基于跨理论模型对超重肥胖儿童/青少年体质量控制行为干预研究

目的 探讨以跨理论模型(transtheoretical mode of behavior change,TTM)为理论基础对超重肥胖儿童/青少年体质量控制行为的干预效果。 方法 将78名自愿参与干预研究的超重肥胖儿童/青少年作为干预对象,采用跨理论模型为指导的健康教育干预模式,对其进行为期6个月的体育锻炼、健康饮食、告别不良生活方式指导,然后自身干预前(T0)、干预1个月(T1)、干预3个月(T3)、第6个月随访(T6)分别利用体质量控制行为量表、变化阶段量表、变化过程量表、决策平衡量表、自我效能量表、体重指数(BMI)等评估其体重控制行为变化效果。 结果 基线调查时79.5%处于体质量控制行为的前意向/意向/准备阶段,20.5%处于行动/准备阶段;干预前(T0)、干预1个月(T1)、干预3个月(T3)、第6个月随访(T6)研究对象变化阶段差异有统计学意义(χ²=72.116,P<0.001),随着干预时间的不断推进,超重肥胖学生体质量控制行为变化阶段不断改善(χ²=60.862,P<0.001);随着干预时点、变化阶段不断推进,饮食行为(20.82±3.22、23.50±4.83、26.78±5.63、28.91±6.68)、运动行为(14.46±2.94、16.41±2.98、18.76±3.55、22.47±4.33)、认知过程(34.67±7.43、36.88±7.49、37.42±8.34、40.23±7.23)、行为过程(38.01±8.14、40.99±8.21、43.42±9.12、44.63±8.76)、知觉利益(23.37±4.63、25.63±4.03、28.01±3.42、29.23±2.52)、知觉障碍(16.96±4.32、19.06±3.61、20.53±3.31、22.35±2.55)、自我效能得分(30.50±9.12、35.50±9.33、38.95±10.13、44.41±9.43)增加差异均有统计学意义(P<0.001);对不同时点BMI进行方差分析,结果显示差异无统计学意义(F=1.751,P=0.183)。 结论 基于TTM的健康教育干预使超重肥胖学生体质量控制行为变化阶段向前推进,体质量控制行为水平不断提升,体质量控制行为变化过程朝着益于体重控制的方向改善。     

棒垒球运动和沙盘游戏对大学生社交焦虑干预效果比较

了解棒垒球、沙盘游戏对大学生社交焦虑的干预效果,为寻求大学生社交焦虑的有效途径和方法提供参考.方法 运用交往焦虑量表和症状自评量表筛选出80名大学生随机分为干预组(40名)和对照组(40名),对干预组进行为期2个月的棒垒球运动或沙盘游戏干预,对照组不作任何干预.干预前后综合运用社交焦虑量表(IAS)、自尊量表(SES)、简易应对方式量表(SCSS)和被试主观评价表,比较两组对象各得分的变化.结果 干预组的干预后社交焦虑总分低于干预前(t=5.093,P<0.01),自尊总分和应对方式分量表积极应对、消极应对均分在干预前后的差异均有统计学意义(t值分别为-3.732,-3.911,3.502,P值均<0.01).其中棒垒球干预组和沙盘干预组的社交焦虑总分在干预后均降低(t值分别为2.934,4.272,P值均<0.01),两组的自尊总分和应对方式分量表均分在干预前后的差异均有统计学意义(P值均<0.05).对照组干预前后各量表得分差异均无统计学意义(P值均>0.05).结论 棒垒球和沙盘游戏均可有效降低大学生的社交焦虑,提升自尊,改进应对方式.     

中等体育锻炼对大学生身体自尊和心理资本的干预效果

探讨体育锻炼对大学生身体自尊和心理资本的促进作用,为改善大学生心理健康水平提供参考.方法 采用体育锻炼等级量表、身体自尊量表和心理资本量表,对郑州地区3所大学195名大学生进行中等强度体育锻炼实验干预研究.结果 干预前,实验组和对照组身体自尊得分分别为(71.21±5.61)和(70.30±5.34)分,心理资本得分分别为(93.87±7.37)和(92.19±5.63)分,差异均无统计学意义(t值分别为1.805,1.759,P值均>0.05).干预后,实验组和对照组身体自尊得分分别为(79.97±5.61)和(71.70±5.34)分,心理资本得分分别为(99.87±5.38)和(93.65±9.57)分,差异均有统计学意义(t值分别为6.802,5.704,P值均<0.01).对照组身体自尊和心理资本得分干预前后差异均无统计学意义(t值分别为1.366,1.383,P值均>0.05),实验组身体自尊和心理资本得分干预前后差异均有统计学意义(t值分别为9.999,8.696,P值均<0.01).结论 持续中等强度的体育锻炼能显著促进大学生身体自尊和心理资本水平的提高.     

银川市肥胖儿童综合干预效果评价

目的了解儿童单纯性肥胖症的综合干预效果,为儿童保健工作提供参考依据。方法采取健康教育、饮食和运动的综合干预措施,选取银川市二十一小学(二～六年级)中符合中国肥胖工作组2004年制定的《中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准》的106名单纯性肥胖儿童,进行体格测量和问卷调查。结果干预1,2,3,4个月后单纯性肥胖儿童BMI值差异均有统计学意义(P值均0.01);不同干预时间肥胖儿童饮食结构变化差异有统计学意义(χ2=40.536,P=0.000);不同干预时间肥胖儿童运动类型的差异有统计学意义(χ2=11.909,P=0.008);不同干预时间肥胖儿童持续运动时间对BMI的变化差异无统计学意义(χ2=3.942,P=0.685)。不同干预时间饮食结构对肥胖儿童BMI值的影响差异无统计学意义(P0.05)。结论实施以健康教育、饮食和运动干预的综合干预措施对控制肥胖儿童体重有明显效果。     

足球课堂教学联合心理辅导对壮族大学生社交焦虑干预效果分析

了解心理辅导和足球课堂教学锻炼对广西壮族大学生社交焦虑的干预效果,为壮族大学生保持身心健康发展提供有力支持.方法 在广西民族大学筛选出120名存在社交焦虑的壮族大学生,随机分为干预组(共3组,各30名)和对照组(30名),分别进行8周的心理辅导和足球课堂教学锻炼,干预前后采用社交焦虑量表、应对方式量表、自尊量表、主观评价表等进行调查,对干预前后结果进行比较.结果 干预后干预组学生(心理辅导组、足球课堂教学锻炼组、心理辅导-足球锻炼组)在积极应对、自尊总分方面均高于干预前,差异均有统计学意义(t值分别为2.84.4.07.P值均<0.01);消极应对、社交焦虑总分干预后均低于干预前,差异均有统计学意义(t值分别为-4.84,-5.29,P值均<0.01).干预后,心理辅导组、足球课堂教学锻炼组、心理辅导-足球锻炼组各方面得分与干预前相比均得到显著改善.差异均有统计学意义(P值均<0.05).总体来看,干预后心理辅导-足球锻炼组在积极应对、自尊总分方面提高的分数更高.分别高于干预前0.59,5.68分;消极应对和社交焦虑得分干预后降低的分数也最高,分别为0.43,12.21分.结论 心理辅导和足球锻炼相结合的干预方式对降低壮族大学生社交焦虑效果最佳,足球课堂教学锻炼、心理辅导也起到一定的干预效果.     

综合健康干预措施对肥胖儿童血脂水平的影响

目的 评估综合健康干预措施对单纯性肥胖儿童血脂水平的影响.方法 采用综合健康干预措施对在深圳市宝安区人民医院治疗的67名单纯肥胖儿童(肥胖组)进行为期1年的干预试验,测定干预前后身高、体重、体重指数(BMI)、血压及血脂水平变化,同时选取65名体重正常儿童作为对照组.结果 肥胖组儿童干预前体重、BMI值、收缩压、舒张压、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均显著高于对照组(P<0.05或P<0.01);干预后BMI、收缩压和TG显著低于干预前(P<0.05或P<0.01),HDL-C明显高于干预前(P<0.05)但显著低于对照组(P<0.05).结论 综合健康干预措施能有效降低单纯性肥胖儿童的体重和BMI,改善其血脂水平,起到调节异常内分泌代谢的作用.     

山阳镇小学生肥胖的家庭干预效果评价

目的 探索小学生肥胖家庭干预的有效性,为学生肥胖防控提供思路和参考。方法 选取2015学年检出的金山小学108名一二年级肥胖学生为干预组,以同期检出的海棠小学109名一二年级肥胖学生为对照组,给予干预组专题健康教育、膳食控制、增加运动等干预措施,对照组不实施任何干预。干预时间为1年,比较2组学生干预前后肥胖相关知识知晓率、肥胖相关指标的变化情况。结果 干预实施1年后,干预组学生肥胖相关知识知晓率从58.54%增长至90.53%(χ2=262.146,P<0.001),干预组家长肥胖相关知识知晓率从77.16%增长至98.97%(χ2=219.977,P<0.001);而对照组学生和家长前后肥胖相关知识知晓率差异均无统计学意义(P>0.05)。干预实施1年后,干预组学生人均BMI变化0.19 kg/m2,干预前后差异无统计学意义(P>0.05),即无显著增长;对照组学生人均BMI变化0.92 kg/m2,前后差异有统计学意义(P<0.001),即有显著增长。干预措施停止后2年内,干预组和对照组学生人均BMI分别变化2.24、1.86 kg/m2,前后差异均有统计学意义(P<0.001),即均显著增长。结论 家庭肥胖干预对控制小学生肥胖具有显著效果,具有推广价值,但要先提高家长们对肥胖的认知,引导家长们自觉防控学生肥胖。     

学龄前儿童饮食行为与超重/肥胖的相关性研究

目的 探讨学龄前儿童饮食行为与超重/肥胖间的关系,为学龄前儿童超重/肥胖防治措施的制订提供参考依据。方法 采用学龄前儿童饮食行为试用量表对387名3~6岁儿童的饮食行为进行调查,同时,测量儿童的身高、体重,并计算体质指数(body mass index,BMI);依据BMI将儿童分为正常体重、超重和肥胖组。运用单因素方差分析比较不同体重组间饮食行为的差异;采用阶层线性回归分析检验学龄前儿童饮食行为与BMI间的相关性。结果 单因素分析结果显示,不良进食习惯、外因性进食、挑食、情绪性进食、过饱响应和食物响应6个维度得分在不同体重组间差异具有统计学意义(P<0.01),食物喜好和主动进食维度得分在不同体重组间差异无统计学意义(P>0.05)。阶层回归分析显示,当排除性别、年龄、母亲文化程度影响后,量表6个维度得分与儿童BMI具有相关性(P<0.01)。反映食物趋向的各维度得分与BMI呈正相关(β:0.09~0.21),反映食物逃避各维度得分与BMI呈负相关(β:-0.47~-0.36)。 结论 学龄前儿童饮食行为与超重/肥胖密切相关,通过干预儿童饮食行为可降低学龄前儿童超重/肥胖的风险。     

篮球锻炼对肥胖初中生体成分干预效果评价

  目的  探讨不同强度篮球锻炼对肥胖初中生体成分的干预效果,为肥胖初中生制定减肥降脂计划提供理论支持。  方法  2020年9—11月,运用典型抽样法,在武汉光谷实验中学抽取48名单纯性肥胖初中生为研究对象,将其分为大、中、小强度篮球训练组和对照组(各12名),对实验组进行为期12周,3次/周,45 min/次不同运动强度的篮球锻炼干预,对照组不做干预,并对干预前后体成分指标进行统计比较。  结果  经过12周小强度篮球锻炼后,肥胖初中生体脂百分比干预后(32.16±2.26)%与干预前(34.44±2.35)%相比差异有统计学意义(t=3.52,P < 0.05),体重、BMI、腰围、骨骼肌干预前后差异均无统计学意义(t值分别为2.31,1.98,1.26,-1.65,P值均 > 0.05)。中强度篮球锻炼对肥胖初中生的体重、体质量指数(BMI)、体脂百分比和腰围在干预前后差异均有统计学意义(t值分别为3.44,3.76,6.56,2.45,P值均 < 0.05)。高强度篮球锻炼后,所有指标干预前后差异均有统计学意义(t值分别为4.14,5.18,11.26,5.89,-2.56,P值均 < 0.05)。  结论  12周篮球锻炼可以有效地改善肥胖初中生体成分的各项指标,高强度篮球锻炼的效果最好,其次为中、小强度,锻炼强度越大效果越好。     

绘画疗法改善肥胖女大学生抑郁的实验研究

目的探讨绘画艺术疗法改善肥胖女大学生抑郁情绪的有效性,为提高肥胖女大学生的学习和生活质量提供依据。方法在大学生中招募志愿者16名随机分为2组:8人为实验组,8人为对照组。实验组参加团体绘画艺术疗法,每周1次,每次2 h,共8次;对照组不采取任何干预。以抑郁自评量表(SDS)、症状自评量表(SCL-90)抑郁项和自尊量表(SES)为测量工具,在团体干预实施前、实施后1周对被试进行测量。结果与对照组相比,实验组被试在干预前后的抑郁自评量表得分显著下降(t=6.75,P<0.01);SCL-90抑郁项均分干预前后比较差异有统计学意义(t=4.32,P<0.05)。实验组被试在干预后的自尊量表得分显著提高(t=5.43,P<0.01)。结论绘画艺术疗法是干预肥胖女大学生抑郁症状的有效途径之一。     

父母教养方式对医学生心理中介因素的影响

目的 探讨父母教养方式与医学生心理健康的中介因素（如个性、自尊、应对方式和心理控制感）之间的关系,从而为大学生心理健康的干预研究提供整合性研究依据.方法 选取786名医学生进行父母教养方式[EMBU]、个性（16PF）、自尊量表（SES）、简易应对方式问卷（SCSQ）、心理控制感（IPC）等问卷测试.结果 医学生组与中文修订版组相比,医学生组的父母教养方式各因子分均低于修订版中文组;父母教养方式对医学生的个性、自尊、应对方式和心理控制感都存在显著性的相关;多元逐步回归分析显示,父母的情感温暖理解（FF1、MF1）、父亲的过度保护（FF6）、母亲的拒绝否认（MF3）和惩罚严厉（MF4）对医学生的个性、自尊、应对方式和心理控制感的影响最大.结论 父母教养方式对医学生的个性、自尊、应对方式和心理控制感有较好的预测效应.     

Computer-mediated intervention tailored on transtheoretical model stages and processes of change increases fruit and vegetable consumption among urban African-American adolescents

PURPOSE: To examine the efficacy of an intervention based on the transtheoretical model (TTM) for increasing fruit and vegetable consumption among economically disadvantaged African-American adolescents. DESIGN: Pretest-posttest quasi-experimental study. SETTING: Youth services agencies located in New York, New Jersey, and Pennsylvania. Agencies were assigned to computer intervention (CIN) and nonintervention control study arms. SUBJECTS: A total of 507 African-American adolescents ages 11 to 14 years. INTERVENTION: Youths in the CIN arm completed four 30-minute intervention sessions tailored on TTM stages and processes of change. MEASURES: Self-reported fruit and vegetable consumption and stages, pros, cons, and self-efficacy for consumption. ANALYSIS: Intervention effects were examined with analysis of covariance models that were controlled for demographic variables and baseline measures of each outcome. Chi-square analyses were used to examine between-arm differences in youths' stage progressions. RESULTS: After adjustment by covariates, pros (p < .025) and fruit and vegetable consumption (p < .001) varied significantly with study arm. Youths in the CIN arm had higher pro scores and fruit and vegetable consumption than controls. More youths in the CIN arm than in the control arm progressed to later stages and maintained recommended intake levels (p < .05). CONCLUSIONS: A TTM-based intervention can increase fruit and vegetable intake and effect positive changes in TTM variables related to intake among economically disadvantaged African-American adolescents.     

Perception of overweight and obesity among Portuguese adolescents: an overview of associated factors

PURPOSE: A national, representative school-based sample of Portuguese youth was used to both identify psychosocial indicators that distinguish obese and overweight adolescents from their peers, and key explainers of body image among obese and overweight adolescents. METHODS: Data on 5697 sixth, eighth and tenth grade public school students, age 11-16 years, from Portugal who participated in the 1998 (HBSC/WHO) survey of adolescent health were analysed. Body mass index (BMI) was calculated based on self-reported weight and height. Body image was measured using a body image tool with a sequence of seven body silhouettes progressing from very thin to overweight. BMI was calculated by reported weight/height (kg/m2), and was categorized based on Cole normalization curve. Adolescents whose BMI was above the 95th percentile (obese) and those with a BMI between 85 and 95 (overweight) were compared with the remainder. Separate analyses of psychosocial variables were conducted by gender, using the chi2-test, t-tests, ANOVA and multiple linear regression. RESULTS: There was a significant difference in physical activity between obese and non-obese youth (P<0.05). Girls reported dieting more than boys (P<0.001), with 15.3% of overweight teens dieting versus 6% of non-overweight teens. Those classified as overweight were significantly more likely to describe themselves as not healthy (P<0.001). A significantly greater proportion of obese/overweight versus non-overweight youth reported difficulty in making friends (P<0.001). BMI (beta=0.491; P=0.000), age (beta=-0.413; P=0.000), involvement in dieting (beta=0.110; P=0.000) and attitude toward appearance (beta=0.032; P=0.007) were significantly associated with body image. CONCLUSIONS: Inaccurate perceptions of the need to diet, poorer self-perceived health status and potential social isolation of those who are overweight were found. The importance of these findings to health promotion strategies is discussed.     

山东省某重点中学高中生考试焦虑自身因素相关的分析

目的探讨高中生考试焦虑的自身相关因素。方法应用考试焦虑量表(TAS)、艾森克个性问卷(EPQ)之成人版本、自尊量表(SES)和应付方式问卷对山东省某重点中学高中523名学生进行调查。结果高中生TAS总分与EPQ的精神质因子分和情绪稳定性因子分呈显著正相关(P<0.001),而与内外向因子分呈显著负相关(P<0.001)。TAS总分与自尊量表总分呈显著负相关(P<0.001)。同时TAS总分与应付方式问卷的自责、幻想、合理化因子分呈显著正相关(P<0.001)。结论高中生考试焦虑的发生与其个性特征、自尊水平和应对方式密切相关。     

Gender, ethnicity, culture and social class influences on childhood obesity among Australian schoolchildren: implications for treatment, prevention and community education

The aim of the study was to explore the associations between obesity, weight perceptions and gender, ethnicity, culture and social class in a large national study of Australian school children. Primary and high schools (N = 47) were recruited from every state and territory of Australia and included 7889 children from government, private and Catholic schools (82% response rate) in August-November, 2006. The socioeconomic status (SES) of schools was based on a government survey of total family income. A questionnaire completed by students, measured demographic details of gender, age, weight perceptions and ethnic/cultural background. Height and weight were measured by trained research assistants. Outcome measures included body mass index (BMI), prevalence of obesity, overweight, weight perceptions. Prevalence of obesity was 6.4% of males and 5.6% of females in primary school students (P = 0.34). More high school males were obese than females (7.7% vs. 5.7%, P = 0.001). Obesity was more prevalent among students from Pacific Islander backgrounds. Adolescents who were most likely to be obese were boys and girls of low SES or Pacific Islander or Middle Eastern/Arabic background. The least likely to be obese were Anglo/Caucasian or Asian students and in particular, the girls. Obese female adolescents from Aboriginal, Middle Eastern/Arabic and Pacific Islander backgrounds were less likely than their Caucasian or Asian peers to perceive themselves as 'too fat'.Those working in clinical, community or educational settings with young people and in particular, obese young people, should be aware that obesity is likely to be more prevalent, more culturally acceptable and perhaps more desirable among children and teens from low SES communities and/or Middle Eastern and Pacific Islander backgrounds. Health and social work professionals should be careful not to exaggerate the risks of overweight or obesity or inadvertently create weight concerns among young people. The different body image perceptions identified in this study should be taken into account when planning clinical, community or preventive initiatives among children or adolescents from varying ethnic groups.     

沈阳市与绍兴市不同肥胖程度青少年脑力负荷前后Stroop测验研究

目的通过观察脑力负荷前后肥胖青少年Stroop测验中各任务条件下耗时数的变化,初步探讨分析肥胖青少年的部分认知功能。方法采用方便取样,最终254名学生纳入分析,根据体质指数(BMI)进行肥胖程度划分。以韦氏智力量表测试60～70min作为脑力活动负荷,负荷前后分别进行Stroop测验。结果脑力活动负荷前,3组学生Stroop测验各指标的耗时数分别进行比较发现,肥胖组和超重组字色矛盾耗时数明显高于正常组(P<0.05)。脑力活动负荷后,肥胖组和超重组纯颜色和字色无关的耗时数均高于正常组(P<0.05),并且随着BMI Z分的增加,3个指标的耗时数均增加。结论青少年超重和肥胖可明显影响Stroop实验相关认知加工过程,且BMI Z分越高,这种认知加工受累越明显。     

Validation of self-reported height and weight in fifth-grade Korean children

Height and weight are important indicators to calculate Body Mass Index (BMI); measuring height and weight directly is the most exact method to get this information. However, it is ineffective in terms of cost and time on large population samples. The aim of our study was to investigate the validity of self-reported height and weight data compared to our measured data in Korean children to predict obese status. Four hundred twenty-two fifth-grade (mean age 10.5 ± 0.5 years) children who had self-reported and measured height and weight data were final subjects for this study. Overweight/obese was defined as a BMI of or above the 85th percentile of the gender-specific BMI for age in the 2007 Korean National Growth Charts or a BMI of 25 or higher (underweight : < 5th, normal : ≥ 5th to < 85th, overweight : ≥ 85th to < 95th). The differences between self-reported and measured data were tested using paired t-test. Differences based on overweight/obese status were tested using analysis of variance (ANOVA) and linear trends. Pearson''s correlation and Cohen''s kappa were tested to examine agreements between the self-reported and measured data. Although measured and self-reported height, weight and BMI were significantly different and children tended to overreport their height and underreport their weight, the correlation between the two methods of height, weight and BMI were high (r = 0.956, 0.969, 0.932, respectively; all P < 0.001), and both genders reported their overweight/non-overweight status accurately (Cohen''s kappa = 0.792, P < 0.001). Although there were differences between the self-reported and our measured methods, the self-reported weight and height was valid enough to classify overweight/obesity status correctly, especially in non-overweight/obese children. Due to bigger underestimation of weight and overestimation of height in obese children, however, we need to be aware that the self-reported anthropometric data were less accurate in overweight/obese children than in non-overweight/obese children.     

基于手机应用程序的膳食干预对超重或肥胖人群减重及食物成瘾的影响

目的探讨基于手机应用程序(application,APP)的膳食干预对成年超重或肥胖人群减重及食物成瘾的影响。方法收集2015年8月至2018年1月宁波市第一医院肥胖多学科联合门诊的18岁以上超重或肥胖者101例作为研究对象。受试者接受健康宣教和个体化饮食指导,并通过智能手机体重管理APP上交饮食日志,营养师对饮食不达标的受试者进行指导和纠正12周。在干预前和干预后(12周)分别进行询问调查、体格检查、实验室检查及耶鲁食物成瘾量表问卷调查,比较干预前后受试者的体重、食物成瘾症状计数得分及食物成瘾者比例的变化情况。分别采用配对资料的t检验、卡方检验或Fisher精确检验对体成分测量值、血生化指标以及症状计数得分进行统计学检验。结果共纳入101例超重或肥胖受试者,男性31例,女性70例,年龄为(30.4±7.3)岁,体质指数(BMI)为(32.76±4.46)kg/m2,体重为(89.95±17.12)kg,食物成瘾者占比为26.73%。通过手机APP膳食干预12周后,患有食物成瘾的人数从27例减至14例,比例下降了12.9%,症状计数≥3的比例从41.6%下降到19.8%(χ2=5.17、11.26,均P<0.01),症状计数由2.25±1.61下降到1.50±1.31(t=3.64,P<0.001);同时,体重、BMI和腰围较干预前分别下降了(6.54±1.03)kg、(2.35±0.36)kg/m2、(6.50±0.86)cm(t=6.36、5.62、3.78,均P<0.001);代谢指标如空腹血糖、胰岛素抵抗指数和低密度脂蛋白胆固醇显著改善,分别下降了(0.38±0.10)mmol/L、1.83±0.46、(0.22±0.75)mmol/L(t=3.67、3.59、2.97,均P<0.01)。结论基于智能手机APP的膳食干预能有效改善超重和肥胖人群的血糖、血脂水平,减少内脏脂肪堆积,减轻胰岛素抵抗程度,改善食物成瘾状态。