健康教育对不同BMI学生脂类食物摄入行为心理的影响

Effects of health education on fat intake behaviors and its psychology in students with different

目的比较健康教育对不同BMI学生脂类食物摄入行为及其心理的影响，为进一步提升个性化健康教育提供依据。方法采取多阶段抽样方法抽取出浙江省两个地市的29个中学班级，超重肥胖组为29个班级中部分BMI超重或肥胖学生121人，正常组为29个班级中与超重肥胖组年龄、年级、性别基本匹配，基线行为阶段匹配的BMI正常学生242人。对两组学生同时进行以行为分阶段理论为基础的干预，量表采用青少年脂肪摄入心理测定量表中文版。采用卡方检验、t检验、非参数检验和二元Logistic回归分析数据。结果超重肥胖学生与正常BMI学生干预后行为阶段均有前进，但超重肥胖学生阶段前进比例更高。干预前超重肥胖学生的改变策略[（2．60±0．79）分]、正向效应[（3．58±0．90）分]与自我效能[（3．01±0．72）分]好于正常BMI学生[（2．34±0．86）分，（3．08±0．91）分，（2．79±0．81）分，P〈0．05]，干预后两组学生差别不显著。Logistic回归分析发现促进正常BMI学生阶段前进的是改变策略改变量（OR=2．168，95％CI：1．560±3．014），促进超重肥胖学生阶段前进的是自我效能改变量（OR=1．801，95％CI：1．026-3．159）。结论针对正常BMI学生要加强心理干预的力度和持续时间，而超重肥胖学生应结合社会支持理论来提升心理干预效果。

Objective To compare the effects of health education on fat intake behavior and its psychology in students with different BMI,provide evidence for improving individual healthy education.Methods A experimental epidemiology was used, Twenty-nine secondary school classes were randomly selected by multi-stage cluster sampling from two cities in Zhejiang province. Overweight or obesity group included all students who were judged overweight or obesity, normal group included students who were judged normal and basic matched by age, grade, sex and stage of baseline.Intervention based on transtheoretical mode was conducted on two groups and intervention results were measured by the adolescent fat intake behavior of psychological measurement scales （Chinese version）. Chi-square tests, T-tests, non-parameters tests and binary logistic regression were performed for data analyses. Results Stage of students with overweight or obesity and with normal BMI all moved forward after intervention,while the proportion of stage advance for students with overweight or obesity was further than students with normal BMI. Change strategy （ 2.60±0.79）, pros （ 3.58±0.90） and self-efficacy（3.01±0.72） of students with overweight or obesity better than students with normal BMI in baseline（ （2.34±0.86）, （3.08±0.91）, （2.79±0.81） ）while difference was not significant after intervention.Logistic regression analysis discovered that the promotion of change strategy moved stage forward for students with normal BMI（ OR= 2.168,95% CI ： 1.560-3.014） and promotion of self-efficiency moved stage forward for students with overweight or obesity（ OR= 1.801,95% CI ：1.026-3.159）. Conclusion The intensity and duration of psychological intervention is essential to be reinforced for students with normal BMI,while for students with overweight and obesity, psychological intervention should be promoted in combination with social support.