儿童肥胖综合干预对自我效能体重认知和行为改变的作用

尚莉伽; 高爱钰; 王海俊; 刘峥

doi:10.16835/j.cnki.1000-9817.2022.02.011

儿童肥胖综合干预对自我效能体重认知和行为改变的作用

doi: 10.16835/j.cnki.1000-9817.2022.02.011

1.
北京市东城区中小学卫生保健所, 100007
2.
北京大学公共卫生学院妇幼卫生学系

基金项目:

国家自然科学基金项目 81903343

中华医学基金项目 11-064

详细信息

作者简介:
尚莉伽(1974-), 女, 河南郑州人, 大学本科, 主治医师, 主要研究方向为学校卫生

通讯作者:
刘峥, E-mail: liuzheng@bjmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R723.14 R179 G627.9
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- 被引次数: 0
出版历程
- 收稿日期: 2021-06-14
- 修回日期: 2021-10-31
- 网络出版日期: 2022-02-24
- 刊出日期: 2022-02-25

Effectiveness of a comprehensive intervention for childhood obesity on self-efficacy, weight perception, and behavior change

1.
Health Care Center of Primary and Secondary Schools in Dongcheng District, Beijing(100007), China

摘要

摘要: 目的探讨儿童肥胖综合干预对自我效能、体重认知和行为改变阶段的作用, 为儿童肥胖的干预提供科学依据。方法研究设计为整群随机对照人群试验。2013年9月在北京市东城区选取12所小学的1 889名儿童(7~11岁), 开展肥胖综合干预。6所学校(930名)被随机分配至干预组, 6所学校(959名)被随机分配至对照组, 干预时长为1年。对研究对象开展面对面问卷调查, 使用R 4.0.3软件分析数据, 并采用多元线性回归模型分析干预效果。结果干预后, 干预组与对照组儿童自我效能评分分别为(4.4±0.9)和(4.2±1.1)分。干预后, 干预组低估和高估自我体重的比例分别为28.4%和11.3%, 对照组则为37.1%和6.9%;相比对照组, 干预组儿童低估体重的风险降低(OR=0.64, 95%CI=0.52~0.80, P<0.01), 高估体重的风险增加(OR=1.79, 95%CI=1.26~2.54, P<0.01)。干预后, 干预组儿童处于行为改变意向阶段和行动阶段的比例分别为65.3%和83.6%, 对照组则为59.8%和69.8%;相比于对照组, 干预组更多儿童在行为改变中转变为意向阶段(OR=1.28, 95%CI=1.03~1.59, P=0.02)和行动阶段(OR=2.59, 95%CI=2.04~3.27, P<0.01)。结论儿童肥胖综合干预对提高自我效能、改善体重认知和促进行为改变有积极作用, 但会增加高估体重的风险。
- 肥胖症 /
- 干预性研究 /
- 体重 /
- 认知 /
- 行为 /
- 儿童
Abstract: Objective To evaluate the effectiveness of a comprehensive intervention for childhood obesity on self-efficacy, weight perception, and stage of behavior change, and to provide a scientific evidence for childhood obesity interventions. Methods The study was a cluster-randomized controlled trial. Twelve primary schools and 1 889 children (aged 7-11 years) from Dongcheng District in Beijing were recruited in September, 2013, and were administered a comprehensive intervention for childhood obesity. Six schools (930) were randomly allocated to the intervention group, and six schools (959) were randomly allocated to the control group. A face-to-face questionnaire survey was carried out, R 4.0.3 software was used to analyze the data, and multiple linear regression model was used to analyze the intervention effect. Results After the intervention, mean (standard deviation) scores of self-efficacy among children in the intervention and control groups were (4.4±0.9) and (4.2±1.1), respectively. After the intervention, the proportion of children in the intervention group who underestimated or overestimated their body weight was 28.4% and 11.3%, respectively, while the figures in the control were 37.1% and 6.9%; compared with the control, the risk of underestimating body weight decreased among children in the intervention group(OR=0.64, 95%CI=0.52-0.80, P<0.01), while the risk of weight overestimation increased(OR=1.79, 95%CI=1.26-2.54, P<0.01). After the intervention, the proportion of children in the contemplation or action stage of behaviour change was 65.3% and 83.6%, while the figures in the control group were 59.8% and 69.8%, respectively; in comparison with the control group, more children in the intervention group were in comtemplation (OR=1.28, 95%CI=1.03-1.59, P=0.02) or action stage of behaviour change(OR=2.59, 95%CI=2.04-3.27, P<0.01). Conclusion The comprehensive intervention for childhood obesity improved self-efficacy, weight perception, and facilitated behavior change, but may increase the risk of weight overestimation.
- Obesity /
- Intervention studies /
- Body weight /
- Cognition /
- Behavior /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 儿童肥胖综合干预对自我效能、体重认知和行为改变阶段的作用

Table 1. Effect of the comprehensive intervention for childhood obesity on self-efficacy, weight perception, and stage of behaviour change

组别	干预前后	自我效能		体重认知			行为改变意向阶段		行为改变行动阶段
组别	干预前后	人数	自我效能较高人数	人数	低估	高估	人数	报告人数	人数	报告人数
干预组	干预前	868	673(77.5)	870	375(43.1)	54(6.2)	885	522(59.0)	896	638(71.2)
	干预后	868	714(82.3)	870	247(28.4)	98(11.3)	885	578(65.3)	896	749(83.6)
对照组	干预前	907	674(74.3)	917	404(44.1)	59(6.4)	919	528(57.5)	923	679(73.6)
	干预后	907	700(77.2)	917	340(37.1)	63(6.9)	919	550(59.8)	923	644(69.8)
注：()内数字为报告率/%；问卷调查收集的信息有缺失，故分析人数少于研究对象人数。

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参考文献(18)

[1]	LIU Z, XU H M, WEN L M, et al. A systematic review and Meta-analysis of the overall effects of school-based obesity prevention interventions and effect differences by intervention components[J]. Int J Behav Nutr Phys Act, 2019, 16(1): 95. doi: 10.1186/s12966-019-0848-8
[2]	BROWN T, MOORE T H M, HOOPER L, et al. Interventions for prevention obesity in children[J]. Cochrane Database Syst Rev, 2019, 7(7): CD001871.
[3]	许鸣, 黄仙红, 骆湘香, 等. 中学生自我效能对肥胖相关行为影响的研究[J]. 卫生软科学, 2016, 30(2): 118-122. doi: 10.3969/j.issn.1003-2800.2016.02.015 XU M, HUANG X H, LUO X X, et al. Study of related behaviors influence of self-efficacy to obesity in school students[J]. Soft Sci Health, 2016, 30(2): 118-122. doi: 10.3969/j.issn.1003-2800.2016.02.015
[4]	COSTA L C, SILVA D A, ALMEIDA S S, et al. Association between inaccurate estimation of body size and obesity in school children[J]. Trends Psychiatry Psychother, 2015, 37(4): 220-226. doi: 10.1590/2237-6089-2015-0009
[5]	尹博. 健康行为改变的跨理论模型[J]. 中国心理卫生杂志, 2007, 21(3): 194-199. doi: 10.3321/j.issn:1000-6729.2007.03.015 YIN B. Trans-theoretical model of change of health behaviors[J]. Chin Ment Health J, 2007, 21(3): 194-199. doi: 10.3321/j.issn:1000-6729.2007.03.015
[6]	PROCHASKA J, DI CLEMENTE C, NORCROSS H. In search of how people change: applications to addictive behavior[J]. Am Psychol, 1992, 47: 1102-1114. doi: 10.1037/0003-066X.47.9.1102
[7]	SWINBURN B, EGGER G, RAZA F. Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity[J]. Prev Med, 1999, 29(6): 563-570. doi: 10.1006/pmed.1999.0585
[8]	LIU Z, LI Q, MADDISON R, et al. A school-based comprehensive intervention for childhood obesity in China: a cluster randomized controlled trial[J]. Child Obes, 2019, 15(2): 105-115. doi: 10.1089/chi.2018.0251
[9]	BERLI C, STADLER G, SHROUT P E, et al. Mediators of physical activity adherence: results from an action control intervention in couples[J]. Ann Behav Med, 2018, 52(1): 65-76. doi: 10.1007/s12160-017-9923-z
[10]	KARSTEN M D A, VAN OERS A M, GROEN H, et al. Determinants of successful lifestyle change during a 6-month preconception lifestyle intervention in women with obesity and infertility[J]. Eur J Nutr, 2019, 58: 2463-2475. doi: 10.1007/s00394-018-1798-7
[11]	BROWN T, OVERCASH F, REICKS M. Frequency of trying to lose weight and its association with children's weight perception and dietary intake(NHANES 2011-2012)[J]. Nutrients, 2019, 11(11): 2703. doi: 10.3390/nu11112703
[12]	RAHIM A N N, CHIN Y S, SULAIMAN N. Socio-demographic factors and body image perception are associated with BMI-for-age among children living in welfare homes in selangor, malaysia[J]. Nutrients, 2019, 11(1): 142. doi: 10.3390/nu11010142
[13]	JI C Y. Working Group on Obesity in China. Report on childhood obesity in China(1): body mass index reference for screening overweight and obesity in Chinese school-age children[J]. Biomed Environ Sci, 2005, 18(6): 390-400.
[14]	WHO. Report of the Commission on Ending Childhood Obesity. Implementation plan: executive summary. (2017-01-17). http://apps.who.int/iris/bitstream/handle/10665/259349/WHO-NMH-PND-ECHO-17.1-eng.pdf?sequence=1&isAllowed=y2017.
[15]	王秀荣. 自我效能理论在单纯性肥胖儿童健康教育中的应用[J]. 中国医疗前沿, 2012(17): 94-95. https://www.cnki.com.cn/Article/CJFDTOTAL-YLQY201217070.htm WANG X R. Application of self-efficacy theory in health education among obese children[J]. Front Chin Med, 2012(17): 94-95. https://www.cnki.com.cn/Article/CJFDTOTAL-YLQY201217070.htm
[16]	林文静. 大连市小学生肥胖健康教育效果评价研究. 大连: 大连医科大学, 2018. LIN W J. Study on the effect of health education among obese pupils in Dalian. Dalian: Dalian Medical University, 2018.
[17]	王丹. 基于校园环境的城市学龄儿童超重/肥胖干预研究: 以深圳松岗小学为例. 武汉: 武汉理工大学, 2018. WANG D. The study of the intervention of the urban school-age children overweight/obesity based on the school environment-take the Songgang Elementary School in Shenzhen City as an example. Wuhan: Wuhan University of Technology, 2018.
[18]	HOEPPNER B B, KELLY J F, URBANOSKI K A, et al. Comparative utility of a single-item versus multiple-item measure of self-efficacy in predicting relapse among young adults[J]. J Subst Abuse Treat, 2011, 41(3): 305-312. doi: 10.1016/j.jsat.2011.04.005