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.

    愛荷華州立大學(xué)的一項(xiàng)新的研究發(fā)現(xiàn)：家庭、學(xué)校和社區(qū)干預(yù)系統(tǒng)有助于孩子們更健康的生活，也是應(yīng)對(duì)國家兒童流行性肥胖癥的一種有效措施。此研究課題在明尼阿波利斯市進(jìn)行，并得到美國國家媒體與家庭學(xué)會(huì)的支持。參加Switch研究課題實(shí)驗(yàn)的孩子們平均看電視時(shí)間是兩個(gè)多小時(shí)，此外，每個(gè)星期他們比沒有參加實(shí)驗(yàn)的孩子多吃兩份水果蔬菜，每天多走300多步路。

    美國國家媒體與家庭學(xué)會(huì)的負(fù)責(zé)人道格拉斯。詹蒂萊是此項(xiàng)研究的帶頭人，他的助教說："研究的結(jié)果比較滿意，正如人們所預(yù)料的那樣。平時(shí)人們生活有所變化都是漸進(jìn)發(fā)生的，但此研究中的變化卻是長(zhǎng)時(shí)間的積累形成的。"

    研究小組共10個(gè)人，除了詹蒂萊外，還包括愛荷華州立大學(xué)的運(yùn)動(dòng)機(jī)能學(xué)副教授格瑞格。威爾克，人類發(fā)展與家庭研究專家丹。羅素，以及愛荷華州立大學(xué)退休的運(yùn)動(dòng)機(jī)能學(xué)教授喬伊。艾斯曼。該研究小組已把他們的研究成果撰寫成論文，發(fā)表在英國專業(yè)刊物BMC評(píng)價(jià)網(wǎng)上。

    研究人員在拉克維拉吉、明尼蘇達(dá)州、塞達(dá)拉皮茲州和愛荷華州四個(gè)州的10個(gè)學(xué)校里挑選了1323名學(xué)生被試（三、四和五年級(jí)學(xué)生）,對(duì)他們和他們的家長(zhǎng)進(jìn)行了長(zhǎng)達(dá)8個(gè)月的干預(yù)后， 進(jìn)行了評(píng)估。此實(shí)驗(yàn)共進(jìn)行了三次測(cè)試，分別在實(shí)施項(xiàng)目前、干預(yù)項(xiàng)目實(shí)施后、六個(gè)月后實(shí)施測(cè)驗(yàn)，收集到了重要的數(shù)據(jù)。

    Switch?課題研究把社區(qū)、學(xué)校和家庭三個(gè)部分作為測(cè)驗(yàn)實(shí)施的環(huán)境特點(diǎn)，鼓勵(lì)孩子們從事多種活動(dòng)，多看多想。社區(qū)部分要利用公告牌之類的付費(fèi)廣告和免費(fèi)媒體，包括人們的各種評(píng)論，增強(qiáng)孩子們對(duì)健康生活方式重要性的意識(shí)。學(xué)校部分就是通過提供給教師設(shè)備和方法，把Switch課題中主要的健康理念納入到學(xué)校每一天，以強(qiáng)化孩子們頭腦中的信息。參與實(shí)驗(yàn)的家庭每月會(huì)收到一些信息包，包括一些改變行為的方法，有助于孩子們形成健康的行為。

    詹蒂萊表示"該研究課題實(shí)施的目的就是為了尋找一個(gè)更全面的方法，預(yù)防兒童肥胖。這個(gè)計(jì)劃的實(shí)施得益于建立干預(yù)措施15年以來得到經(jīng)驗(yàn)和教訓(xùn)，有一點(diǎn)就是，研究中如果家長(zhǎng)不參與的話，孩子們就得不到足夠的運(yùn)動(dòng)，因而關(guān)注孩子們自身效果不是很好。所以， 理想的研究課題是在多生態(tài)層面同時(shí)展開，這樣人們會(huì)得到來自個(gè)人、家庭和社區(qū)的平行而又重復(fù)交叉的信息。

    詹蒂萊說，6個(gè)月后的隨訪評(píng)估中，Switch課題研究中的測(cè)試對(duì)兒童的積極影響仍然很大，這說明隨著時(shí)間的推移，被試兒童與其他兒童的差異仍然保持。事實(shí)上，研究人員稍微增加了后續(xù)干預(yù)，這可以降低將來體重減輕時(shí)帶來的危險(xiǎn)。

    愛荷華州立大學(xué)研究鍛煉與健康關(guān)系的威爾克教授說："對(duì)我來說，最重要是我們?cè)诹鶄�(gè)月的隨訪跟蹤調(diào)查中得到了比干預(yù)程序結(jié)束時(shí)更理想的結(jié)論，那是唯一的。這意味著對(duì)孩子們實(shí)施干預(yù)程序是有效果的，且效果得到保持，而且每個(gè)家庭有時(shí)間把這個(gè)項(xiàng)目應(yīng)用到孩子們的生活中。"

    愛荷華州立大學(xué)的研究者們正計(jì)劃著對(duì)這次研究中收集到的數(shù)據(jù)做進(jìn)一步分析，以備將來更深入的研究，其中包括Switch課題中的一個(gè)支持系統(tǒng)。