통합적 비만 캠프 프로그램에 참여한 과체중 아동의 식이 효능감과 식습관 향상이 비만도 감소에 미치는 영향
Effects of improvements in eating self-efficacy and habits on the decrease in body mass index (BMI) among overweight children in a multidisciplinary camp program
정경미 (연세대학교)
전용관 (연세대학교)
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초록
본 연구에서는 ‘한국 비만 아동의 신체 활동과 건강(KOCPA)’ 연구의 2차 캠프 프로그램에 참여한4-6학년의 과체중 이상 아동들을 대상으로 캠프 참여가 캠프 직후와 1개월의 사후 관리 후 실제적인 체중 감소 및 심리적 요인에 어떤 효과를 가지는지 살펴보고, 부모가 보고한 아동의 심리적 요인의 변화는 어떠한지를 살펴보았다. 또한 프로그램 참여를 통한 식이 효능감 및 바람직한 식습관의 증가량이 실제 비만도 감소에 미치는 영향을 분석하였다. 캠프 프로그램은 신체 활동, 식이 요법, 행동 수정 프로그램으로 구성되어 7박 8일간 진행되었으며, 캠프 참여 아동들은 행동 수정 프로그램에서 학습한 내용을 토대로 캠프 종료 후 1개월 간 자기 관리를 수행하였다. 그 결과, 캠프프로그램을 통해 비만도가 유의미하게 감소하고 식이 효능감과 식습관이 유의미하게 개선되었으며, 1개월간의 사후 관리 후 비만도와 식습관에 대한 효과가 유지되었다. 또한 캠프 이전에 비해 1개월간의 사후 관리 후 부모가 보고한 아동 식이 효능감, 식습관 점수는 모두 유의미한 향상을 보였다. 마지막으로, 식이 효능감과 바람직한 식습관의 변화량이 비만도 감소를 유의미하게 예측한것으로 나타났다. 이와 같은 결과를 바탕으로 본 연구의 의의와 한계점에 대하여 논의하였다.
- keywords
- 비만, 과체중, 아동, 통합적 캠프 프로그램, 행동 수정, 자기 관리, 비만도, 식이 효능감, 식습관, obese, overweight, children, multidisciplinary camp program, behavior modification, self-management, BMI, eating self-efficacy, eating habit
Abstract
The purpose of this study was to examine 1) an effectiveness of a multidisciplinary camp program for overweight children, 2) maintenance of the effectiveness after the program, 3)changes in parent-reported child eating self-efficacy and eating habit, and 4) the association between changes in eating self-efficacy and eating habit and changes in child BMI. Total of 32 children (BMI 26.09±3.33kg/m2), aged 9 to 12 participated in the camp program and follow-up meeting. The camp program consisted of physical activities, dietary restriction and behavior modification for a week. After the program, children were instructed to continue physical activities and diet using self-management skills learned from the behavior modification in the program. After the program, BMI of children significantly decreased, and child-reported eating self-efficacy and eating habit scores significantly increased. It was shown that although the improvement in eating self-efficacy was not maintained at the one-month follow-up period,the improvements in BMI and eating habit were maintained. Parent-reported child eating self-efficacy and eating habit scores significantly increased at the follow-up. Finally, increase in child-reported eating self-efficacy and eating habit scores significantly predicted the decrease in BMI. Implications and limitations were also discussed.
- keywords
- 비만, 과체중, 아동, 통합적 캠프 프로그램, 행동 수정, 자기 관리, 비만도, 식이 효능감, 식습관, obese, overweight, children, multidisciplinary camp program, behavior modification, self-management, BMI, eating self-efficacy, eating habit
참고문헌
김경희. (2001). 비만아동을 위한 체중조절 프로그램의 효과. 한국식생활문화학회지, 16(2), 89-98.
김경희. (2007). 체중조절 프로그램을 통한 비만아동들의 비만도, 신체만족감 및 자아존중감의 변화. 대한지역사회영양학회지, 12(4), 449-461.
김미리혜. (2001). 체중조절 프로그램이 아동의 비만도, 체력 및 자긍심에 미친 효과. 한국심리학회지: 건강, 6(2), 145-156.
김현아, 김은경. (1996). 학령기 비만아동을 위한 체중조절 프로그램의 실시 및 효과평가. 한국영양학회지, 29(3), 307-320.
김현준. (2007). 건강교육과 자발적 운동참여 프로그램이 비만 및 과체중아동의 신체조성과 자기효능감에 미치는 영향. 대한비만학회지, 16(3), 130-137.
대한비만학회 소아비만위원회. (2006). 소아․청소년 비만관리 지침서. 서울: 대한비만학회.
박광혜, 강혜영. (2007). 일 도시 초등학교 비만 아동의 신체조성, 비만도, 식습관, 스트레스에 미치는 비만관리 프로그램 효과. 한국학교보건학회지, 20(2), 1-12.
보건복지부. (2005). 국가 비만관리 종합대책.
신은경, 이진화, 이연경, 이혜성. (2005). 단기간 영양교육 캠프가 비만아동의 식품과 영양소 섭취에 미치는 영향. 한국식품영양과학회지, 34(7), 987-999.
이미경. (2008). 비만아동의 6박7일 캠프 참여가 비만도, 심혈관 질환 위험요인 및 염증지표에 미치는 영향. 연세대학교 석사 학위 청구 논문.
이진복, 이정오, 김성원, 강재헌, 양윤준. (2000). 서울시내 일부 초등학교 아동에서의 비만의 유병률 및 위험요인. 가정의학회지, 21(7), 866-875.
전용균. 이기홍. (2005). 비만처치 프로그램이 비만아동의 혈중지질과 신체구성에 미치는 영향. 한국스포츠리서치, 16(6), 231-238.
조인숙, 류현숙, 박인혜, 강서영. (2007). 비만관리 프로그램이 비만아동의 비만도와 식생활태도, 식습관 및 운동습관에 미치는 효과. 아동간호학회지, 13(4), 399-406.
질병관리본부, 대한소아과학회, 소아․청소년 신체발육표준치 제정위원회. (2007). 2007년 소아․청소년 표준 성장도표 해설.
최미경, 전예숙, 이지은, 이용숙, 배윤정, 김미현 등. (2007). 일부 비만 초등학생을 위한 건강영양캠프의 효과 평가. 한국식품영양학회지, 20(1), 79-87.
최주연, 권정혜, 이재현. (2001). 행동수정 프로그램이 비만 아동의 체중감소에 미치는 효과. 한국심리학회지: 임상, 20(4), 611-623.
한국영양학회. (2005). 한국인 영양 섭취 기준.
Bernier, M., & Avard, J. (1986). Self-efficacy, outcome, and attrition in a weight-reduction program. Cognitive Therapy & Research, 10, 319-338.
Braet, C., Mervielde, I., & Vandereycken, W. (1996). Psychological aspects of childhood obesity: A controlled study in a clinical and nonclinical sample. Journal of Pediatric Psychology, 22(1), 59-71.
Braet, C., Tanghe, A., Bode, P. D., Franckx, H., & Winckel, M. V. (2003). Inpatient treatment of obese children: a multicomponent programme without stringent calorie restriction. European Journal of Pediatrics, 162, 391-396.
Brislin, R. W. (1970). Back-translation for crosscultural research. Journal of Cross-Cultural Psychology, 1, 185-216.
Brownell, K., D., & Kaye, F. S. (1982). A school-based behavior modification, nutrition education, and physical activity program for obese children. The American Journal of Clinical Nutrition, 35, 277-283.
Clark, M. M., Abrams, D. B., & Niaura, R. S. (1991). Self-Efficacy in weight management. Journal of Consulting and Clinical Psychology, 59(5), 739-744.
Clarke, K. K., Freeland-Graves, J., Klohe-Lehman, D. M., & Bohman, T. M. (2007). Journal of the American Dietetic Association, 107, 1146-1154.
Cooper, C., Sarvey, S., Collier, D., Willson, C., Green, I., & Porties, M. L. et al. (2006). For comparison: experience with a children's obesity camp. Surgery for Obesity and Related Diseases, 2, 622-626.
Deckelbaum, R. J., & Williams, C. L. (2001). Childhood obesity: The health issue. Obesity Research, 9(Suppl. 4), 239-243.
Deforche, B., Bourdeaudhuij, I. D., Debode, P., Vinaimont, F., Hills, A. P., Verstraaete, S. et al. (2003). Changes in fat mass, fat-free mass and aerobic fitness in severely obese children and adolescents following a residential treatment programme. European Journal of Pediatrics, 162, 616-622.
Ebbeling, C. B., Pawlak, D. B., & Ludwig, D. S. (2002). Childhood obesity: public-health crisis, common sense cure. Lancet, 360, 473-482.
Elfhag, K., & Rӧssner, S. (2005). Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obesity Review, 6, 67-85.
Eliakim, A., Kaven, G., Berger, I., Friedland, O., Wolach, B., & Nemet, D. (2002). The effect of a combined intervention on body mass index and fitness in obese children and adolescents - a clinical experience. European Journal of Pediatrics, 161, 449-454.
Eneli, I. U., Cunningham, A., & Woolford, S. J. (2008). The multidisciplinary obesity program: An update. Progress in Pediatric Cardiology, 25, 129-136.
Epstein, L. H., Valoski, A., Wing, R. R., & McCurley, J. (1990). Ten-year follow-up of behavioral, family-based treatment for obese children. Journal of American Medical Association, 264(19), 2519-2523.
Epstein, L. H., & Wing, R. R. (1987). Behavioral treatment of childhood obesity. Psychological Bulletin, 101(3), 331-342.
Epstein, L. H., Wing, R. R., & Valoski, A. (1985). Childhood obesity. Pediatric Clinics of North America, 32(2), 363-379.
Gately, P. J., Cooke, C. B., Barth, J. H., Bewick, B. M., Radley, D., & Hill, A. J. (2005). Children's residential weight-loss programs can work: A prospective cohort study of short-term outcomes for overweight and obese children. Pediatrics, 116(1), 73-77.
Gately, P. J., Cooke, C. B., Butterly, R. J., Mackreth, P., & Carroll, S. (2000). The effects of a children's summer camp programme on weight loss, with a 10 month follow-up. International Journal of Obesity, 24, 1445-1453.
Glenny, A. M., O'Meara, S., Melville, A., Sheldon, T. A., & Wilson, C. (1997). The treatment and prevention of obesity: a systematic review of the literature. International Journal of Obesity, 21, 715-737.
Golan, M., Fainaru, M. & Weizman, A. (1998). Role of behaviour modification in the treatment of childhood obesity with the parents as the exclusive agents of change. International Journal of Obesity, 22, 1217-1224.
Guillaume, M. (1999). Defining obesity in childhood:current practice. American Journal on Clinical Nutrition, 70(suppl), 126-130.
Hamilton, S. B. (1980). Instructionally-based training in self-control: Behavior- specific and generalized outcomes resulting from student-implemented self-motivation projects. Teaching of Psychology, 7(3), 140-145.
Hinshaw, S. P., Owens, E. B., Wells, K. C., Kraemer H. C., Abikoff, H. B., Arnold, L. E., et al. (2000). Family process and treatment outcome in the MTA: Negative/ineffective parenting practices in relation to multimodal treatment. Journal of Abnormal Child Psychology, 28(6), 555-568.
Jelalian, E., & Saelens, B. E. (1999). Empirically supported treatments in pediatric psychology:Pediatric obesity. Journal of Pediatric Psychology, 24(3), 223-248.
King, N. A., Hester, J., & Gately, P. J. (2007). The effect of a medium-term activity- and diet-induced energy deficit on subjective appetite sensations in obese children. International Journal of Obesity, 31, 334-339.
Knöpfli, B. H., Radtke, T., Lehmann, M., Schätzle, B., Eisenblätter, J., Gachnang, A. et al. (2008). Effects of a multidisciplinary inpatient intervention on body composition, aerobic fitness, and quality of life in severely obese girls and boys. Journal of Adolescent Health, 42, 119-127.
Linde, J. A., Rothman, A. J., Baldwin, A. S., & Jeffery, R. W. (2006). The impact of self-efficacy on behavior change and weight change among overweight participants in a weight loss trial. Health Psychology, 25(3), 282-291.
Lobstein, T., Baur, L., & Uauy, R. (2004). Obesity in children and young people: a crisis in public health. Obesity Reviews, 5(Suppl.1), 4-85.
Marks, R., Allegrante, J. P., & Lorig, K. L. (2005). A review and synthesis of research evidence for self- efficacy-enhancing interventions for reducing chronic disability: Implications for health education practice (Part II). Health Promotion Practice, 6(2), 148-156.
Martin, P. D., Dutton, G. R., & Brantley, P. J. (2004). Self-efficacy as a predictor of weight change in African-American women. Obesity Research, 12(4), 646-651.
Nemet D., Barkan, S., Epstein, Y., Freidland, O., Kowen, C., & Eliakim, A. (2005). Short- and long-term beneficial effects of a combined dietary-behavioral-physical activity intervention for the treatment of childhood obesity. Pediatrics, 115(4), 443-449.
Parcel, G. S., Edmunson, E., Perry, C. L., Feldman, H. A., O'Hara-Tompkins, N., Nader, P. R. et al. (1995). Measurement of self-efficacy for diet-related behaviors among elementary school children. Journal of School Psychology, 65(1), 23-27.
Pierce, J. W., & Wardle, J. (1997). Cause and Effect beliefs and self-esteem of overweight children. Journal of Child Psychology and Psychiatry, 38(6), 645-650.
Pi-Sunyer, F. X. (1991). Health implications of obesity. The American Journal of Clinical Nutrition, 53, 1595-1603.
Renman, C., Engström, I., Silfverdal, S. A., & Åman, J. (1999). Mental health and psychosocial characteristics in adolescent obesity: a population-based case-control study. Acta Paediatrica, 88, 998-1003.
Roach, J. B., Yadrick, M. K., Johnston, J. T., Boudreaux, L. J., Forsythe III, W. A., Billon, W. (2003). Using self-efficacy to predict weight loss among young adults. Journal of the American Dietetic Association, 103(10), 1357-1359.
Rodin, J., Elias, M., Silberstein, L. R., & Wagner, A. (1988). Combined behavioral and pharmacologic treatment for obesity: predictors of successful weight maintenance. Journal of Consulting and Clinical Psychology, 56(3), 399-404.
Savoye, M., Shaw, M., Dziura, J., Tamborlane, W. V., Rose, P., Guandalini, C. et al. (2007). Effects of a weight management program on body composition and metabolic parameter in overweight children. Journal of the American Medical Association, 297(24), 2697-2704.
Snethen, J. A., Broome, M. E., & Cashin, S. E. (2006). Effective weight loss for overweight children: A meta-analysis of intervention studies. Journal of Pediatric Nursing, 21(1), 45-56.
Stuart, R. B. (1967). Behavioral control of overeating. Behavior Research and Therapy, 5, 357-365.
Sweeting, H. N. (2007). Measurement and definitions of obesity in childhood and adolescence: A field guide for the uninitiated. Nutrition Journal, 6, 32-39.
Swinburn, B., & Egger, G. (2002). Preventive strategies against weight gain and obesity. Obesity Reviews, 2, 289-301.
Varni, J. W., Limbers, C., & Burwinkle, T. M. (2007). Literature Review: Health-related quality of life measurement in pediatric oncology: Hearing the voices of the children. Journal of Pediatric Psychology, 32(9), 1151-1163.
Wadden, T. A., & Stunkard, A. J. (Eds.). (2002). Handbook of obesity. New York : The Guilford Press.
Walker, L. L. M., Gately, P. J., Bewick, B. M., & Hill, A. J. (2003). Children's weight-loss camps: psychological benefit or jeopardy? International Journal of Obesity, 27, 748-754.
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