The impact of a 3-year after-school obesity prevention program in elementary school children (original) (raw)
American Journal of Health Promotion, 2020
Purpose: To evaluate the effect of a 17-week intervention, including an after-school physical activity (PA) club 3 d/wk, on moderate-to-vigorous physical activity (MVPA), body mass index (BMI) z score, percentage body fat (%BF), and cardiorespiratory fitness (CRF) among fifth to eighth grade girls having a BMI z score !0, and explore whether intervention outcomes varied by club attendance (1 vs 2 vs 3 d/wk). Design: Secondary analysis of data from a group randomized controlled trial (N ¼ 1519, 10-to 15-year-old girls: n ¼ 753 intervention; n ¼ 766 control). Setting: Twenty-four Midwestern US schools (n ¼ 12 intervention; n ¼ 12 control). Sample: Subsample (n ¼ 1194 girls) from trial's intervention (n ¼ 593 girls) and control (n ¼ 601 girls) groups having BMI z scores !0. Measures: Moderate-to-vigorous physical activity (min/h), BMI z score, %BF, and CRF ( _ VO 2max : mL/kg/min) were estimated at baseline and postintervention. Analysis: Linear mixed-effect models. Results: Intervention group gained less %BF (B ¼ À0.35, P ¼ .016), and their CRF decreased less (B ¼ 0.22, P ¼ .010) than the control. Marginally significant findings showed girls attending the club an average of 1 d/wk had greater increases in %BF (B ¼ 0.33, P ¼ .087) and MVPA (B ¼ 0.20, P ¼ .083) and a greater decrease in CRF (B ¼ À0.20, P ¼ .061) than girls attending 3 d/wk. No differences occurred between girls who attended 2 versus 3 d/wk for any outcomes. The intervention attenuated an increase in %BF and a decrease in CRF among girls at risk for obesity from baseline to postintervention. Offering the after-school PA club 2 d/wk may be adequate for achieving outcomes.
BMC Public Health, 2017
Background: The prevalence of non-communicable diseases (NCDs) is increasing worldwide, also among children. Information about primary prevention of NCD's is increasing; however, convincing strategies among children is needed. The present paper describes the design and methods in the Health Oriented Pedagogical Project (HOPP) study. The main objective is to evaluate the effects of a school-based physical activity intervention program on cardio-metabolic risk factors. Secondary objectives include assessment of physical, psychological and academic performance variables. Methods: The HOPP study is a 7 years longitudinal large-scale controlled intervention in seven elementary schools (n = 1545) with two control schools (n = 752); all aged 6-11 years at baseline. The school-based physical activity intervention program includes an increase in physical activity (PA) of 225 min/week as an integrated part of theoretical learning, in addition to the curriculum based 90 min/week of ordinary PA. Primary outcomes include cardio-metabolic risk factors measured as PA level, BMI status, waist circumference, muscle mass, percent fat, endurance test performance, total serum cholesterol, high-density lipoprotein (HDL), non-HDL, micro C-reactive protein (mCRP) and long-term blood sugar (HbA1c). In addition, secondary outcomes include anthropometric growth measures, physical fitness, quality of life (QoL), mental health, executive functions, diet and academic performance. Discussion: HOPP will provide evidence of effects on cardio-metabolic risk factors after a long-term PA intervention program in elementary schoolchildren. School-based PA intervention programs may be an effective arena for health promotion and disease prevention. Trial registration: The study is registered in Clinical trials (ClinicalTrials.gov Identifier: NCT02495714) as of June 20 th-2015, retrospectively registered. The collection of baseline values was initiated in mid-January 2015.
HOP'N after-school project: an obesity prevention randomized controlled trial
International Journal of …
Background: This paper reports the primary outcomes of the Healthy Opportunities for Physical Activity and Nutrition (HOP’N) after-school project, which was an effectiveness trial designed to evaluate the prevention of childhood obesity through building the capacity of after-school staff to increase physical activity (PA) and fruit and vegetable (FV) opportunities. Methods: We conducted a three-year, nested cross-sectional group randomized controlled effectiveness trial. After a baseline assessment year (2005-2006), schools and their after-school programs were randomized to the HOP’N after-school program (n = 4) or control (n = 3), and assessed for two subsequent years (intervention year 1, 2006- 2007; intervention year 2, 2007-2008). Across the three years, 715 fourth grade students, and 246 third and fourth grade after-school program participants were included in the study. HOP’N included community government human service agency (Cooperative Extension) led community development efforts, a three-time yearly training of after-school staff, daily PA for 30 minutes following CATCH guidelines, a daily healthful snack, and a weekly nutrition and PA curriculum (HOP’N Club). Child outcomes included change in age- and gender-specific body mass index z-scores (BMIz) across the school year and PA during after-school time measured by accelerometers. The success of HOP’N in changing after-school program opportunities was evaluated by observations over the school year of after-school program physical activity sessions and snack FV offerings. Data were analyzed in 2009. Results: The intervention had no impact on changes in BMIz. Overweight/obese children attending HOP’N afterschool programs performed 5.92 minutes more moderate-to-vigorous PA per day after intervention, which eliminated a baseline year deficit of 9.65 minutes per day (p < 0.05) compared to control site overweight/obese children. Active recreation program time at HOP’N sites was 23.40 minutes (intervention year 1, p = 0.01) and 14.20 minutes (intervention year 2, p = 0.10) greater than control sites. HOP’N sites and control sites did not differ in the number of FV offered as snacks. Conclusions: The HOP’N program had a positive impact on overweight/obese children’s PA and after-school active recreation time.
Applied Physiology, Nutrition, and Metabolism, 2018
The global rate of obesity in childhood is becoming an epidemic and many authors have established a significant association between childhood obesity and overweight in adulthood. It is therefore necessary to seek effective strategies to reduce these levels of obesity. The aim of this study was to evaluate the impact of the Healthy Habits Program (HHP). The participants comprised 158 children from the fifth and sixth grades (intervention group, n = 82; control group, n = 76). The HHP is a school-based physical activity program focusing on promoting a healthy lifestyle. It lasted for 8 months, and measurements were taken at the beginning and end of the program. Physiological variables (total cholesterol, triglycerides, blood glucose, blood pressure, and maximal oxygen consumption), anthropometric variables (body mass index (BMI)) and behavioral variables (breakfast, quality of diet, meal frequency, physical activity, sedentary behavior, sleep, and perceived health) were evaluated. Rep...
Journal of Pediatric Advance Research, 2024
Background: The prevalence of obesity is extremely high and increasing in elementary school children in the US, but recent systematic reviews have concluded that there are no simple, generalizable and successful obesity prevention strategies available. Objective: To assess whether an 8-week-school-based physical activity intervention would reduce BMI percentiles and improve physical fitness in both normal weight and obese children. Material and Methods: One hundred and one children were consented to the study (mean age 8.12 ± 0.10 years). BMI and BMI percentiles for age and gender were determined using EpiInfo. Participants were classified as Obese (OB) (n=48) if they had a BMI percentile of ≥ 95% for their age and gender. Normal weight (NW) was (n=53) classified as having a BMI percentile lower than 75% for age and gender. Intervention consisted of an 8-week enhanced physical activity program in school (100 minutes/week). Physical fitness was assessed using the FITNESSGRAM test battery. Repeated measures GLM was used to assess within and between subjects' effects from preto post-testing. Results: GLM showed significant results within subject and between subject for BMI percentile, trunk lifts, push-ups, sit ups, sit and reach and the 1-mile run (p's <0.01). However, our results also showed that there was a significant reduction in BMI percentile (0.001), weight (p=0.05) and waist/hip ratio (p=0.01) for the obese group. Conclusion: Our study demonstrated that an 8-week physical activity intervention was successful in improving physical fitness in NW and OB children. The 8-week program also was successful in reducing BMI percentile in the OB group. Future studies should consider increasing both the duration of the program and the sample size.
BMJ, 2010
Objective To assess the effectiveness of a school based physical activity programme during one school year on physical and psychological health in young schoolchildren. Design Cluster randomised controlled trial. Setting 28 classes from 15 elementary schools in Switzerland randomly selected and assigned in a 4:3 ratio to an intervention (n=16) or control arm (n=12) after stratification for grade (first and fifth grade), from August 2005 to June 2006. Participants 540 children, of whom 502 consented and presented at baseline. Intervention Children in the intervention arm (n=297) received a multi-component physical activity programme that included structuring the three existing physical education lessons each week and adding two additional lessons a week, daily short activity breaks, and physical activity homework. Children (n=205) and parents in the control group were not informed of an intervention group. For most outcome measures, the assessors were blinded. Main outcome measures Primary outcome measures included body fat (sum of four skinfolds), aerobic fitness (shuttle run test), physical activity (accelerometry), and quality of life (questionnaires). Secondary outcome measures included body mass index and cardiovascular risk score (average z score of waist circumference, mean blood pressure, blood glucose, inverted high density lipoprotein cholesterol, and triglycerides). Results 498 children completed the baseline and followup assessments (mean age 6.9 (SD 0.3) years for first grade, 11.1 (0.5) years for fifth grade). After adjustment for grade, sex, baseline values, and clustering within classes, children in the intervention arm compared with controls showed more negative changes in the z score of the sum of four skinfolds (−0.12, 95 % confidence interval −0.21 to −0.03; P=0.009). Likewise, their z scores for aerobic fitness increased more favourably (0.17, 0.01 to 0.32; P=0.04), as did those for moderate-vigorous physical activity in school (1.19, 0.78 to 1.60; P<0.001), all day moderate-vigorous physical activity (0.44, 0.05 to 0.82; P=0.03), and total physical activity in school (0.92, 0.35 to 1.50; P=0.003). Z scores for overall daily physical activity (0.21, −0.21 to 0.63) and physical quality of life (0.42, −1.23 to 2.06) as well as psychological quality of life (0.59, −0.85 to 2.03) did not change significantly. Conclusions A school based multi-component physical activity intervention including compulsory elements improved physical activity and fitness and reduced adiposity in children. Trial registration Current Controlled Trials ISRCTN15360785.
Archives of pediatrics & adolescent medicine, 1999
To assess differences through grade 8 in diet, physical activity, and related health indicators of students who participated in the Child and Adolescent Trial for Cardiovascular Health (CATCH) school and family intervention from grades 3 through 5. Follow-up of the 4-center, randomized, controlled field trial with 56 intervention and 40 control elementary schools. We studied 3714 (73%) of the initial CATCH cohort of 5106 students from ethnically diverse backgrounds in California, Louisiana, Minnesota, and Texas at grades 6, 7, and 8. Self-reported daily energy intake from fat at baseline was virtually identical in the control (32.7%) and intervention (32.6%) groups. At grade 5, the intake for controls remained at 32.2%, while the intake for the intervention group declined to 30.3% (P<.001). At grade 8, the between-group differential was maintained (31.6% vs 30.6%, P = .01). Intervention students maintained significantly higher self-reported daily vigorous activity than control st...
School-Based Obesity Interventions: A Literature Review
Journal of School Health, 2008
BACKGROUND: Childhood obesity is an impending epidemic. This article is an overview of different interventions conducted in school settings so as to guide efforts for an effective management of obesity in children, thus minimizing the risk of adult obesity and related cardiovascular risk.