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A new Iowa State University study found that a family, school and community intervention program helps children live healthier lives and could be a new tool in the fight against the nation's childhood obesity epidemic. In the study, children who participated in The Switch? program -- a program developed by the Minneapolis-based National Institute on Media and the Family （NIMF） -- watched an average of two fewer hours of television and also consumed two more servings of fruits and vegetables per week than those who weren't in the program. Program participants also walked 300 more steps per day.
"The successes in this study were modest, which is what one would expect," said Iowa State Assistant Professor of Psychology Douglas Gentile, the lead researcher and director of research for NIMF. "People usually make incremental changes, but those add up over time."
In addition to Gentile, the 10-member research team included ISU researchers Greg Welk, an associate professor of kinesiology; and Dan Russell, a professor of human development and family studies; as well as former Iowa State kinesiology professor Joey Eisenmann. The research team authored a paper on their results, which has been posted online in BMC Medicine Evaluation, a professional journal in the United Kingdom.
The researchers evaluated the eight-month intervention program in a group of 1,323 students （third, fourth and fifth graders） and their parents from 10 schools -- split between Lakeville,Minn. and Cedar Rapids,Iowa.Measures of the key behaviors were collected three times from the children -- prior to administering the program, immediately after it was completed, and six months following its completion.
The Switch? program encourages children to "Switch what they Do, View and Chew?" and features three components: community, school and family. The community component promotes awareness of the importance of healthy lifestyles using paid advertising, such as billboards; and unpaid media, including editorials. The school component reinforces the Switch messages by providing teachers with materials and methods to integrate key health concepts into the school day. And in the family component, participating families receive monthly packets containing behavioral tools to assist them in altering their health behaviors.
"The program is designed to be a more comprehensive approach to childhood obesity prevention," Gentile said. "It results from several lessons we learned, while creating interventions over the past 15 years. One is that focusing on kids can work, but unless the family's on board, you're not going to get much movement. So the ideal program would be to work at multiple ecological levels all at once so that people are getting repeated, parallel, overlapping messages at the individual, family and community levels."
Gentile reports that the positive effects on children remained significant at the six-month follow-up evaluation, indicating maintenance of these differences over time. In fact, they increased slightly following the intervention, which may contribute to reduced weight risks in the future.
"To me, the strongest finding is that we found stronger results in the six-month follow-up than at the end of the intervention -- and that's unique," said ISU's Welk, who studies exercise and health. "That would imply that the lessons took hold after the intervention and families have had time to apply them to their lives."
The ISU researchers are planning further analysis of the data gathered in this research for future studies, including one that will explore a "booster" component of The Switch? program.
爱荷华州立大学的一项新的研究发现：家庭、学校和社区干预系统有助于孩子们更健康的生活，也是应对国家儿童流行性肥胖症的一种有效措施。此研究课题在明尼阿波利斯市进行，并得到美国国家媒体与家庭学会的支持。参加Switch研究课题实验的孩子们平均看电视时间是两个多小时，此外，每个星期他们比没有参加实验的孩子多吃两份水果蔬菜，每天多走300多步路。
美国国家媒体与家庭学会的负责人道格拉斯。詹蒂莱是此项研究的带头人，他的助教说："研究的结果比较满意，正如人们所预料的那样。平时人们生活有所变化都是渐进发生的，但此研究中的变化却是长时间的积累形成的。"
研究小组共10个人，除了詹蒂莱外，还包括爱荷华州立大学的运动机能学副教授格瑞格。威尔克，人类发展与家庭研究专家丹。罗素，以及爱荷华州立大学退休的运动机能学教授乔伊。艾斯曼。该研究小组已把他们的研究成果撰写成论文，发表在英国专业刊物BMC评价网上。
研究人员在拉克维拉吉、明尼苏达州、塞达拉皮兹州和爱荷华州四个州的10个学校里挑选了1323名学生被试（三、四和五年级学生）,对他们和他们的家长进行了长达8个月的干预后， 进行了评估。此实验共进行了三次测试，分别在实施项目前、干预项目实施后、六个月后实施测验，收集到了重要的数据。
Switch?课题研究把社区、学校和家庭三个部分作为测验实施的环境特点，鼓励孩子们从事多种活动，多看多想。社区部分要利用公告牌之类的付费广告和免费媒体，包括人们的各种评论，增强孩子们对健康生活方式重要性的意识。学校部分就是通过提供给教师设备和方法，把Switch课题中主要的健康理念纳入到学校每一天，以强化孩子们头脑中的信息。参与实验的家庭每月会收到一些信息包，包括一些改变行为的方法，有助于孩子们形成健康的行为。
詹蒂莱表示"该研究课题实施的目的就是为了寻找一个更全面的方法，预防儿童肥胖。这个计划的实施得益于建立干预措施15年以来得到经验和教训，有一点就是，研究中如果家长不参与的话，孩子们就得不到足够的运动，因而关注孩子们自身效果不是很好。所以， 理想的研究课题是在多生态层面同时展开，这样人们会得到来自个人、家庭和社区的平行而又重复交叉的信息。
詹蒂莱说，6个月后的随访评估中，Switch课题研究中的测试对儿童的积极影响仍然很大，这说明随着时间的推移，被试儿童与其他儿童的差异仍然保持。事实上，研究人员稍微增加了后续干预，这可以降低将来体重减轻时带来的危险。
爱荷华州立大学研究锻炼与健康关系的威尔克教授说："对我来说，最重要是我们在六个月的随访跟踪调查中得到了比干预程序结束时更理想的结论，那是唯一的。这意味着对孩子们实施干预程序是有效果的，且效果得到保持，而且每个家庭有时间把这个项目应用到孩子们的生活中。"
爱荷华州立大学的研究者们正计划着对这次研究中收集到的数据做进一步分析，以备将来更深入的研究，其中包括Switch课题中的一个支持系统。
