广州市中学生超重肥胖健康教育干预效果评价

梁健平; 梁月朗; 郭嘉佳; 贡梓军; 程琦; 刘丽; 姚振江

doi:10.16835/j.cnki.1000-9817.2023.04.005

广州市中学生超重肥胖健康教育干预效果评价

doi: 10.16835/j.cnki.1000-9817.2023.04.005

1.
广东省广州市中小学卫生健康促进中心，510180
2.
广东药科大学公共卫生学院流行病与卫生统计学系

基金项目:

2018年广州市教育科学规划课题 201811644

2018年度国家自然科学基金资助项目 81874271

详细信息

作者简介:
梁健平(1983-)，女，广东广州人，硕士，副主任医师，主要研究方向为青少年生长发育及健康教育

通讯作者:
姚振江，E-mail：497345240@qq.com

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 R193
计量
- 文章访问数: 262
- HTML全文浏览量: 91
- PDF下载量: 77
- 被引次数: 0
出版历程
- 收稿日期: 2023-01-05
- 修回日期: 2023-02-20
- 网络出版日期: 2023-04-26
- 刊出日期: 2023-04-25

Evaluation of intervention effect of health education on overweight and obesity among middle school students in Guangzhou

1.
Guangzhou Primary and Secondary School Health Promotion Center, Guangzhou(510180), China

摘要

摘要: 目的探讨群体层面(健康教育讲座、公众号推送)和个人层面(个性化膳食指导意见)相结合的健康教育对广州市中学生超重肥胖的干预效果，为中学生超重肥胖的预防控制提供依据。方法于2018年通过方便抽样的方法抽取广州市3所初中和3所高中，经体检筛查出1 457名超重肥胖的12~18岁学生。对超重肥胖学生通过公众号推送健康推文、举办健康教育讲座、下发《学生个性化膳食指导意见》手册等措施进行干预，干预时间为2018年9月至2019年12月。使用χ²检验比较干预前后的超重肥胖构成比，计算需治疗人数(NNT)评价干预效果。结果干预前超重构成比为66.71%(972/1 457)，干预后下降至59.92%(873/1 457)；干预前肥胖构成比为33.29%(485/1 457)，干预后下降至26.63%(388/1 457)。肥胖学生中NNT最小的是12~13岁女生组(NNT=2.6，95%CI=1.9~4.1)，NNT最大的是14~18岁男生组(NNT=5.9，95%CI=4.7~8.1)；超重学生中12~13岁女生组NNT最小(NNT=2.7，95%CI=2.2~3.5)，14~18岁男生组NNT最大(NNT=7.4，95%CI=6.0~9.7)。结论群体层面(健康教育讲座、公众号推送)与个人层面(个性化膳食指导意见)相结合的健康教育方式可有效干预广州市中学生的超重肥胖。
- 超重 /
- 肥胖症 /
- 健康教育 /
- 干预性研究 /
- 学生
Abstract: Objective To explore the effect of the comprehensive intervention on overweight and obesity among middle school students at the population level (health education lecture and official account push) and individual level (personalized dietary guidance), so as to provide a reference for preventing and controlling their overweight and obesity. Methods Three junior high schools and three senior high schools were randomly selected in Guangzhou in 2018 by convenience sampling. Through physical examination, 1 457 overweight and obese students aged from 12 to 18 years old were screened. Intervention was administered through "Student Personalized Dietary Guidance" manual, health tweets on the official accounts, and health education lectures from September 2018 to December 2019. The Chi-square test was used to compare the difference in overweight and obesity constituent ratio between the two groups before and after the intervention. And intervention effect was evaluated by analyzing the number needed to treated(NTT). Results The proportion of overweight before the intervention was 66.71% (972/1 457), and decreased to 59.92% (873/1 457) after the intervention; the proportion of obesity before the intervention was 33.29% (485/1 457), which decreased to 26.63% (388/1 457) after the intervention. Among obese students, the smallest NNT was seen in the girl group aged 12-13 years (NNT=2.6, 95%CI=1.9-4.1), while the largest NNT in the boy group aged 14-18 years (NNT=5.9, 95%CI=4.7-8.1). The NNT of the girls aged 12-13 years was the smallest (NNT=2.7, 95%CI=2.2-3.5), and the NNT of the boys aged 14-18 years was the largest (NNT=7.4, 95%CI=6.0-9.7). Conclusion Health education at population level (health education lectures, official account push) with individual level (personalized dietary guidance) can effectively intervene overweight and obesity among middle school students in Guangzhou.
- Overweight /
- Obesity /
- Health education /
- Intervention studies /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 不同性别年龄段学生干预前后营养状况分布比较

Table 1. Distribution of nutritional status of students of different sex and age before and after intervention

性别	年龄/岁	人数	干预前		干预后			χ²值	P值
性别	年龄/岁	人数	超重	肥胖	正常	超重	肥胖	χ²值	P值
男	12~13	241	160(66.39)	81(33.61)	40(16.60)	136(56.43)	65(26.97)	43.70	< 0.01
	14~18	689	429(62.26)	260(37.74)	58(8.42)	415(60.23)	216(31.35)	62.30	< 0.01
女	12~13	187	137(73.26)	50(26.74)	50(26.74)	106(56.68)	31(16.58)	58.41	< 0.01
	14~18	340	246(72.35)	94(27.65)	48(14.12)	216(63.53)	76(22.35)	51.84	< 0.01
注： ()内数字为构成比/%。

下载: 导出CSV

参考文献(25)

[1]	ABARCA-GÓMEZ L, ABDEEN Z A, HAMID Z A, et al. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults[J]. Lancet, 2017, 390(10113): 2627-2642. doi: 10.1016/S0140-6736(17)32129-3
[2]	MICHA R, MANNAR V, AFSHIN A, et al. 2020 global nutrition report: action on equity to end malnutrition[M]. Bristol, UK: Development Initiatives, 2020: 51-52.
[3]	郑冬梅, 梁学军, 靳景璐, 等. 中国儿童肥胖的评估、治疗和预防指南[J]. 中国妇幼健康研究, 2021, 32(12): 1716-1722. doi: 10.3969/j.issn.1673-5293.2021.12.001 ZHENG D M, LIANG X J, JIN J L, et al. Guidelines for the assessment, treatment and prevention of childhood obesity in China[J]. Chin J Matern Child Health Res, 2021, 32(12): 1716-1722. (in Chinese) doi: 10.3969/j.issn.1673-5293.2021.12.001
[4]	MORADI M, MOZAFFARI H, ASKARI M, et al. Association between overweight/obesity with depression, anxiety, low self-esteem, and body dissatisfaction in children and adolescents: a systematic review and Meta-analysis of observational studies[J]. Crit Rev Food Sci Nutr, 2022, 62(2): 555-570. doi: 10.1080/10408398.2020.1823813
[5]	YATSUYA H, LI Y, HILAWE E H, et al. Global trend in overweight and obesity and its association with cardiovascular disease incidence[J]. Circ J, 2014, 78(12): 2807-2818. doi: 10.1253/circj.CJ-14-0850
[6]	NGUYEN H N, FUJIYOSHI A, ABBOTT R D, et al. Epidemiology of cardiovascular risk factors in Asian countries[J]. Circ J, 2013, 77(12): 2851-2859. doi: 10.1253/circj.CJ-13-1292
[7]	BROWN T, MOORE T H, HOOPER L, et al. Interventions for preventing obesity in children[J]. Cochrane Database Syst Rev, 2019, 7(7): CD001871.
[8]	SOBOL-GOLDBERG S, RABINOWITZ J, GROSS R. School-based obesity prevention programs: a Meta-analysis of randomized controlled trials[J]. Obesity (Silver Spring), 2013, 21(12): 2422-2428. doi: 10.1002/oby.20515
[9]	林文静, 马亚楠, 闻德亮. 基于学校的儿童肥胖干预研究进展[J]. 中国学校卫生, 2018, 39(11): 1748-1751. doi: 10.16835/j.cnki.1000-9817.2018.10.045 LIN W J, MA Y N, WEN D L. Advances in school-based childhood obesity intervention research[J]. Chin J Sch Health, 2018, 39(11): 1748-1751. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2018.10.045
[10]	广州市教育局. 广州市儿童青少年膳食健康手册[M]. 广州: 广州出版社, 2017. Bureau of Education of Guangzhou Municipality. Dietary health handbook for children and adolescents in Guangzhou[M]. Guangzhou: Guangzhou Press, 2017. (in Chinese)
[11]	北京大学儿童青少年卫生研究所. 学龄儿童青少年超重与肥胖筛查: WS/T 586—2018[S]. 北京: 中国标准出版社, 2018. Institute of Child and Adolescent Health, Peking University. Overweight and obesity screening in school-age children and adolescents: WS/T 586-2018[S]. Beijing: China Standard Press, 2018. (in Chinese)
[12]	贾佳, 施荣伟, 郑凯, 等. 南京市中学生超重肥胖现状及影响因素的研究[J]. 发育医学电子杂志, 2020, 8(2): 135-139. doi: 10.3969/j.issn.2095-5340.2020.02.008 JIA J, SHI R W, ZHENG K, et al. Current status and influencing factors of overweight and obesity among middle school students in Nanjing[J]. J Dev Med, 2020, 8(2): 135-139. (in Chinese) doi: 10.3969/j.issn.2095-5340.2020.02.008
[13]	史平, 王丹, 杜鹏, 等. 北京市石景山区中学生超重肥胖现状及影响因素[J]. 中国健康教育, 2013, 29(1): 39-41, 60. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK201301013.htm SHI P, WANG D, DU P, et al. Current status and influencing factors of overweight and obesity among middle school students in Shijingshan District, Beijing[J]. Chin J Health Educ, 2013, 29(1): 39-41, 60. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK201301013.htm
[14]	付连国, 王海俊, 阳益德, 等. 儿童青少年对肥胖危险因素知晓的现状分析[J]. 北京大学学报(医学版), 2015, 47(3): 410-413. https://www.cnki.com.cn/Article/CJFDTOTAL-BYDB201503009.htm FU L G, WANG H J, YANG Y D, et al. Current situation analysis of obesity risk factors in children and adolescents[J]. J Peking Univ (Health Sci), 2015, 47(3): 410-413. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-BYDB201503009.htm
[15]	王建华. 都是肥胖惹的祸: 浅谈儿童2型糖尿病的诊治[J]. 心血管病防治知识(科普版), 2014(11): 24-27. https://www.cnki.com.cn/Article/CJFDTOTAL-XUGB201411006.htm WANG J H. It's all the scourge of obesity: a brief discussion on the diagnosis and treatment of type 2 diabetes mellitus in children[J]. Knowled Prev Treat Cardiovasc Dis(Popular Sci Edit), 2014(11): 24-27(in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XUGB201411006.htm
[16]	高新颖, 常宇娟, 石凤英, 等. 综合干预前后肥胖儿童体成分变化的研究[J]. 中国社区医师, 2020, 36(22): 186-187. https://www.cnki.com.cn/Article/CJFDTOTAL-XCYS202022092.htm GAO X Y, CHANG Y J, SHI F Y, et al. Changes in body composition in obese children before and after comprehensive intervention[J]. Chin Commun Phys, 2020, 36(22): 186-187. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XCYS202022092.htm
[17]	陈贻珊, 张一民, 孔振兴, 等. 我国儿童青少年超重、肥胖流行现状调查[J]. 中华疾病控制杂志, 2017, 21(9): 866-869, 878. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201709002.htm CHEN Y S, ZHANG Y M, KONG Z X, et al. Investigation on the prevalence of overweight and obesity in children and adolescents in China[J]. Chin J Dis Control Prev, 2017, 21(9): 866-869, 878. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201709002.htm
[18]	罗琳, 姚鑫, 黄娴. 健康信念模式和自我效能理论在超重女中学生中的应用效果评价[J]. 中国学校卫生, 2015, 36(6): 830-833. http://www.cjsh.org.cn/article/id/zgxxws201506009 LUO L, YAO X, HUANG X. Evaluation of the effectiveness of health belief model and self-efficacy theory in overweight female secondary school students[J]. Chin J Sch Health, 2015, 36(6): 830-833. (in Chinese) http://www.cjsh.org.cn/article/id/zgxxws201506009
[19]	DABAS A, SETH A. Prevention and management of childhood obesity[J]. Ind J Pediatr, 2018, 85(7): 546-553.
[20]	STONER L, ROWLANDS D, MORRISON A, et al. Efficacy of exercise intervention for weight loss in overweight and obese adolescents: Meta-analysis and implications[J]. Sports Med, 2016, 46(11): 1737-1751.
[21]	刘艳芹, 赵慧玉, 李洁. 基于有氧运动的综合干预对单纯性肥胖儿童脂肪肝的影响[J]. 中国临床研究, 2017, 30(6): 828-830. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK201706032.htm LIU Y Q, ZHAO H Y, LI J. Effect of comprehensive intervention based on aerobic exercise on fatty liver disease in children with simple obesity[J]. Chin J Clin Res, 2017, 30(6): 828-830. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK201706032.htm
[22]	GOW M L, VAN DOORN N, BRODERICK C R, et al. Sustained improvements in fitness and exercise tolerance in obese adolescents after a 12 week exercise intervention[J]. Obes Res Clin Pract, 2016, 10(2): 178-188.
[23]	程巧云, 郑文峰, 吴宏, 等. 学校健康促进干预对中学生超重肥胖的影响[J]. 中国学校卫生, 2021, 42(3): 381-384, 388. doi: 10.16835/j.cnki.1000-9817.2021.03.015 CHENG Q Y, ZHENG W F, WU H, et al. Effects of school health promotion intervention on overweight and obesity in middle school students[J]. Chin J Sch Health, 2021, 42(3): 381-384, 388. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.03.015
[24]	REINEHR T, ROTH C L. Is there a causal relationship between obesity and puberty?[J]. Lancet Child Adolesc Health, 2019, 3(1): 44-54.
[25]	陆文姬. 上海市初中学生超重胖流行特征及相关危险因素研究[D]. 上海: 复旦大学, 2012. LU W J. Study on epidemiological characteristics of overweight and obesity and related risk factors in junior high school students in Shanghai[D]. Shanghai: Fudan University, 2012. (in Chinese)