Surkan,PamelaJ;AndersonSteeves,Elizabeth;PollackPorter,Keshia;Gittelsohn,Joel
目的评估以儿童为中心的多层次肥胖干预对青少年主要照顾者食物相关行为（获取、准备、水果和蔬菜（FV）消费）的二次影响。DesignB 'More Healthy Communities for Kids （BHCK）小组随机对照试验通过批发商和小商店策略、针对青少年的同伴导师主导的营养教育以及针对他们的成年照顾者的社交媒体和短信，促进了健康食品和食品相关行为的获取。测量包括护理人员（516名）自我报告的30天内家庭食物获取FV、零食和杂货的频率，以及226名护理人员通过NCI FV筛选器的通常FV消费子样本。分层模型评估平均治疗效果（ATE）。治疗对治疗效果（TTE）分析评估了行为改变与接触BHCK之间的相关性。后评估的暴露分数是基于自我报告的BHCK材料观看和参与活动。美国巴尔的摩市的30个低收入社区。参与者：9-15岁青少年的成人看护人。结果护理人员中，女性占90·89%；平均年龄39.31岁（sd 9.31）。基线平均（sd）摄入量（份数/d）为水果1.30（1.69）份，蔬菜1.35（1.05）份。在ATE中，没有发现对照顾者食物相关行为的显著干预作用。在TTE中，BHCK暴露评分（范围：0 - 6·9）每增加1分，照料者的每日水果消费量增加0.2份（0.24份（0.11份））；95% ci 0.04, 0.47)。报告更多社交媒体曝光的护理人员每日水果摄入量增加了两倍（3.16 (0.92)）；（95%可信区间为1.33,4.99），购买不健康食品的频率较基线有所增加。结论以儿童为中心的社区营养干预也可能有利于家庭成员的水果摄入。以儿童为重点的干预措施应包括成人照顾者，并应评估干预措施对家庭成员的影响。未来的多层次研究应考虑使用社交媒体来提高覆盖面和吸引护理参与者。
ObjectiveTo evaluate the secondary impact of a multilevel, child-focused, obesity intervention on food-related behaviours (acquisition, preparation, fruit and vegetable (FV) consumption) on youths’ primary caregivers.DesignB’More Healthy Communities for Kids (BHCK) group-randomized controlled trial promoted access to healthy foods and food-related behaviours through wholesaler and small store strategies, peer mentor-led nutrition education aimed at youths, and social media and text messaging targeting their adult caregivers. Measures included caregivers’ (n 516) self-reported household food acquisition frequency for FV, snacks and grocery items over 30 d, and usual FV consumption in a sub-sample of 226 caregivers via the NCI FV Screener. Hierarchical models assessed average treatment effects (ATE). Treatment-on-the-treated-effect (TTE) analyses evaluated correlation between behavioural change and exposure to BHCK. Exposure scores at post-assessment were based on self-reported viewing of BHCK materials and participating in activities.SettingThirty Baltimore City low-income neighbourhoods, USA.ParticipantsAdult caregivers of youths aged 9–15 years.ResultsOf caregivers, 90·89 % were female; mean age 39·31 (sd 9·31) years. Baseline mean (sd) intake (servings/d) was 1·30 (1·69) fruits and 1·35 (1·05) vegetables. In ATE, no significant intervention effect was found on caregivers’ food-related behaviours. In TTE, each point increase in BHCK exposure score (range: 0–6·9) increased caregivers’ daily fruit consumption by 0·2 servings (0·24 (se 0·11); 95 % CI 0·04, 0·47). Caregivers reporting greater social media exposure tripled their daily fruit intake (3·16 (se 0·92); 95 % CI 1·33, 4·99) and increased their frequency of unhealthy food purchasing v. baseline.ConclusionsChild-focused community-based nutrition interventions may also benefit family members’ fruit intake. Child-focused interventions should involve adult caregivers and intervention effects on family members should be assessed. Future multilevel studies should consider using social media to improve reach and engage caregiver participants.
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