초등학생 대상의 건강 효능감과 지식을 중심으로 한 심혈관 건강증진 중재 효과 Intervention Effect on Health Efficacy and Knowledge in Cardiovascular Health Promotion Behaviors in Children원문보기
목적: 본 연구는 학령기 아동 대상의 건강 효능감과 지식을 중심으로 한 심혈관 건강증진 중재 효과를 확인하기 위해 수행되었다. 방법: 본 연구는 반복측정 설계를 적용한 단일군 사전사후 연구 설계로 219명의 초등학생들 대상으로 하고 있다. 심혈관 건강증진 중재는 학교 수업을 기반으로 하는 주1회, 4주 교육으로 구성된 1차 중재와 부모에게 1차 중재 내용을 가정통신문의 형태로 전달하여 학생들의 건강 생활습관 유지에 있어서 부모의 역할을 강조하는 2차 중재로 구성되어 있다. 건강 효능감, 지식, 아동이 지각하는 부모의 모니터링에 대해 중재 전 기초 조사를 실시하고, 1차 중재 및 2차 중재 후 각각 실시하였다. 결과: 정신 건강 자아 효능감은 조사 시점에 따라 유의하게 증가하였다 (F = 32.88, p < 0.0001). 1차 및 2차 중재 후 신체 건강 자아 효능감의 경우 사전 조사에 비해 유의하게 증가하였으나 (F = 50.51, p < 0.0001), 부모 중재 기간 동안에는 건강 자아 효능감에 유의한 변화가 없었다. 지식수준은 전반적으로 증가하는 경향을 보였으나 (F =10.23, p < 0.0001), 부모 중재 후에는 오히려 감소하는 경향을 보였다. 또한 전반적인 자아 효능감에 영향을 미치는 요인으로 아동이 지각한 부모 모니터링인 것으로 나타났다. 결론: 본 연구의 결과는 학교 기반의 심혈관 건강 증진 프로그램이 건강 자아 효능감과 지식수준을 향상시키는 데 있어서 효과적이라는 기존 연구 결과를 지지하고 있다. 이 외에 학령기 아동의 건강 생활 습관 유도를 목적으로 건강 자아 효능감과 지식수준 향상을 위한 중재를 수행하는 데 있어서 부모의 영향을 고려해야 함을 제시하고 있다.
목적: 본 연구는 학령기 아동 대상의 건강 효능감과 지식을 중심으로 한 심혈관 건강증진 중재 효과를 확인하기 위해 수행되었다. 방법: 본 연구는 반복측정 설계를 적용한 단일군 사전사후 연구 설계로 219명의 초등학생들 대상으로 하고 있다. 심혈관 건강증진 중재는 학교 수업을 기반으로 하는 주1회, 4주 교육으로 구성된 1차 중재와 부모에게 1차 중재 내용을 가정통신문의 형태로 전달하여 학생들의 건강 생활습관 유지에 있어서 부모의 역할을 강조하는 2차 중재로 구성되어 있다. 건강 효능감, 지식, 아동이 지각하는 부모의 모니터링에 대해 중재 전 기초 조사를 실시하고, 1차 중재 및 2차 중재 후 각각 실시하였다. 결과: 정신 건강 자아 효능감은 조사 시점에 따라 유의하게 증가하였다 (F = 32.88, p < 0.0001). 1차 및 2차 중재 후 신체 건강 자아 효능감의 경우 사전 조사에 비해 유의하게 증가하였으나 (F = 50.51, p < 0.0001), 부모 중재 기간 동안에는 건강 자아 효능감에 유의한 변화가 없었다. 지식수준은 전반적으로 증가하는 경향을 보였으나 (F =10.23, p < 0.0001), 부모 중재 후에는 오히려 감소하는 경향을 보였다. 또한 전반적인 자아 효능감에 영향을 미치는 요인으로 아동이 지각한 부모 모니터링인 것으로 나타났다. 결론: 본 연구의 결과는 학교 기반의 심혈관 건강 증진 프로그램이 건강 자아 효능감과 지식수준을 향상시키는 데 있어서 효과적이라는 기존 연구 결과를 지지하고 있다. 이 외에 학령기 아동의 건강 생활 습관 유도를 목적으로 건강 자아 효능감과 지식수준 향상을 위한 중재를 수행하는 데 있어서 부모의 영향을 고려해야 함을 제시하고 있다.
Objectives: This study was conducted to identify the intervention effects on health efficacy and health knowledge related to health behaviors for improving cardiovascular health in elementary school children. Methods: A repeated measure, pre-post-test design was used to identify the intervention eff...
Objectives: This study was conducted to identify the intervention effects on health efficacy and health knowledge related to health behaviors for improving cardiovascular health in elementary school children. Methods: A repeated measure, pre-post-test design was used to identify the intervention effect on health efficacy and health knowledge among 5th grade school children. Intervention consisted of a curriculum classroom intervention and parent intervention. Health efficacy, health knowledge, and perceived parental monitoring were measured for testing intervention effect. A sample of 219 participants completed a baseline pre-test and two tests during intervention and after intervention from March to July 2004. Results: Mental health efficacy improved significantly from baseline test to the test after intervention (F = 32.88, p < 0.0001). Physical health efficacy also significantly increased during intervention (F = 50.51, p < 0.0001), but did not significantly change after parent intervention. Health knowledge increased significantly from baseline test to the test after education (F =10.23, p < 0.0001), but decreased after parent intervention. Perceived parental monitoring had a significant impact on mental health efficacy and physical health efficacy. Conclusion: The findings support school-based cardiovascular health promotion intervention as effective in improving health efficacy and health knowledge. Parental influence should also be considered to maintain improved health efficacy and health knowledge by thinking process in the intervention for elementary school children.
Objectives: This study was conducted to identify the intervention effects on health efficacy and health knowledge related to health behaviors for improving cardiovascular health in elementary school children. Methods: A repeated measure, pre-post-test design was used to identify the intervention effect on health efficacy and health knowledge among 5th grade school children. Intervention consisted of a curriculum classroom intervention and parent intervention. Health efficacy, health knowledge, and perceived parental monitoring were measured for testing intervention effect. A sample of 219 participants completed a baseline pre-test and two tests during intervention and after intervention from March to July 2004. Results: Mental health efficacy improved significantly from baseline test to the test after intervention (F = 32.88, p < 0.0001). Physical health efficacy also significantly increased during intervention (F = 50.51, p < 0.0001), but did not significantly change after parent intervention. Health knowledge increased significantly from baseline test to the test after education (F =10.23, p < 0.0001), but decreased after parent intervention. Perceived parental monitoring had a significant impact on mental health efficacy and physical health efficacy. Conclusion: The findings support school-based cardiovascular health promotion intervention as effective in improving health efficacy and health knowledge. Parental influence should also be considered to maintain improved health efficacy and health knowledge by thinking process in the intervention for elementary school children.
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문제 정의
The findings support a school-based cardiovascular health promotion intervention as effective in improving health efficacy and health knowledge. Based on a theoretical framework and prevention strategies for a healthy lifestyle, this study shows an evidence for school-based health promotion intervention in children. In addition, parental influence on child health behavior is significant.
Efficacy activated processes include cognitive, motivational, affective and selection processes. The curriculum was designed to increase self-efficacy and selected efficacy-activated processes during skill acquisition. The interventions included a series of skill-based classroom curriculum and home-based activities.
After four weeks of classroom sessions, reading materials and quiz sheets were given for the parents to do with their children. The purpose of these assignments were to inform parents of what their children learned how they can help them to have a healthy lifestyle by doing assignments together.
(2004) reported that baseline self-efficacy had an impact on physical activity before intervention, and intervention had a mediating effect on physical activity after intervention through self-efficacy. Therefore, this study evaluated health efficacy as an outcome variable on intervention for changing behaviors. The result, consistent with other studies based on the SCT, affirms that the school-based health intervention has a significant impact on health efficacy (physical and mental) (Edmunson et al.
This result suggest the development of education skill or method to effectively deliver the health information for children. This study made an effort to induce the participant of children within class and to bring on the interesting using handbook, video-taped information, role playing, and group works. However, the education effect was not to long.
This study was a school-based repeated measure study of a sample of 5th grade healthy children at an elementary school in a suburban city in Korea. It was an eight-week, school-based intervention designed to improve health efficacy and health knowledge about cardiovascular health promotion in school-aged children.
This study was designed to promote health behaviors related to cardiovascular health promotion in childhood for healthy lifestyle. The rationale is that the 5th graders, aged 11～12 years old children, is a transition period from childhood to adolescence, and this childhood period is easier than adolescence to establish health promotion behaviors, including physical activity, eating habits and prevention of smoking before risky habits are formed in early childhood.
Thus, this study was designed using social cognitive theory and conducted to identify the intervention effect on health efficacy and health knowledge for the promotion of cardiovascular health in children.
제안 방법
Health knowledge and health efficacy were measured to identify the intervention effects. Perceived parental monitoring was measured to explore the effect of parental influence on health knowledge and health efficacy.
This study was a school-based repeated measure study of a sample of 5th grade healthy children at an elementary school in a suburban city in Korea. It was an eight-week, school-based intervention designed to improve health efficacy and health knowledge about cardiovascular health promotion in school-aged children. The intervention consisted of a school-based curriculum and parental involvement in an educational program.
This study with only one intervention group could not identified other social contextual factors, which influenced on health behaviors. Other limitation of this study is that change of health behaviors was not evaluated directly, and then the mediating factors was evaluated such as heath self efficacy, knowledge, and parental influence, instead of health behaviors. The last one is relatively short intervention period to yield the behaviors change, and the follow-up test wasn't.
Participants were assessed at three time points, baseline (pre-intervention as the first test: labeled as T1), the second test (T2) after the curriculum intervention, and the third test (T3) after the entire intervention, following the curriculum and the parent intervention (see Figure 1).
Newsletters were sent to parents with the students' homework to make parents aware of the program and to help them do homework with their children regarding the cardiovascular health program contents. The curriculum intervention was conducted one hour per week for 4 weeks in own their classroom as regular class and the parent intervention once a week for 4 weeks in their own home as homework after completion of the curriculum class intervention.
In this model, psychosocial risk factors were the most proximal targets for change by the intervention. The first step of the process included identification of the behaviors we wanted the children to adopt, specifically, reduced fat and sodium intake, to increase participation in moderate to vigorous physical activity, and to resist the initiation of smoking.
Therefore, an eight week school-based intervention was conducted to increase health efficacy and health knowledge for promoting cardiovascular health through change of risk health behaviors. The program provided motivation to change and perform health behaviors. The findings showed that the intervention had a significant and positive influence on health efficacy and health knowledge for promoting cardiovascular health in children.
The school-based intervention based on social cognitive theory in this study for eight-weeks consisted of four sessions of 45-minute classroom activity weekly for children and four sessions for their parents following classroom education. This curriculum was developed and applied by a research team of clinical nurse specialists, experts in health education and a doctoral student of nursing science.
Health knowledge as an outcome variable was developed for this study based on the intervention contents. This scale had 4 categories with a total of 12 items: the function of the heart and circulation, exercise, healthy diet, smoking, and CVD. A sum score was used for analysis.
대상 데이터
These Six participants were excluded because of missing data due to discontinuation. Of the 219 participants who completed questionnaires, 51.6% were boys, and 48.4% girls. The mean age was 11 years old.
The participants were 5th graders in one elementary school that was randomly selected in a suburban area. The data were collected from March to July 2004 in one elementary school. The total number of participants was 225 but only 219 were included the final analysis.
The participants were 5th graders in one elementary school that was randomly selected in a suburban area. The data were collected from March to July 2004 in one elementary school.
The data were collected from March to July 2004 in one elementary school. The total number of participants was 225 but only 219 were included the final analysis. These Six participants were excluded because of missing data due to discontinuation.
데이터처리
The repeated- measure ANOVA was conducted to determine whether the health efficacy and health knowledge varied over time to simultaneously identify the intervention effect at the second test (T2) and the third test (T3). A generalized estimating equation (GEE) analysis of repeated measures regression was used to assess the time-related intervention effect before and after intervention (Twisk, 2003).
이론/모형
Health efficacy was measured using the School Health Efficacy Questionnaire (SHEQ) (Froman & Owen, 1991; Froman & Owen, 1999).
성능/효과
The findings of this study provide evidence that health efficacy based on a social cognitive theoretical framework applied to school-based intervention can improve cardiovascular health promoting behaviors and prevent future cardiovascular disease. In addition, perceived parental monitoring, a critical factor for child health and development, was confirmed as a mediating effect on health efficacy and health knowledge related to promoting a healthy lifestyle for cardiovascular health promotion and prevention.
후속연구
Further studies should elicit active parent involvement for intervention and develop a strategy for active participation in cardiovascular health promotion. We would recommend the use of a longitudinal design including comprehensive schoolbased intervention to promote cardiovascular health in children.
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