Chinese Journal of Rehabilitation Theory and Practice ›› 2025, Vol. 31 ›› Issue (6): 642-649.doi: 10.3969/j.issn.1006-9771.2025.06.004
Previous Articles Next Articles
Received:
2025-05-05
Revised:
2025-05-15
Published:
2025-06-25
Online:
2025-06-16
Contact:
E-mail: Supported by:
CLC Number:
SHAO Xueyun. Physical activity, functioning and psycho-behavioral health in obese children: policy framework and health behavior intervention model[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 642-649.
Table 1
Framework and contents of international and Chinese policies of physical activity, functioning and psycho-behavior health for children in obesity"
政策 | 发布机构与年份 | 目标人群 | 关键指标 | 干预方法 | 干预目标 | 主要功能 结局及 ICF编码 | 主要心理/行为健康结局及ICF编码 |
---|---|---|---|---|---|---|---|
2018-2030年促进身体活动全球行动计划:加强身体活动,造就健康世界[ | WHO (2018) | 全年龄段,重点是5~17岁儿童青少年 | 每天MVPA≥ 60 min 减少久坐时间 | 多部门(卫生、教育、交通、城市规划)协同 | 到2030年全球缺乏活动人群减少15% | 改善心肺功能(b455) 增强肌肉力量(b730) | 提升心理健康(b152) 改善认知功能(b164) |
WHO身体活动与久坐行为指南[ | WHO (2020) | 5~17岁 | 每天MVPA ≥ 60 min 久坐时间 < 2 h | 家庭+学校教育 | 体质量控制、降低久坐行为 | 提升VO₂max (b440) 改善步行能力(d450) | 提高自尊心(b126) 降低抑郁状态(b152) |
WHO停止肥胖加速计划[ | WHO (2023) | 0~18 岁 | d4552跑步 d640做家务 | 城市空间、数字健康 | 控制儿童肥胖 | 降低BMI (b530) 提升6分钟步行试验成绩(d455) | 降低抑郁状态(b152) |
全球青少年健康测量指南[ | WHO (2024) | 10~19岁 | MVPA不足率 屏幕时间≥ 2 h | 国家监测 | 统一指标 | 降低超重率(b530) | 提升社会参与水平(d8) |
UNICEF战略计划2022-2025[ | UNICEF (2021) | 0~18岁儿童及青少年,重点关注弱势群体 | 每天MVPA≥60 min (学龄儿童) 减少久坐行为 | 学校+社区+家庭整合干预 | 促进儿童全面发展,提高教育公平性 | 增强运动能力(b730) 改善心肺功能(b455) | 提升心理健康(b152) 促进社会参与(d910) |
将每所学校建成健康促进学校:全球标准和指标[ | WHO & UNESCO (2021) | 5~18岁在校学生 | 每日校内体育活动≥30 min 减少久坐学习时间 | 学校课程+环境改造+健康服务 | 创建支持性学校环境,促进身心健康 | 改善身体协调性(b760) 增强耐力(b455) | 提高学业表现(d166) 减少焦虑情绪(b152) |
国家学生体质健康标准(2014年修订)[ | 教育部(2014) | 中小学生、大学生 | 学生体质分层评价 | 校园体测、分级运动处方 | 改善体质等级 | 50 m跑 立定跳远(d4553) 坐位体前屈(b730; b710) 跳绳(d4553); 仰卧起坐(b730; b710) | 提升课堂注意力(b1402) |
健康中国行动(2019-2030)[ | 国务院(2019) | 7~18岁 | 每周进行3次,每次30 min以上中等强度运动 | 课堂+课外+家庭“三结合” | 学生体质达标率≥ 25% | 改善心肺功能(b455) 提升肌力(b730) | 学习专注性提升(b140) |
营养与健康学校建设指南[ | 教育部/卫健委 (2021) | 学龄儿童青少年 | 校园运动设施、课间活动 | 健康促进学校 | 综合健康 | 提升VO₂max (b440) 降低BMI (b530) | 提高自尊性(b126) 提升社交活动(d8) |
Table 2
Health behavior intervention models for children in obesity"
项目 | BST | FBBT | HeLP |
---|---|---|---|
主要目标/人群 | 高食物反应性儿童 个体易感性 | 家庭整体 居家环境 | 学校/同伴群体 教育场景相关的社会环境 |
主要干预方法 | 餐前中-高强度运动 家长情绪性进食教育 | 行为化饮食控制(“交通灯”饮食) 家庭契约 父母示范 | 戏剧疗法 同伴支持融入日常活动 |
关键机制 | 调节能量平衡 增强动机 | 重塑环境机会 提升自我效能 技能培养 | 营造积极氛围 强化归属感与动机 维持持续参与 |
理论基础 | 行为理论 生理学(食欲调节) | 社会认知理论 行为矫正 家庭系统理论 | 生态学模型 社会学习理论 自我决定理论(归属感、动机) |
主要优势 | 针对高危人群 兼顾生理与心理因素 | 借助家庭强影响力 实现全面环境改变 | 嵌入学校既有结构 利用同伴影响 覆盖人群范围广 |
潜在局限/注意事项 | 可推广性 目标人群识别 对时间/资源要求高 | 父母负担与参与度 家庭动力复杂 需专业治疗师 | 学校实施一致性 成本-效果差异 需教师/员工支持 |
[1] |
ZHANG X, LIU J, NI Y, et al. Global prevalence of overweight and obesity in children and adolescents: a systematic review and meta-analysis[J]. JAMA Pediatr, 2024, 178(8): 800-813.
doi: 10.1001/jamapediatrics.2024.1576 pmid: 38856986 |
[2] |
NCD Risk Factor Collaboration. Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults[J]. Lancet, 2024, 403(10431): 1027-1050.
doi: 10.1016/S0140-6736(23)02750-2 pmid: 38432237 |
[3] | RANKIN J, MATTHEWS L, COBLEY S, et al. Psychological consequences of childhood obesity: psychiatric comorbidity and prevention[J]. Adolesc Health Med Ther, 2016, 7(2): 125-146. |
[4] | SINGH A S, SALIASI E, VAN DEN BERG V, et al. Effects of physical activity interventions on cognitive and academic performance in children and adolescents: a novel combination of a systematic review and recommendations from an expert panel[J]. Br J Sports Med, 2019, 53(10): 640-647. |
[5] |
朱志强, 徐巧玲, 邵雪云. 肥胖和超重儿童参与身体活动的健康效益:系统综述的系统综述[J]. 中国康复理论与实践, 2025, 31(3): 296-305.
doi: 10.3969/j.issn.1006-9771.2025.03.006 |
ZHU Z Q, XU Q L, SHAO X Y. Health benefits of physical activity for obese and overweight children: a systematic review of systematic reviews[J]. Chin J Rehabil Theory Pract, 2025, 31(3): 296-305. | |
[6] | MARTIN A, BOOTH J N, LAIRD Y, et al. Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight[J]. Cochrane Database Syst Rev, 2018, 3(3): Cd009728. |
[7] | United Nations. The Sustainable Development Goals Report Special Edition[EB/OL]. (2023-01-02) [2024-12-11]. https://sdgs.un.org/sites/default/files/2023-07/The-Sustainable-Development-Goals-Report-2023_0.pdf. |
[8] | World Health Organization. Global recommendations on physical activity for health[R]. Geneva: World Health Organization, 2010. |
[9] | World Health Organization. Global action plan on physical activity 2018-2030: more active people for a healthier world[R]. Geneva: World Health Organization, 2018. |
[10] | World Health Organization. WHO guidelines on physical activity and sedentary behaviour[R]. Geneva: World Health Organization, 2020. |
[11] | World Health Organization. WHO acceleration plan to stop obesity[R]. Geneva: World Health Organization, 2023. |
[12] | United Nations International Children's Emergency Fund. UNICEF Strategic Plan 2022-2025[R/OL]. (2021-10-10) [2024-12-21]. https://www.unicef.org/reports/unicef-strategic-plan-2022-2025. |
[13] | World Health Organization, United Nations Educational, Scientific and Cultural Organization. Making every school a health-promoting school: global standards and indicators[R]. Geneva: World Health Organization, 2021. |
[14] |
SWINBURN B A, KRAAK V I, ALLENDER S, et al. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report[J]. Lancet, 2019, 393(10173): 791-846.
doi: S0140-6736(18)32822-8 pmid: 30700377 |
[15] |
RUTTER H, SAVONA N, GLONTI K, et al. The need for a complex systems model of evidence for public health[J]. Lancet, 2017, 390(10112): 2602-2604.
doi: S0140-6736(17)31267-9 pmid: 28622953 |
[16] | 世界卫生组织. 国际功能、残疾和健康分类(国际中文增补版)[M]. 邱卓英,译. 日内瓦: 世界卫生组织, 2015. |
World Health Organization. International Classification of Functioning, Disability and Health (International Chinese Supplement)[M]. QIU Z Y, trans trans. Geneva: World Health Organization, 2015. | |
[17] | World Health Organization. The adolescent health indicators recommended by the Global Action for Measurement of Adolescent Health: guidance for monitoring adolescent health at country, regional, and global levels[M]. Geneva: World Health Organization, 2024. |
[18] | GUTHOLD R, STEVENS G A, RILEY L M, et al. Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1.6 million participants[J]. Lancet Child Adolesc Health, 2020, 4(1): 23-35. |
[19] | 中华人民共和国教育部. 教育部关于印发«国家学生体质健康标准(2014年修订)»的通知[A/OL]. (2014-07-07) [2025-01-11]. http://www.moe.gov.cn/s78/A17/twys_left/moe_938/moe_792/s3273/201407/t20140708_171692.html. |
[20] | 中华人民共和国中央人民政府. 健康中国行动(2019—2030年)[R/OL]. (2019-07-15) [2025-01-12]. https://www.gov.cn/xinwen/2019-07/15/content_5409694.htm. |
[21] | 卫生健康委办公厅, 教育部办公厅, 市场监管总局办公厅, 等. 关于印发营养与健康学校建设指南的通知[A/OL]. (2021-06-07) [2025-02-13]. https://www.gov.cn/zhengce/zhengceku/2021-06/24/content_5620557.htm. |
[22] | WYSZYŃSKA J, RING-DIMITRIOU S, THIVEL D, et al. Physical activity in the prevention of childhood obesity: the position of the European Childhood Obesity Group and the European Academy of Pediatrics[J]. Front Pediatr, 2020, 8(2): 535705. |
[23] | 国家卫生健康委办公厅, 教育部办公厅, 市场监管总局办公厅, 等. 关于印发儿童青少年肥胖防控实施方案的通知[A/OL]. (2020-10-16) [2025-02-23]. https://www.gov.cn/zhengce/zhengceku/2020-10/24/content_5553848.htm. |
[24] | 教育部办公厅. 教育部办公厅关于进一步加强中小学生体质健康管理工作的通知[A/OL]. (2021-04-19) [2025-01-23]. https://www.gov.cn/zhengce/zhengceku/2021-04/26/content_5602164.htm. |
[25] |
杨亚茹, 邱卓英, 陈迪, 等. 主要残疾类别的定义、分类、分级以及评估研究:基于ICF和ICD-11的方法[J]. 中国康复理论与实践, 2025, 31(4): 373-381.
doi: 10.3969/j.issn.1006-9771.2025.04.001 |
YANG Y R, QIU Z Y, CHEN D, et al. Disability definition, classification, grading and assessment in disability eligibility: an ICF and ICD-11 framework perspective[J]. Chin J Rehabil Theory Pract, 2025, 31(4): 373-381. | |
[26] | World Health Organization. ICF Browser[EB/OL]. (2024-12-27) [2025-02-10]. https://apps.who.int/classifications/icfbrowser/. |
[27] | LLEWELLYN C H, KININMONTH A R, HERLE M, et al. Behavioural susceptibility theory: the role of appetite in genetic susceptibility to obesity in early life[J]. Philos Trans R Soc Lond B Biol Sci, 2023, 378(1885): 20220223. |
[28] | D'ANGELI G, MESCE M, CERNIGLIA L, et al. Observational tools using video recordings of parent-child feeding interactions: a narrative review[J]. Children (Basel), 2022, 9(12): 1924. |
[29] |
EPSTEIN L H, WILFLEY D E, KILANOWSKI C, et al. Family-based behavioral treatment for childhood obesity implemented in pediatric primary care: a randomized clinical trial[J]. JAMA, 2023, 329(22): 1947-1956.
doi: 10.1001/jama.2023.8061 pmid: 37314275 |
[30] | PAN C Y, CHANG Y K, TSAI C L, et al. Effects of physical activity intervention on motor proficiency and physical fitness in children with ADHD: an exploratory study[J]. J Attent Disord, 2017, 21(9): 783-795. |
[31] | WYATT K, LLOYD J, CREANOR S, et al. Cluster randomised controlled trial and economic and process evaluation to determine the effectiveness and cost-effectiveness of a novel intervention [Healthy Lifestyles Programme (HeLP)] to prevent obesity in school children[R]. Southampton, UK: NIHR Journals Library, 2018. |
[32] | LAVELLE M A, KNOPP M, GUNTHER C W, et al. Youth and peer mentor led interventions to improve biometric-, nutrition, physical activity, and psychosocial-related outcomes in children and adolescents: a systematic review[J]. Nutrients, 2023, 15(12): 2658. |
[33] | PÉREZ-JORGE D, GONZÁLEZ-LUIS M A, RODRÍGUEZ-JIMÉNEZ M D C, et al. Educational programs for the promotion of health at school: a systematic review[J]. Int J Environ Res Public Health, 2021, 18(20): 10818. |
[34] | CARNELL S, THAPALIYA G, JANSEN E, et al. Biobehavioral susceptibility for obesity in childhood: behavioral, genetic and neuroimaging studies of appetite[J]. Physiol Behav, 2023, 271(4): 114313. |
[35] |
LLOYD J, CREANOR S, LOGAN S, et al. Effectiveness of the Healthy Lifestyles Programme (HeLP) to prevent obesity in UK primary-school children: a cluster randomised controlled trial[J]. Lancet Child Adolesc Health, 2018, 2(1): 35-45.
doi: S2352-4642(17)30151-7 pmid: 29302609 |
[36] |
SIRICO F, BIANCO A, D'ALICANDRO G, et al. Effects of physical exercise on adiponectin, leptin, and inflammatory markers in childhood obesity: systematic review and meta-analysis[J]. Child Obes, 2018, 14(4): 207-217.
doi: 10.1089/chi.2017.0269 pmid: 29762052 |
[37] |
BOUTELLE K N, RHEE K E, LIANG J, et al. Effect of attendance of the child on body weight, energy intake, and physical activity in childhood obesity treatment: a randomized clinical trial[J]. JAMA Pediatr, 2017, 171(7): 622-628.
doi: 10.1001/jamapediatrics.2017.0651 pmid: 28558104 |
[1] | LI Sha. Adaptive development evaluation indicator system for students with special needs based on ICF [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 628-634. |
[2] | ZHU Chenchen, LIAO Sisi, PAN Jianming, XIA Bihua, HONG Ningjie. Early home-based education and rehabilitation for infants and toddlers with developmental disabilities: construction of goal and service system using ICF [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 635-641. |
[3] | WU Dang, ZHANG Qing, WU Jiaming, JIA Wenrong, WU Aihong, WU Jian. Support system for children with special needs participating in physical activity in an inclusive education context [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 650-657. |
[4] | WEI Xiaowei. Physical activity and psychological-behavioral health among college students: policy frameworks and theoretical models [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 658-665. |
[5] | LIU Xuan, GAO Ling, CHU Fengming, CHEN Jie, ZHANG Ming. Effect of brain-computer interface combined with upper limb rehabilitation robot on upper limb function of stroke patients [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 703-710. |
[6] | ZHOU Tiantian, ZHANG Tong, ZHANG Qi, LIANG Yanhua, ZHANG Yanqing, YUE Qing, LI Sijia. Effect of Lokomat robotic-assisted gait training on lower limb motor function in children with hemiplegia [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 711-720. |
[7] | FENG Haiyang. Reliability and validity of foot function index in flatfeet of children and adolescents [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 729-735. |
[8] | BAI Min, CAO Lihua, YE Ziqi, ZHOU Dingjie, LI Xueping. Effect of electromyographic perception-assisted robotic training combined with paired association stimulation on upper limb function in hemiplegic patients after stroke [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 505-512. |
[9] | ZOU Congcong, WANG Xiaojun, MA Jinrong, LU Shangbo, DING Yong, WANG Hani, SONG Jianfei. Effect of transcutaneous auricular vagus nerve stimulation combined with dual-task training on upper limb function in patients with ischemic stroke [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 513-519. |
[10] | PAN Yi, HOU Shuanglong, WEN Xiaoni. Transcutaneous vagus nerve stimulation for executive function in adults: a scoping review [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 520-528. |
[11] | WU Aihong, ZHANG Qing, WU Jiaming, XIE Junxia, WU Dang. Construction of a competency-based and functioning-oriented training curriculum system for inclusive education teachers in primary and secondary schools [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 539-547. |
[12] | WANG Mei, ZHU Wenping. Health benefits of physical activity in patients with type 2 diabetes: a systematic review of systematic reviews [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 553-560. |
[13] | SHI Bin, XU Ning, ZHOU Guangxue. Application of mirror therapy in motor function rehabilitation for stroke: a bibliometric analysis from 2005 to 2024 [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 561-572. |
[14] | ZHOU Bo, SHE Wanbin, XIANG Songbai. Application of artificial intelligence in diagnosis and intervention for children with autism spectrum disorder: a bibliometric analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 573-580. |
[15] | ZHANG Xiaoyan, CAO Jing, QIU Zhuoying, YAN Zixue, CHEN Yanke. Characteristics of adaptive behavior in children with intellectual and developmental disabilities [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 592-600. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||
|