小学生肥胖的学校-家庭-社区综合干预模式研究
Study on an Integrated School-family-community Intervention on Obesity-related Behaviors of Primary School Pupils
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摘要:
目的 利用健康促进策略,采取学校-家庭-社区联动的模式对小学生肥胖状况进行干预,并评价该模式的可行性和有效性。 方法 抽取上海市青浦区经济、教学条件相似的两所城区小学作为研究现场,一所为干预组,另一所为对照组。研究对象为该二校的3年级全体小学生,共466名。其中,干预组264名,对照组202名。采用调查表了解研究对象对肥胖的知识、态度、行为(KAP),测量调查对象的身高、体重,检测血糖、血脂等指标。在此基础上,采取学校-家庭-社区综合干预的模式对干预组研究对象进行群体干预,包括健康教育、合理膳食、加强运动等;对照组则不施加任何有组织的干预措施。 结果 调查结果显示干预前:(1)小学生肥胖相关知识水平普遍较低;(2) "爱吃甜食"、"每日看电视时间"、"父母亲肥胖"和"高出生体重"是儿童肥胖的危险因素;(3)两校间小学生超重肥胖率、血糖异常率均无明显差异,血脂相关指标中除了对照组学生三酰甘油平均值和异常率均高于干预组(P < 0.05)之外,其他指标均无明显差异。采取干预措施一年后:(1)干预组学生超重肥胖率有一定程度的下降,并略低于对照组学生,但差异尚无统计学意义(P > 0.05);(2)干预组学生相关血生化指标中除低密度脂蛋白平均值和异常率均明显下降外,其他指标未见明显变化;对照组学生除了血胆固醇外,其余血脂指标均有明显上升;(3)学生对肥胖的KAP变化:干预组学生的肥胖知晓率较干预前明显提高,高于对照组(P<0.01);小学生对预防肥胖态度也有了明显地改变,饮食、运动行为有一定改善。 结论 利用健康促进策略,采用学校-家庭-社区联动的综合干预模式预防小学生肥胖是可行、有效的,应持续推进并值得在社区推广。 Abstract:Objective The intergrated intervention on obesity-related behaviors of primary school pupils, derived from health promotion strategies and combined with the school-family-community cooperative module, was studied to assess its feasibility and effectiveness. Methods Two urban schools which were compatible to the average economic condition and teaching level of Qingpu district were selected for cluster sampling. A total of 466 pupils at grade 3 were investigated. Among them, 264 were from the intervened school and 202 were from the control one. A structured questionnaire was designed to investigate the participants' knowledge, attitude and practice (KAP)on obesity control. Meanwhile, the physical exams were conducted to obtain the data of the participants, including height, weight, glucose, total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Based on the investigation, a school-family-community cooperative module was adopted to the intervention group with measures such as health education, balanced diet, enhanced physical activities employed. However, the control group carried no intervention. Results The cross-sectional survey showed that before the intervention:(1)Pupils had limited knowledge on obesity control. (2)The main risk factors of obesity were "preference for sweet food", "time for watching TV every day", "obesity history of parents", and "overweight at birth". (3)The survey showed no statistical significance of differences in the rates of obese pupils and glucose abnomality between the intervention group and control group. The mean value of TG and the abnormal rate in the control group was higher than that in the in tervention group (P < 0.05), while other blood fat parameters showed no significant differences. One year after intervention, the findings showed:(1) The rate of obesity was reported a slight decrease in the intervention group, and was slightly lower than that of the control group, but there was no statistic significance of difference between two groups (P > 0.05); (2)Changes of indices:the blood biochemical parameters reported no obvious change except the decreases in the abnormality and LDL in the intervention group. Except for cholesterol, all blood fat parameters reported obvious increases in the control group; (3)Change of KAP on obesity control:the awareness rate showed a clear increase in the intervented group after intervention, and was obviously higher than that of the control group (P < 0.01). The study showed pupils had changed their attitudes to obesity control greatly and improved their habits of diet and physical activity to a certain extent. Conclusion The intervention has been proved feasible, effective and applicable to the promotion and scaling-up in the communities.
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