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上海市某區(qū)小學生的超重肥胖綜合干預效果評價

發(fā)布時間:2018-08-16 18:24
【摘要】:目的:1評價兒童營養(yǎng)健康教育及身體活動干預對其營養(yǎng)知識、態(tài)度,飲食行為及肥胖率的作用。2開發(fā)、制作開展小學生營養(yǎng)健康教育的課件與宣傳材料(針對教師、學生、家長)。3提高項目學校學生及其家長、老師和領導的營養(yǎng)健康知識水平,培養(yǎng)小學生健康的生活方式。4.探索兒童肥胖的綜合防控技術,從而制定兒童肥胖的有效干預模式,為兒童肥胖的有效防控提供科學依據。 方法:本研究是一項在學校里進行的隨機對照干預試驗,干預時間為1年,干預措施主要包括健康教育和身體活動兩方面。采用整群隨機抽樣方法,在上海市松江區(qū)抽取4所小學,其中3所作為干預校實施干預,1所作為對照校,在每所學校2-4年級中,每年級隨機抽取2個班的小學生做效果評價。對1015名學生(干預組786人,對照組229人)實施為期1年的干預。干預前和干預后對所有研究對象及其家長、教師進行肥胖相關知信行問卷調查,對小學生進行體格檢查,包括身高、體重和血紅蛋白等。 結果:干預前:①小學生的超重率10.3%,肥胖率為10.1%,其中男生的超重率為12.1%,肥胖率為12.6%;女生的超重率為8.1%,肥胖率為7.0%;男生的超重率和肥胖率均高于女生(P0.01)。小學生的血紅蛋白平均值為133.85±9.38g/L,其中貧血(血紅蛋白120g/L)的比例為4.9%。②小學生的營養(yǎng)知識題目中有4道題目(共12題)的正確率低于80%;每天堅持吃早餐的小學生占83.3%;平均每天至少喝一次奶制品的孩子占50.6%;在最近一個月,至少吃一次西式快餐的占53.8%;小學生營養(yǎng)相關知識最主要的和最希望獲得的來源均是“家長”;小學生最常吃的零食排名前三位是“新鮮蔬菜、水果”、“奶及奶制品”和“谷類”,最常喝的飲料排名前三位是“茶飲料”、“純牛奶及酸奶”和“果蔬飲料”;小學生的營養(yǎng)相關知識、健康行為態(tài)度和飲食行為三者之間呈正相關關系。③家長的營養(yǎng)知識題目中有3道題目(共12題)的正確率低于80%;每天堅持吃早餐的家長占76.0%,有84.9%的家長在家為孩子準備早餐;平均每天至少喝一次奶制品的家長占21.8%;在最近一個月,至少吃一次西式快餐的占45.8%;家長營養(yǎng)相關知識最主要的和最希望獲得的來源均是“電視、廣播”;家長最常吃為孩子準備的零食排名前三位是“新鮮蔬菜、水果”、“奶及奶制品”和“谷類”,最常為孩子準備的飲料排名前三位是“純牛奶及酸奶”、“含乳飲料”和“果蔬飲料”;家長的文化程度與營養(yǎng)相關知識、健康行為態(tài)度和飲食行為之間呈正相關關系;家長在營養(yǎng)相關知識、健康行為態(tài)度、飲食行為三個方面與小學生之間均存在正相關關系。④教師的營養(yǎng)知識題目中有2道題目(共12題)的正確率低于80%;每天堅持吃早餐的教師占58.5%;平均每天至少喝一次奶制品的教師占22.7%;在最近一個月,至少吃一次西式快餐的占37%;教師營養(yǎng)相關知識最主要的的來源是“報刊、雜志、書籍”,最希望獲得的途徑是“專家指導”。干預效果評價:①干預后,干預組小學生超重率上升0.9%,肥胖率下降2.1%,但差異無統(tǒng)計學意義。干預組小學生血紅蛋白值上升了1.25g/L,而對照組有所下降;兩組小學生貧血率均下降,差異均無統(tǒng)計學意義。②干預后,干預組小學生、家長及教師的肥胖相關知識、態(tài)度、行為得分的增長率顯著高于對照組,且差異具有統(tǒng)計學意義。干預組得分增長率小學生分別為8.2%,9.7%,10.0%;家長4.6%,2.6%,5.7%;教師8.6%,6.9%,11.0%。 結論:小學生及家長對營養(yǎng)相關知識及健康行為觀點有普遍性的了解,但部分題目仍存在誤區(qū),家長對子女在營養(yǎng)知識、健康行為態(tài)度及飲食行為方面都有一定的影響。以營養(yǎng)健康教育和“快樂十分鐘”為主的綜合干預措施,對小學生超重肥胖率有一定的效果,同時也對改善小學生及其家長、教師的營養(yǎng)知識、健康行為態(tài)度和飲食行為起到了一定作用,對兒童肥胖的防控起到積極作用,但需長期堅持并評價其效果。
[Abstract]:Objective: 1. To evaluate the effect of nutritional health education and physical activity intervention on nutritional knowledge, attitude, dietary behavior and obesity rate of children. 2. To develop courseware and propaganda materials for nutritional health education of primary school students (for teachers, students, parents). 3. To improve nutritional health knowledge of students and their parents, teachers and leaders. 4. To explore the comprehensive prevention and control technology of childhood obesity, so as to formulate an effective intervention model for childhood obesity, and provide a scientific basis for the effective prevention and control of childhood obesity.
Methods: A randomized controlled intervention study was conducted in a school for one year. The intervention included health education and physical activity. Four primary schools in Songjiang District of Shanghai were selected by cluster random sampling method. Three of them were used as intervention schools and one was used as control school, and 2-4 in each school. 1,015 pupils (786 in the intervention group and 229 in the control group) were intervened for one year. Before and after the intervention, all the subjects and their parents and teachers were surveyed with obesity-related knowledge, beliefs and behaviors questionnaire, and the pupils were examined by physical examination, including height, weight and blood. Red protein and so on.
Results: Before the intervention, the overweight rate was 10.3% and the obesity rate was 10.1%. The overweight rate was 12.1% for boys and 12.6% for girls, 8.1% for girls and 7.0% for obesity. The overweight rate and obesity rate of boys were higher than those of girls (P 0.01). The average hemoglobin level of pupils was 133.85 + 9.38 g/L, including anemia (hemoglobin 12.1%). (2) The correct rate of 4 nutritional knowledge questions (12 questions) was lower than 80%; 83.3% of the pupils insisted on eating breakfast every day; 50.6% of the children drank milk products at least once a day; 53.8% of the pupils ate western fast food at least once in the last month; and the pupils had the most nutritional knowledge. The top three snacks for pupils were "fresh vegetables, fruits", "milk and dairy products" and "cereals". The top three drinks for pupils were "tea drinks", "pure milk and yoghurt" and "fruit and vegetable drinks"; nutrition-related knowledge and health of pupils. There was a positive correlation between behavior attitude and dietary behavior. 3) The correct rate of three nutritional knowledge questions (12 questions) was less than 80%; 76.0% of the parents who insisted on eating breakfast every day, 84.9% of the parents prepared breakfast for their children at home; 21.8% of the parents who drank dairy products at least once a day on average; and in the last month, Forty-five.8 percent of parents ate at least one Western-style snack; the most important sources of nutrition-related knowledge and wishes were "TV, radio"; the top three snacks for children were "fresh vegetables, fruits", "milk and dairy products" and "cereals", and the top three drinks for children were the most frequently prepared snacks. It is "pure milk and yoghurt", "milk-containing beverage" and "fruit and vegetable beverage". Parents'educational level is positively correlated with nutrition-related knowledge, healthy behavior attitude and dietary behavior. Parents' nutrition-related knowledge, healthy behavior attitude and dietary behavior are positively correlated with primary school students. Among the nutritional knowledge questions, the correct rate of two questions (12 questions altogether) was less than 80%; 58.5% of the teachers insisted on eating breakfast every day; 22.7% of the teachers drank dairy products at least once a day; 37% of the teachers ate western fast food at least once a month; and the most important source of nutritional knowledge was "newspapers, magazines, books". Evaluation of intervention effect: 1. After intervention, the overweight rate of pupils in intervention group increased by 0.9%, and the obesity rate decreased by 2.1%, but there was no significant difference between the two groups. Significance. 2) After intervention, the growth rate of obesity-related knowledge, attitude and behavior scores of pupils, parents and teachers in intervention group was significantly higher than that of control group, and the difference was statistically significant.
Conclusion: Primary school students and their parents have a general understanding of nutrition-related knowledge and health behavior views, but some problems still exist misunderstandings. Parents have certain influence on their children's nutrition knowledge, health behavior attitude and dietary behavior. Overweight and obesity rate has a certain effect, but also to improve the nutritional knowledge of pupils and their parents, teachers, healthy behavior attitudes and dietary behavior has played a certain role in the prevention and control of obesity in children play a positive role, but long-term adherence and evaluation of its effect.
【學位授予單位】:復旦大學
【學位級別】:碩士
【學位授予年份】:2013
【分類號】:R723.14

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