Abstract：
Health promotion from an early age is key to preventing unhealthy weight development in childhood, and parental involvement is essential. The school-based Healthy School Start intervention aims to promote healthy dietary and activity habits in the home environment and prevent child obesity through parental support. This study evaluated the effectiveness of the third iteration of the programme on children\'s dietary and activity behaviours, and body composition through a cluster-randomised controlled trial. The trial included 17 schools (8 intervention) in disadvantaged areas in mid-Sweden with 353 families with 5- to 7-year-old children. The primary outcomes were intake of selected healthy and unhealthy foods and beverages measured using photography. Secondary outcomes were physical activity and sedentary time measured by accelerometry, and measured weight and height. All outcomes were assessed at baseline and post-intervention (8 months). Linear multi-level regression showed significant favourable effects of the intervention for intake of sweet beverages (b = - 0.17, p = 0.04), intake of healthy foods (b = 0.11, p = 0.04), and more time in moderate to vigorous physical activity during weekdays (b = 5.68, p = 0.02). An unfavourable sub-group effect of the intervention was found for children from families with low education regarding sedentary time on weekends (b = 23.04, p = 0.05). The results align with the previous two trials of the programme, indicating that school-based parental support is a useful approach for health promotion in young children in disadvantaged areas. Trial registration: ClinicalTrials.gov: No. NCT03390725, retrospectively registered on January 4, 2018, https://clinicaltrials.gov/ct2/show/NCT03390725 .
摘要：
从小促进健康是防止儿童不健康体重发展的关键，父母的参与至关重要。基于学校的健康学校开始干预旨在促进家庭环境中的健康饮食和活动习惯，并通过父母的支持预防儿童肥胖。这项研究评估了该计划第三次迭代对儿童饮食和活动行为的有效性，和身体成分通过一项集群随机对照试验。该试验包括瑞典中部贫困地区的17所学校（8所干预措施），其中353个家庭有5至7岁的儿童。主要结果是使用摄影测量的选定健康和不健康食品和饮料的摄入量。次要结果是通过加速度测量法测量的身体活动和久坐时间，测量体重和身高。在基线和干预后（8个月）评估所有结果。线性多水平回归显示了干预对甜味饮料摄入的显着有利效果（b=-0.17，p=0.04），健康食品的摄入量（b=0.11，p=0.04），工作日进行中等至剧烈体育锻炼的时间更长（b=5.68，p=0.02）。对于周末久坐时间受教育程度低的家庭的儿童，发现干预措施具有不利的亚组效应（b=23.04，p=0.05）。结果与该计划的前两项试验一致，这表明，以学校为基础的父母支持是促进贫困地区幼儿健康的有用方法。试用注册：ClinicalTrials.gov：编号NCT03390725，于2018年1月4日回顾性注册，https://clinicaltrials.gov/ct2/show/NCT03390725。
