免费暑期活动与低收入家庭学童的体重指数

IF 24.7 1区 医学 Q1 PEDIATRICS
Michael W. Beets, Sarah Burkart, Christopher Pfledderer, Elizabeth Adams, R. Glenn Weaver, Bridget Armstrong, Keith Brazendale, Xuanxuan Zhu, Brian Chen, Alexander McLain
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Secondary analyses examined the dose response of zBMI change with parent-reported child attendance at SDCs during the summer for all children (intervention and control).ResultsA total of 422 children (mean [SD] age, 8.2 [1.5] years; 202 [48%] female, 220 [52%] male, 292 [69%] at or below 200% federal poverty level, 127 [30%] with food insecurity) were randomized to 1 of 2 conditions: summer as usual (control, n = 199) or free SDC (n = 223). Intent-to-treat analysis indicated mean (SE) change in zBMI at the end of the summer was 0.046 (0.027) for the control and −0.048 (0.025) for the intervention group, representing a significant between-group difference of −0.094 (95% CI, −0.166 to −0.022). 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引用次数: 0

摘要

重要性在学校停课的暑假期间,儿童的体重指数(BMI)会加速上升。低收入家庭的儿童最容易受到影响。夏季体重指数加速上升可能是由于取消了学校提供的促进健康的结构。在夏季,一种常见的促进健康的结构形式是夏令营(SDCs)。夏令营主要是收费服务,这给低收入家庭的儿童造成了经济障碍。研究免费使用现有的社区日间夏令营是否能缓解小学适龄儿童体重指数 z 值(zBMI)的加速增长。这项随机临床试验于 2021 年、2022 年和 2023 年夏季在美国东南部进行。参与者是来自低收入家庭为主的儿童(幼儿园至四年级),他们被随机分配到由公园和娱乐委员会运营的 SDC 或照常过暑假(对照组)。主要结果和测量主要结果是在放学前(5 月)和暑假返校时(8 月底)测量的 zBMI 变化的组间差异。结果共有 422 名儿童(平均 [SD] 年龄,8.2 [1.5] 岁;202 [48%] 名女性,220 [52%] 名男性,292 [69%] 名处于或低于 200% 的联邦贫困水平,127 [30%] 名存在食物不安全问题)被随机分配到两种条件中的一种:夏季照常(对照组,n = 199)或免费 SDC(n = 223)。意向治疗分析表明,夏季结束时,对照组 zBMI 的平均变化(SE)为 0.046 (0.027),干预组为 -0.048 (0.025),组间差异显著,为 -0.094 (95% CI, -0.166 to -0.022)。剂量-反应分析表明,每周参加 SDC 的时间每增加一天,zBMI 就会减少-0.034 到-0.018,这意味着从未参加过暑期活动的儿童的zBMI增加了 0.046 到 0.080,而每个工作日参加暑期活动的儿童的zBMI减少了-0.09 到-0.04。未来的研究应在不同地区重复这些发现,并确定最佳的编程剂量,以减轻不健康的 zBMI 增长:NCT04072549
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Free Summer Programming and Body Mass Index Among Schoolchildren From Low-Income Households
ImportanceChildren experience accelerated gains in body mass index (BMI) during the summer months when school is not in session. Children from low-income households are most susceptible. Accelerated BMI gain in summer may be due to the removal of the health-promoting structure provided by schools. During summer, a common form of health-promoting structure is summer day camps (SDCs). Summer day camps are predominately fee for service, which creates a financial barrier for children from low-income households. One solution to mitigate accelerated BMI gain is providing free access to an existing SDC.ObjectiveTo investigate whether providing free access to an existing community SDC can mitigate accelerated BMI z score (zBMI) gain in elementary school–age children.Design, Setting, and ParticipantsThis randomized clinical trial was conducted during the summers of 2021, 2022, and 2023 in the southeastern United States. Participants were children (kindergarten through fourth grade) from predominantly low-income households who were randomized to attend an SDC operated by a parks and recreation commission or continue summer as usual (control).InterventionFree SDC every weekday (Monday through Friday) for 8 to 10 weeks.Main Outcomes and MeasuresThe primary outcome was between-group differences in change of zBMI measured before school ended (May) and on return to school from summer (late August). Secondary analyses examined the dose response of zBMI change with parent-reported child attendance at SDCs during the summer for all children (intervention and control).ResultsA total of 422 children (mean [SD] age, 8.2 [1.5] years; 202 [48%] female, 220 [52%] male, 292 [69%] at or below 200% federal poverty level, 127 [30%] with food insecurity) were randomized to 1 of 2 conditions: summer as usual (control, n = 199) or free SDC (n = 223). Intent-to-treat analysis indicated mean (SE) change in zBMI at the end of the summer was 0.046 (0.027) for the control and −0.048 (0.025) for the intervention group, representing a significant between-group difference of −0.094 (95% CI, −0.166 to −0.022). Dose-response analyses indicated that every 1 day per week increase in attending an SDC resulted in a −0.034 to −0.018 zBMI reduction, which translates to a gain of 0.046 to 0.080 zBMI for children never attending summer programming vs −0.09 to −0.04 zBMI reduction for children attending summer programming every weekday.Conclusions and RelevanceProviding children free access to existing community summer programming can have a meaningful effect on children’s zBMI gain during the summer. Future studies should replicate these findings across different regions and identify the optimal dose of programming to mitigate unhealthy zBMI gains.Trial RegistrationClinicalTrials.gov Identifier: NCT04072549
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来源期刊
JAMA Pediatrics
JAMA Pediatrics PEDIATRICS-
CiteScore
31.60
自引率
1.90%
发文量
357
期刊介绍: JAMA Pediatrics, the oldest continuously published pediatric journal in the US since 1911, is an international peer-reviewed publication and a part of the JAMA Network. Published weekly online and in 12 issues annually, it garners over 8.4 million article views and downloads yearly. All research articles become freely accessible online after 12 months without any author fees, and through the WHO's HINARI program, the online version is accessible to institutions in developing countries. With a focus on advancing the health of infants, children, and adolescents, JAMA Pediatrics serves as a platform for discussing crucial issues and policies in child and adolescent health care. Leveraging the latest technology, it ensures timely access to information for its readers worldwide.
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