上海市某区小学生的超重肥胖综合干预效果评价

发布时间：2018-08-16 18:24

【摘要】：目的：1评价儿童营养健康教育及身体活动干预对其营养知识、态度,饮食行为及肥胖率的作用。2开发、制作开展小学生营养健康教育的课件与宣传材料(针对教师、学生、家长)。3提高项目学校学生及其家长、老师和领导的营养健康知识水平,培养小学生健康的生活方式。4.探索儿童肥胖的综合防控技术,从而制定儿童肥胖的有效干预模式,为儿童肥胖的有效防控提供科学依据。方法：本研究是一项在学校里进行的随机对照干预试验,干预时间为1年,干预措施主要包括健康教育和身体活动两方面。采用整群随机抽样方法,在上海市松江区抽取4所小学,其中3所作为干预校实施干预,1所作为对照校,在每所学校2-4年级中,每年级随机抽取2个班的小学生做效果评价。对1015名学生(干预组786人,对照组229人)实施为期1年的干预。干预前和干预后对所有研究对象及其家长、教师进行肥胖相关知信行问卷调查,对小学生进行体格检查,包括身高、体重和血红蛋白等。结果：干预前：①小学生的超重率10.3%,肥胖率为10.1%,其中男生的超重率为12.1%,肥胖率为12.6%；女生的超重率为8.1%,肥胖率为7.0%；男生的超重率和肥胖率均高于女生(P0.01)。小学生的血红蛋白平均值为133.85±9.38g/L,其中贫血(血红蛋白120g/L)的比例为4.9%。②小学生的营养知识题目中有4道题目(共12题)的正确率低于80%；每天坚持吃早餐的小学生占83.3%；平均每天至少喝一次奶制品的孩子占50.6%；在最近一个月,至少吃一次西式快餐的占53.8%；小学生营养相关知识最主要的和最希望获得的来源均是“家长”；小学生最常吃的零食排名前三位是“新鲜蔬菜、水果”、“奶及奶制品”和“谷类”,最常喝的饮料排名前三位是“茶饮料”、“纯牛奶及酸奶”和“果蔬饮料”；小学生的营养相关知识、健康行为态度和饮食行为三者之间呈正相关关系。③家长的营养知识题目中有3道题目(共12题)的正确率低于80%；每天坚持吃早餐的家长占76.0%,有84.9%的家长在家为孩子准备早餐；平均每天至少喝一次奶制品的家长占21.8%；在最近一个月,至少吃一次西式快餐的占45.8%；家长营养相关知识最主要的和最希望获得的来源均是“电视、广播”；家长最常吃为孩子准备的零食排名前三位是“新鲜蔬菜、水果”、“奶及奶制品”和“谷类”,最常为孩子准备的饮料排名前三位是“纯牛奶及酸奶”、“含乳饮料”和“果蔬饮料”；家长的文化程度与营养相关知识、健康行为态度和饮食行为之间呈正相关关系；家长在营养相关知识、健康行为态度、饮食行为三个方面与小学生之间均存在正相关关系。④教师的营养知识题目中有2道题目(共12题)的正确率低于80%；每天坚持吃早餐的教师占58.5%；平均每天至少喝一次奶制品的教师占22.7%；在最近一个月,至少吃一次西式快餐的占37%；教师营养相关知识最主要的的来源是“报刊、杂志、书籍”,最希望获得的途径是“专家指导”。干预效果评价：①干预后,干预组小学生超重率上升0.9%,肥胖率下降2.1%,但差异无统计学意义。干预组小学生血红蛋白值上升了1.25g/L,而对照组有所下降；两组小学生贫血率均下降,差异均无统计学意义。②干预后,干预组小学生、家长及教师的肥胖相关知识、态度、行为得分的增长率显著高于对照组,且差异具有统计学意义。干预组得分增长率小学生分别为8.2%,9.7%,10.0%；家长4.6%,2.6%,5.7%；教师8.6%,6.9%,11.0%。结论：小学生及家长对营养相关知识及健康行为观点有普遍性的了解,但部分题目仍存在误区,家长对子女在营养知识、健康行为态度及饮食行为方面都有一定的影响。以营养健康教育和“快乐十分钟”为主的综合干预措施,对小学生超重肥胖率有一定的效果,同时也对改善小学生及其家长、教师的营养知识、健康行为态度和饮食行为起到了一定作用,对儿童肥胖的防控起到积极作用,但需长期坚持并评价其效果。
[Abstract]:Objective: 1. To evaluate the effect of nutritional health education and physical activity intervention on nutritional knowledge, attitude, dietary behavior and obesity rate of children. 2. To develop courseware and propaganda materials for nutritional health education of primary school students (for teachers, students, parents). 3. To improve nutritional health knowledge of students and their parents, teachers and leaders. 4. To explore the comprehensive prevention and control technology of childhood obesity, so as to formulate an effective intervention model for childhood obesity, and provide a scientific basis for the effective prevention and control of childhood obesity.
Methods: A randomized controlled intervention study was conducted in a school for one year. The intervention included health education and physical activity. Four primary schools in Songjiang District of Shanghai were selected by cluster random sampling method. Three of them were used as intervention schools and one was used as control school, and 2-4 in each school. 1,015 pupils (786 in the intervention group and 229 in the control group) were intervened for one year. Before and after the intervention, all the subjects and their parents and teachers were surveyed with obesity-related knowledge, beliefs and behaviors questionnaire, and the pupils were examined by physical examination, including height, weight and blood. Red protein and so on.
Results: Before the intervention, the overweight rate was 10.3% and the obesity rate was 10.1%. The overweight rate was 12.1% for boys and 12.6% for girls, 8.1% for girls and 7.0% for obesity. The overweight rate and obesity rate of boys were higher than those of girls (P 0.01). The average hemoglobin level of pupils was 133.85 + 9.38 g/L, including anemia (hemoglobin 12.1%). (2) The correct rate of 4 nutritional knowledge questions (12 questions) was lower than 80%; 83.3% of the pupils insisted on eating breakfast every day; 50.6% of the children drank milk products at least once a day; 53.8% of the pupils ate western fast food at least once in the last month; and the pupils had the most nutritional knowledge. The top three snacks for pupils were "fresh vegetables, fruits", "milk and dairy products" and "cereals". The top three drinks for pupils were "tea drinks", "pure milk and yoghurt" and "fruit and vegetable drinks"; nutrition-related knowledge and health of pupils. There was a positive correlation between behavior attitude and dietary behavior. 3) The correct rate of three nutritional knowledge questions (12 questions) was less than 80%; 76.0% of the parents who insisted on eating breakfast every day, 84.9% of the parents prepared breakfast for their children at home; 21.8% of the parents who drank dairy products at least once a day on average; and in the last month, Forty-five.8 percent of parents ate at least one Western-style snack; the most important sources of nutrition-related knowledge and wishes were "TV, radio"; the top three snacks for children were "fresh vegetables, fruits", "milk and dairy products" and "cereals", and the top three drinks for children were the most frequently prepared snacks. It is "pure milk and yoghurt", "milk-containing beverage" and "fruit and vegetable beverage". Parents'educational level is positively correlated with nutrition-related knowledge, healthy behavior attitude and dietary behavior. Parents' nutrition-related knowledge, healthy behavior attitude and dietary behavior are positively correlated with primary school students. Among the nutritional knowledge questions, the correct rate of two questions (12 questions altogether) was less than 80%; 58.5% of the teachers insisted on eating breakfast every day; 22.7% of the teachers drank dairy products at least once a day; 37% of the teachers ate western fast food at least once a month; and the most important source of nutritional knowledge was "newspapers, magazines, books". Evaluation of intervention effect: 1. After intervention, the overweight rate of pupils in intervention group increased by 0.9%, and the obesity rate decreased by 2.1%, but there was no significant difference between the two groups. Significance. 2) After intervention, the growth rate of obesity-related knowledge, attitude and behavior scores of pupils, parents and teachers in intervention group was significantly higher than that of control group, and the difference was statistically significant.
Conclusion: Primary school students and their parents have a general understanding of nutrition-related knowledge and health behavior views, but some problems still exist misunderstandings. Parents have certain influence on their children's nutrition knowledge, health behavior attitude and dietary behavior. Overweight and obesity rate has a certain effect, but also to improve the nutritional knowledge of pupils and their parents, teachers, healthy behavior attitudes and dietary behavior has played a certain role in the prevention and control of obesity in children play a positive role, but long-term adherence and evaluation of its effect.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R723.14

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