Intervention On The Diet Behavior Problems Of Children Aged1to5Years In Changning District

Background:Diet behavior includes feeding behavior, eating behavior, food selection and eating atmosphere. Children’s diet behavior problems are familiar in paediatrics and child healthcare. Literatures in different countries reported different rates of children’s diet behavior problems, which20-50%among. But all these literatures showed diet behavior problems may influenced child health. The children’s common diet behavior problems included eating little, eating slowly, having no interest on food, refusing some food, refusing to eat the new food, only preferring to some food and so on. The diet behavior problems of children aged1to5years often present in the family and kindergarten. And parents sometimes seek help from child healthcare outpatient department. Therefore doctors should indentify, supervise, evaluate, interfere and instruct children’s diet behavior problems. Doctors should take charge for the intervention on children’s diet behavior problems. Internal literatures showed there were not any systematic intervention methods and mechanism on children’s diet behavior problems, the individual general intervention of behavior change communication is no using in children’s diet behavior problems, and the mechanism and flow of diet behavior intervention are not established.Objective:To evaluate the intervention on the diet behavior problems of children aged1to5years in Changning District, sum up the intervention methods to improve and maintain the changed behavior of children who have the diet behavior problems, and establish the intervention mechanism of the diet behavior problems of children aged1to5years.Method:1. Questionnaire:The self-designed questionnaire include main minder’s characters, children’s diet behaviors, parents’ evaluation on diet behaviors and intervention, parents’anxiety, parents’ understanding of intervention, and so on. 2. Individual comprehensive intervention:We adopt the intervention research method and set the intervention group and control group. The intervention method was communication on behavioral change, including establishing intervention files for children, developing parent training school, formulating the individual rectification plan, and providing the prescription of rectification. The duration of intervention was9months. Subjects in intervention group received monitor-evaluation-advice circle when the base line and1month,3months,6months and9months after the beginning of interventions. The subjects in the control group received the routine child health care, and completed questionnaires before and after the intervention.3. Data analysis:The data was input in the EPIdata software and analyzed by SPSS16.0.Result:1. Basic characters:86children were in the invention group, including48boys (55.81%) and38girls (44.18%).80children were in the control group, including44boys (55%) and36girls (45%). In the intervention group,8children were between1and2years old,8children were between2and3years old,23children were between3and4years old,30children were between4and5years old, and17children were between5and6years old. In the control group,7children were between1and2years old,12children were between2and3years old,24children were between3and4years old,22children were between4and5years old, and15children were between5and6years old. On the base line, the average weight and height of intervention group were15.9±3. Okg and101.3±9.3cm, and the average weight and height of children in control group were15.9±2.6kg and101.8±9.5cm. There were no statistic difference on sex, age, height and weigh between the intervention group and control group.2. Main problems:The reported children’s diet problems from parents showed in the intervention group58children (67.44%) only preferred little food,38children (16.28%) only preferred some kind of food, and14children (16.28%) had no interest on food. In the control group56children (70.00%) only preferred little food,37children (46.25%) only preferred some kind of food, and8children (10.00%) had no interest on food. There were22,43,16,21,18and25children in the intervention group and17,51,19,13,19and14children in the control group having diet behavior problems about eating little, eating slowly, having no interest on food, refusing some food, refusing to eat the new food, and only preferring to some food severally.3.Intervention process:All the children in the intervention group completed5follow-up visits when the base line and1month,3months,6months and9months after the beginning of interventions. Parents in the intervention group received365health recipes, and41average. There were two parents trainings:one was about "strategy on children’s diet behavior", and78parents (90.70%) took part in; The other was cases share, and73parents (84.88%) took part in. The times of individual instruction was450,5.2average. There was significant difference on weight, height and diet behavior score before and after intervention (P<0.001).4. Effect of individual intervention:The increase of weight and height were2.1±1.1kg and5.7±1.8cm in the intervention group, and1.5±0.9kg and4.0±1.9cm in the control group. There was significant statistic difference between two groups on the increase of weight and height. The "sometimes and often" of diet behavior problems changed a lot. The ratio of "eat little" reduced from66.30%to26.74%. The ratio of "eat slowly" reduced from75.58%to41.86%. The ratio of "have no interest on food" reduced from59.30%to19.77%. The ratio of "refuse the food" reduced from52.33%to23.26%. The ratio of "refuse to eat the new food" reduced from54.65%to16.28%. The ratio of "only prefer to some food" reduced from56.98%to24.42%. The decreased scores of children diet behavior problems about "eat little","eat slowly","have no interest on food","refuse the food" and "refuse to eat the new food" in intervention group were0.80±0.93,0.81±1.00,0.78±0.91,0.85±1.05,0.81±1.03and0.77±1.07, and were0.21±0.54,0.28±0.67,0.15±0.7,0.18±0.71,0.1±0.69and-0.14±0.84in control group. There was significant statistic difference between two groups about all these children diet behavior problems (P<0.001). After intervention,43children’s parents in intervention group (50%) and69parents in control group thought their children still had diet behavior problems. Significant statistic difference was between two groups (X2=24.81, P<0.01.76parents thought it was very necessary to adopt behavior intervention on children diet problems, and10parents thought it was necessary. After6months of the beginning of intervention,13parents (15.12%) in intervention group and56parents (70%) in control group were still worry about children diet behavior problems,48parents (55.81%) in intervention group and22parents (27.5%) in control group felt less anxious, and25parents (29.07%) in intervention group and2parents (2.75%) in control group did not feel anxious. There was significant statistic difference between two groups (X2=56.25, P<0.005).Discussion:The comprehensive measures of communication on behavioral change were effect on physical development, improving the diet behavior of children. Parents increased their confidence and reduced their anxiety. The joint health-school-family mechanism was established improving diet behavior of children aged1-5years.Conclusion:The comprehensive measures of communication on behavioral change were effect on improving the diet behavior of children aged1-5years old, maintaining children’s good diet behaviors, keeping diet balance, and advancing the growth and development. Using the monitor-evaluation-advice circle in the intervention, parents knew the intervention measures well; children’s diet behaviors changed a lot, so parents became less anxious about children diet behavior problems. We should combine community, hospital, family and school to focus on improving children diet behavior, and establish joint health-school-family mechanism.