综合干预改善儿童体形认知准确性的效果研究

Effect of a comprehensive intervention to improve the accuracy of children’s body size perception

目的 探讨综合干预对儿童体形认知准确性的改善效果,为建立儿童正确的体形认知提供理论依据。方法 采用整群分层随机抽样方法,按行政区进行分层,对北京、长治、乌鲁木齐24所小学四年级1 287名儿童进行综合干预(2018年9月-2019年6月),干预组12所学校648名学生,对照组12所学校639名学生。通过“Ma体形图”测量体形认知准确性,采用线性混合模型分析综合干预对儿童体形认知准确性的作用。结果 基线时,干预组和对照组儿童的体形认知准确率分别为56.6%和51.5%,体形低估率分别为42.0%和47.7%,体形高估率分别为1.4%和0.8%。干预后,与对照组相比,干预组儿童体形认知不准确率(OR=0.50,95%CI=0.37~0.68,P<0.01)和体形低估率下降(OR=0.37,95%CI=0.26~0.54,P<0.01),体形高估率在两组间差异无统计学意义(P=0.51)。分层分析结果显示,干预对不同性别、营养状况、地区、独生/非独生子女儿童的体形认知准确性均有改善作用(交互项P值均>0.05)。结论 儿童的体形认知不准确率较高,以体形低估为主。综合干预可以有效减少体形低估,改善儿童体形认知准确性。

Objective To analyze the effect of a comprehensive intervention on the accuracy of children’s body size perception, so as to provide a theoretical basis for child body size perception improvement. Methods The participants were selected from a cluster-randomized controlled trial(September 2018 to June 2019). A total of 1 287 children in 24 primary schools(clusters) equally distributed among three regions(Beijing, Changzhi and Urumqi) were selected, which included 12 intervention schools(648 students) and 12 control schools(639 students). The accuracy of body size perception was measured by Ma figural stimuli. A linear mixed model was employed to analyze the effect of the comprehensive intervention on the accuracy of children’s body size perception. Results At baseline, the accuracy rate of body size perception among children in the intervention group and the control group was 56.6% and 51.5%, respectively. The underestimation rate was 42.0% and 47.7%, and the overestimation rate was 1.4% and 0.8%. After the intervention, compared with the control group, the inaccuracy rate(OR=0.50, 95%CI=0.37-0.68, P<0.01) and the underestimation rate in the intervention group decreased(OR=0.37, 95%CI=0.26-0.54, P<0.01). There was no significant difference in the overestimation rate between the two groups(P=0.51). The results of the stratified analysis showed that the intervention could improve the accuracy of children’s body size perception, regardless of their gender, nutritional status, region, or whether or not they were only child(P>0.05). Conclusion The inaccuracy rate of children’s body size perception, which mainly involved underestimation was high. A comprehensive intervention can effectively reduce body size underestimation and improve the accuracy of children’s body size perception.