家庭支持在儿童饮食运动行为干预对知识和行为影响中的中介作用

彭远舟; 王海俊; 林艺; 冯向先; 张芳; 高爱钰; 周双; 刘峥

doi:10.16835/j.cnki.1000-9817.2022.11.003

家庭支持在儿童饮食运动行为干预对知识和行为影响中的中介作用

doi: 10.16835/j.cnki.1000-9817.2022.11.003

彭远舟¹,
王海俊¹,
林艺²,
冯向先³,
张芳⁴,
高爱钰⁵,
周双¹,
刘峥^1, ,

1.
北京大学公共卫生学院妇幼卫生学系, 北京 100191
2.
乌鲁木齐市中小学卫生保健所
3.
长治医学院公共卫生与预防医学系
4.
北京市门头沟区中小学卫生保健所
5.
北京市东城区中小学卫生保健所

基金项目:

国家自然科学基金项目 81903343

国家自然科学基金项目 81973053

详细信息

作者简介:
彭远舟(1995-), 女, 云南大理人, 在读硕士, 主要研究方向为儿少卫生与妇幼保健学

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: G 78 R 153.2 G 806
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- 文章访问数: 479
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- 被引次数: 0
出版历程
- 收稿日期: 2022-02-23
- 修回日期: 2022-05-25
- 网络出版日期: 2022-11-30
- 刊出日期: 2022-11-25

Effect of a dietary and exercise intervention on children's cognition and behaviors: the mediating role of family support

1.
Department of Maternal and Child Health, School of Public Health, Peking University, Beijing (100191), China

摘要

摘要: 目的评估儿童饮食运动行为干预对其认知和行为的影响, 并探究家庭支持的中介作用, 以期为有效的儿童肥胖干预策略提供科学依据。方法基于2018—2019年在北京、长治、乌鲁木齐24所小学共1 392名四年级学生及其家长中开展的儿童饮食运动行为干预项目, 通过问卷调查收集家长的支持情况以及儿童的认知和行为。在学校—家庭—个人3个层面上对干预组儿童开展饮食运动行为干预, 对儿童的饮食运动知识、饮食习惯、运动行为、静坐视屏行为进行评估, 采用线性混合效应模型先分析干预对儿童认知和行为评分的作用, 再探讨家庭支持的中介作用。结果干预1年后, 相比对照组, 干预组饮食运动知识评分高(OR=2.34, 95%CI=1.71~3.21)、饮食习惯评分高(OR=2.58, 95%CI=1.75~3.82)和静坐视屏评分高(OR=1.91, 95%CI=1.35~2.68)的儿童比例明显升高(P值均 < 0.01), 干预组儿童存在家庭支持的比例提高(OR=3.45, 95%CI=2.19~5.45), 其中父亲(OR=2.70, 95%CI=1.68~4.35)、母亲(OR=3.71, 95%CI=2.28~6.04)、祖母(OR=1.65, 95%CI=1.00~2.70)和外祖母(OR=2.14, 95%CI=2.12~2.16)支持儿童控制体重的比例提高(P值均 < 0.05)。中介作用分析显示, 家庭支持在综合干预与儿童饮食习惯和静坐视屏评分的关联中存在中介作用。结论儿童饮食运动行为干预可促进其认知和行为, 家庭支持是重要的中介因素。将家庭干预纳入儿童肥胖综合防控策略可提高儿童饮食运动行为的干预效果。
- 家庭 /
- 饮食习惯 /
- 运动活动 /
- 干预性研究 /
- 知识 /
- 儿童
Abstract: Objective To evaluate the effect of a dietary and exercise intervention on cognition and behaviors among primary school students, and to further explore the mediating role of family support, in order to provide scientific evidence for future effective intervention strategies. Methods A dietary and exercise intervention program for childhood obesity prevention was carried out in 24 primary schools in Beijing, Changzhi and Urumqi from 2018 to 2019, and 1 392 children in grade four as well as their parents were included. Family support and children's cognition and behaviors were collected through questionnaire. To carry out diet and exercise behavior intervention on the three levels of school, family and individual in the intervention group, and children's dietary and exercise knowledge, eating habits, physical activities, as well as sedentary and screen behaviors were evaluated. The linear mixed model was used to analyze the effect of intervention on children's cognition and behaviors, and the mediation model was used to explore the role of family support. Results The proportion of children with higher score of dietary and exercise knowledge (OR=2.34, 95%CI=1.71-3.21), eating habits (OR=2.58, 95%CI=1.75-3.82), and sedentary and screen behaviors (OR=1.91, 95%CI=1.35-2.68) increased in the intervention group after one-year intervention (P < 0.01), compared with the control group, respectively. The intervention also increased the proportion of children's family support in the intervention group compared with the control group (OR=3.45, 95%CI=2.19-5.45), and the support from children's fathers (OR=2.70, 95%CI=1.68-4.35), mothers (OR=3.71, 95%CI=2.28-6.04), paternal grandmothers (OR=1.65, 95%CI=1.00-2.70), and maternal grandmothers (OR=2.14, 95%CI=2.12-2.16) increased significantly (P < 0.05). The mediation analysis showed that family support played a mediating role in association between comprehensive intervention and children's eating habits as well as sedentary and screen behaviors. Conclusion The dietary and exercise intervention effectively promoted children's cognition and behaviors, and family support played an important mediating role.
- Family /
- Food habits /
- Motor activity /
- Intervention studies /
- Knowledge /
- 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 干预对儿童相关认知和行为评分的作用

Table 1. Effect of intervention on the score of children's cognition and behaviors

儿童相关认知和行为评分	选项	干预组人数		对照组人数		模型1		模型2
儿童相关认知和行为评分	选项	基线	终期	基线	终期	OR值(OR值95%CI)	P值	OR值(OR值95%CI)	P值
饮食运动知识	高	490	606	498	529	2.28(1.68~3.09)	＜0.01	2.34(1.71~3.21)	＜0.01
饮食习惯	高	476	556	496	417	2.73(1.83~4.09)	＜0.01	2.58(1.75~3.82)	＜0.01
运动行为	高	478	499	465	518	1.11(0.66~1.87)	0.69	1.10(0.66~1.85)	0.71
静坐视屏	高	468	528	444	430	1.92(1.37~2.69)	＜0.01	1.91(1.35~2.68)	＜0.01
注：模型1调整儿童年龄、性别、基线儿童相关认知或行为评分、学校整群效应及干预分组；模型2在模型1的基础上进一步调整父亲和母亲的受教育程度。儿童相关认知和行为评分均以低为参照组。表中人数为基线和终期儿童相关认知和评分高的人数。

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表 2 干预对家庭支持的作用

Table 2. Effect of intervention on family support

家庭支持		干预组人数		对照组人数		模型1		模型2
家庭支持		基线	终期	基线	终期	OR值(OR值95%CI)	P值	OR值(OR值95%CI)	P值
家庭支持情况	存在家庭支持	563	604	553	446	3.42(2.16~5.40)	＜0.01	3.45(2.19~5.45)	＜0.01
家庭成员的支持态度	父亲支持	477	442	456	331	2.57(1.62~4.09)	＜0.01	2.70(1.68~4.35)	＜0.01
	母亲支持	535	541	512	397	3.57(2.24~5.70)	＜0.01	3.71(2.28~6.04)	＜0.01
	祖父支持	137	124	140	79	1.16(0.61~2.21)	0.65	1.09(0.55~2.15)	0.80
	祖母支持	168	156	165	99	1.52(0.96~2.42)	0.08	1.65(1.00~2.70)	0.05
	外祖父支持	74	75	82	67	1.43(0.46~4.46)	0.54	3.00(0.57~15.80)	0.20
	外祖母支持	106	96	98	75	2.38(0.87~6.48)	0.09	2.14(2.12~2.16)	＜0.01
注：模型1调整儿童年龄、性别、基线儿童相关认知或行为评分、学校整群效应及干预分组；模型2在模型1的基础上进一步调整父亲和母亲的受教育程度。家庭支持情况以均不支持为参照组，家庭成员的支持态度均以不支持为参照组。表中人数为基线和终期儿童支持的人数。

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