中学生肥胖相关行为分阶段管理模式的研究

In recent years, there is an increasingly growth in obesity and overweight in middle school students. Thus, the problem about how to reduce the behavior, which may result in obesity, and how to improve the consciousness of self-protection of students have attracted great attention from government, and wide attention of all social sectors. This project intends to use the Transtheoretical Model and Stages of Change (TTM), through on-site investigation and expert consultation, improves the evaluation of obesity-related behavior of middle school students and identification of stages of these behaviors in TTM. Based on the Canonical correlation Analysis and Structural Equation Modeling, this project analyses the changing rule and the interrelationship for obesity-related behavior, explores the intervention strategies and measures of obesity-related behaviors in phases in middle school. In addition, this project establishes the health management cycle of "measure - assessment - intervention - evaluation - to intervention again" of obesity-related behavior to conduct the intervention - control experiments epidemiological study...This project has five main goals: 1) explore an effective approach to prevent and control obesity-related behavior for students in middle school; 2) seek and improve the technology and method for "reducing unhealthy life behavior"; 3) reduce obesity and overweight of students in the middle school, and advance the management of Chronic diseases; 4) increasingly improve the health management effect; and therefore, enhance the health quality of middle school students; and 5) promote the application of TTM in managing adolescent health management in China.

近几年，中学生肥胖和超重增势迅猛，如何减少学生肥胖相关行为、提高学生自我保护意识，已引起政府高度重视和社会各界广泛关注。本项目拟运用"the Transtheoretical Model and Stages of Change,TTM"(中国称为跨理论或行为分阶段转变理论模型）,通过现场调查、专家咨询，完善基于TTM的中学生肥胖相关行为评价和阶段识别、测定量表；利用典则相关分析和结构方程模型，揭示学生肥胖相关行为变化规律及内在联系；探索学生肥胖相关行为分阶段干预措施；构建肥胖相关行为"测量-评估-干预-再测评-再干预"循环管理模式，并进行干预-对照实验流行病学论证。以探索有效促进中学生肥胖相关行为的转变、寻求和完善"减少不健康的生活行为"的技术和手段；降低我国学生肥胖和超重流行；实现慢性病管理关口前移；加快提高健康管理效果，增强中学生的健康素质；促进TTM在我国青少年健康管理中的运用。

近几年，中学生肥胖和超重增势迅猛，如何减少学生肥胖相关行为、提高学生自我保护意识，已经引起家长、学校、政府高度重视和社会各界广泛关注。本项目运用the Transtheoretical Model and Stages of Change（国内有些专家翻译为行为分阶段转变理论模型，有些专家翻译为跨理论模型），通过现场调查、专家咨询，研制、修正和完善了中学生肥胖相关行为（包括久坐行为、体育锻炼行为、果蔬摄入行为、脂肪摄入行为）评估、阶段识别和相关因素八个测定量表。发现了中学生肥胖相关行为存在分阶段现象，前意向阶段的学生居多。运用logistic回归、结构模型等统计方法，分析了中学生肥胖相关行为变化阶段、自我效能、决策平衡、改变策略、周围环境影响之间的关系，发现中学生从前意识阶段到维持阶段改变策略、决策平衡(正向效应)、自我效能随着变化阶段的提高而增加，而决策平衡负向效应随着变化阶段的提高而减少。根据前期研究结果和不同行为变化阶段学生心理特点，对肥胖相关行为处于不同阶段上的学生设计出不同的干预措施，建立不良健康行为“测量-评估-干预-再测评-再干预”循环的健康管理模式，并进行干预-对照实验流行病学验证。结果发现中学生肥胖相关行为分阶段干预策略和管理模式相对比较有效，即“对症治疗”效果好于统一用一种“一刀切”干预措施。. 本项目研究的中学生肥胖相关行为评估、阶段识别和相关因素测定量表，探索的预防和控制中学生肥胖相关行为的形成和发展、寻求和完善“减少不健康的生活行为”的技术和手段，为降低我国中学生肥胖和超重流行，促进行为分阶段理论模型在我国青少年健康管理中的运用，加快提高健康管理效果，增强中学生的健康素养提供了一些科学依据。