探討美國幼兒熱舞與健康教案在預防學齡前兒童肥胖 之效果：一個統合分析研究

Investigation of Effect of Hip-Hop to Health Jr. Obesity Intervention Program: A Meta-Analysis

台灣近代幼兒的活動皆以靜態居多，且居住地點皆缺乏適當的戶外運動場 所，使得學齡前幼兒的肥胖比例偏高。學齡前時期的肥胖與多種健康相關議題有 關，包含心血管疾病、認知功能障礙、發展遲緩等。我國所頒布的幼兒園教保活 動課程大綱在顯示出國人逐漸有預防幼兒肥胖的觀念，雖然此觀念之立意良好， 但卻缺乏一套標準化統一的教案來幫助第一線的教保人員貫徹此理念。在美國有 一套針對學齡前幼兒設計之教案稱為幼兒熱舞與健康教案，為一種實證性的課 程，透過教室内討論、體能活動與父母的溝通三個部分組成。為得知此教案之效 果，本研究透過搜尋自1965年至2018年PubMed、Embase與Cochrane Library 等三大資料庫進行系統性文獻搜尋，關鍵字包括學齡前兒童或是年齡介於2-5 歲、預防與管理過重或是肥胖、隨機分派研究、幼兒熱舞與健康教案。最後篩選 出4個隨機分派研究，並採用標準化平均差異來比較其介入成效。研究結果指 出，在採用幼兒熱舞與健康教案介入一年後及兩年後其BMI相較於控制組均有 顯著性的改善肥胖之成效，其標準化平均差異分別為-0.18，95°%信賴區間 -0.29~-0.06，p 值為 0.002 與-0.30，95%信賴區間-0.46~-0.14，p 值為

The preschool child activities are mainly of static actions in modern Taiwan. Insufficiency of outdoor playgrounds in the residential areas also contributes to the rising prevalence of obesity in early childhood. Preschool obesity is associated with several health issues， including cardiovascular diseases， cognitive function defect， and stunted growth and development. The newly promulgated course guidelines of kindergarten education and protection suggest that concept of childhood-obesity prevention is firmly formed among the Taiwanese. However， the well-intended decree lacks a standardized protocol for the preschool educators to implement the procedures. Hip-Hop to Health Jr. Obesity is a standardized obesity-prevention program designed for preschool children. The community-based program consists of nutrition lessons， physical activities， and parent participation. To determine the effect of this program， we performed a systematic review through 3 major literature databases， including Pubmed， Embase， and Cochrane Library， from 1965 to 2018. The keywords used for literature searching included “preschool child”，“age from 2 to 5”，“prevent/manage overweight/obesity”，“randomized clinical trial” and “Hip Hop to Health Jr”. We included 4 randomized trials into the mata-analysis. The standardized mean difference (SMD) was utilized to evaluate the effect of intervention. Our study indicates that the Hip Hop to Health Jr. program significantly reduces the BMI in the years I and II follow-ups， with SMDs of -0.18 (95%〇 CI=-0.29〜-0.06， p-value=0.002) and -0.30 (95% CI=-0.46 〜-0.14， ^-value