School-Based Obesity Interventions: A Literature Review (original) (raw)
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School-Based Interventions on Childhood Obesity
American Journal of Preventive Medicine, 2009
Background: Over the past decade, childhood obesity has been recognized as an increasing health problem worldwide. It is a predictor of obesity during adulthood, which is strongly linked to chronic lifestyle diseases. Purpose: This paper aims to evaluate the effectiveness of school-based programs in the prevention and management of childhood obesity. Methods: A comprehensive literature search was undertaken for RCTs and clinical controlled trials on school-based interventions that addressed childhood obesity, published between 1995 and 2007. The papers included for the meta-analysis were those in which ORs or standardized mean differences and their 95% CIs were reported or could be calculated from available data. Results: Meta-analysis showed that the odds of participants' being overweight and obese in the school-based intervention programs compared with the control arm were significantly protective in the short term (ORϭ0.74, 95% CIϭ0.60, 0.92). Interventions that were conducted for more than 1 year had a higher OR of decreasing the prevalence of obesity. However, intervention programs were not effective in decreasing BMI compared with control treatments, with a weighted mean difference of Ϫ0.62 (95% CIϭϪ1.39, 0.14). Conclusions: This meta-analysis showed that there was convincing evidence that school-based interventions are effective, at least short-term, in reducing the prevalence of childhood obesity. Longer-running programs were more effective than shorter programs.
Effect of School‑based Interventions to Control Childhood Obesity: A Review of Reviews
Effectiveness of school‑based interventions to prevent or control overweight and obesity among school children was reviewed for a 11‑year period (January 2001 to December 2011). All English systematic reviews, meta‑analyses, reviews of reviews, policy briefs and reports targeting children and adolescents which included interventional studies with a control group and aimed to prevent or control overweight and/or obesity in a school setting were searched. Four systematic reviews and four meta‑analyses met the eligibility criteria and were included in the review. Results of the review indicated that implementation of multi‑component interventions did not necessarily improve the anthropometric outcomes. Although intervention duration is a crucial determinant of effectiveness, studies to assess the length of time required are lacking. Due to existing differences between girls and boys in responding to the elements of the programs in tailoring of school‑based interventions, the differences should be taken into consideration. While nontargeted interventions may have an impact on a large population, intervention specifically aiming at children will be more effective for at‑risk ones. Intervention programs for children were required to report any unwanted psychological or physical adverse effects originating from the intervention. Body mass index was the most popular indicator used for evaluating the childhood obesity prevention or treatment trials; nonetheless, relying on it as the only indicator for adiposity outcomes could be misleading. Few studies mentioned the psychological theories of behavior change they applied. Recommendations for further studies on school‑based interventions to prevent or control overweight/obesity are made at the end of this review.
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.
BMC Public Health, 2014
Background: Home and school environments conducive for unhealthy eating and physical inactivity are precursors of obesity. The aim of this study is evaluation of the effectiveness of a multi-component school-based weight management programme for overweight and obese primary school children via a home-school joint venture. Methods: This study made use of variety of behavioural modification strategies integrating into the Health Promoting School approach to promote healthy lifestyles. The participants were overweight and obese students aged between 8 and 12 from six participating schools. The interventions involved students attending ten 75 minutes after-school sessions and one 3-hour weekend session of practical interactive and fun activities on healthy eating and exercise, and meal plan together with parents and printed tailor-made management advices. Parents received an introductory seminar with 2 sets of specially designed exercise for their overweight children. The tools to measure bodyweight and fat percentage and standing height were bio-impedance body fat scale and a portable stadiometer. Self-administered questionnaire was used to measure knowledge, attitudes and behaviours. McNemar test was utilized to compare the proportions of behaviour changes within the same group to assess for the trends of changes. BMI z-score and body fat percentage of intervention participants at baseline, 4 month and 8 month were compared pair-wisely using tests of within subject contrasts in repeated measures ANOVA to assess for programme sustainability. Results: Those students in the intervention group reduced their BMI z-score (−0.21, 95% CI −0.34 to −0.07, P = 0.003) and body fat (−2.67%, 95% CI −5.12 to −0.22, P = 0.033) compared to wait list control group with statistical significant, and the intervention group also had a significant reduction in BMI z-score (−0.06, 95% CI −0.11, −0.007, P = 0.028) and body fat (−1.71%, 95% CI, −3.44 to 0.02, P = 0.052) after a 4 month maintenance period. Improvement of dietary habits and positive attitudes towards exercise were observed among the intervention group. Conclusion: School based weight management programme integrated into a Health Promoting School approach with improved school policies and environment in supporting individual skills of obese students and their parents appears to be a promising practice for sustaining weight control. Trial registration: ISRCTN58795797.
Elementary School-Based Obesity Intervention Using an Educational Curriculum
Journal of primary care & community health, 2016
Pediatric obesity is a significant public health problem with a prevalence of 16.9% among US children. School-based obesity interventions show promise for reducing adiposity in elementary age children. This pilot study evaluated the impact of the Let's Go! 5-2-1-0 pediatric obesity intervention program in an elementary school setting. This was a cluster randomized controlled field trial comprising 8 classrooms of second- and third-grade children. The impact of implementation of a standardized 5-2-1-0 curriculum was evaluated in the classrooms by looking at health behavior (self-reported fruit and vegetable and sugar-containing beverage intake, and screen time), physical activity (steps measured by pedometer), and body mass index (BMI). Half of the classrooms were given 5-2-1-0 teaching over a 4-month period. There was no statistical difference in improvement of healthy habits, BMI, or physical activity in the intervention group compared with the control group. The 5-2-1-0 interv...
PLOS ONE, 2022
Background School-based health-promoting interventions are increasingly seen as an effective population strategy to improve health and prevent obesity. Evidence on the long-term effectiveness of school-based interventions is scarce. This study investigates the four-year effectiveness of the school-based Healthy Primary School of the Future (HPSF) intervention on children's body mass index z-score (BMIz), and on the secondary outcomes waist circumference (WC), dietary and physical activity (PA) behaviours. Methods and findings This study has a quasi-experimental design with four intervention schools, i.e., two full HPSFs (focus: diet and PA), two partial HPSFs (focus: PA), and four control schools. Primary school children (aged 4-12 years) attending the eight participating schools were invited to enrol in the study between 2015 and 2019. Annual measurements consisted of children's anthropometry (weight, height and waist circumference), dietary behaviours (child-and parent-reported questionnaires) and PA levels (accelerometers). Between 2015 and 2019, 2236 children enrolled. The average exposure to the school condition was 2�66 (SD 1�33) years, and 900 participants were exposed for the full four years (40�3%). After
Integrative Review of School-based Childhood Obesity Prevention Programs
Journal of Pediatric Health Care, 2009
Childhood and adolescent overweight and obesity in the United States are rapidly becoming a major pediatric health concern. Schools are a critical part of the social environment that shape children&amp;#39;s eating and physical activity patterns. While school-based programs may affect a student&amp;#39;s perception of physical activity and the influence of dietary practices on overall health, the current variability in the theoretical underpinnings and methodological approaches used to implement these programs makes them difficult to evaluate for quality and evidence of effectiveness of the outcomes achieved across programs. The purpose of this study is to conduct an integrative research review using Cooper&amp;#39;s framework to provide an overview of the degree of variability in the methodological approaches and theoretical frameworks of school-based obesity prevention programs that utilize one or more of the following interventions: dietary, physical activity, healthy lifestyle education, and/or parental involvement. This review will examine the variations in the duration of the interventions; whether the interventions were guided by the use of a theoretical framework; the strength of evidence supporting the studies; and whether the interventions demonstrated a reduction in body mass index or weight loss. A total of 16 articles were found based on the inclusion criteria for this study. Eight of the 16 studies (50%) applied theoretical frameworks. Significant variability was found in the duration of intervention between the studies analyzed. The range of duration was 5 weeks to 8 years, with an average of 16.8 months. Fourteen of 16 studies (88%) implemented dietary habit interventions. Fourteen of 16 studies (88%) implemented physical education programs. All 16 studies applied healthy lifestyle education. Nine of 16 studies integrated family involvement into the obesity intervention. Nine of 16 studies (56%) evaluated the effect of their intervention on body mass index.
The impact of a 3-year after-school obesity prevention program in elementary school children
Childhood obesity (Print), 2012
Background: Children tend to be sedentary during the after-school hours, and this has deleterious effects on their health. the objective of the present study was to determine the effects of a 3-year after-school physical activity (PA) program, without restriction of dietary energy intake, on percent body fat (%bF), cardiorespiratory fitness (CRF), and cardiometabolic markers in children.
International Journal of Environmental Research and Public Health
With the significant decrease in physical activity rates, the importance of intervention programs in the schools, where children spend a significant part of the day, has become indisputable. The purpose of this review is to systematically examine the possibility of school-based interventions on promoting physical activity and physical fitness as well as preventing obesity. A systematic approach adopting PRISMA statement was implemented in this study. Three different databases (2010–2019) were screened and primary and secondary school-based intervention programs measuring at least one variable of obesity, physical activity, or physical fitness were included. The risk of bias was assessed using the validated quality assessment tool for quantitative studies. Among 395 potentially related studies, 19 studies were found to meet the eligibility criteria. A general look at the studies examined reveals that among the outcomes, of which most (18/19) were examined, a significant improvement w...
A School-Based Intervention to Reduce Excess Weight in Overweight and Obese Primary School Students
Biological research for nursing, 2016
This study evaluated the effect of an intervention for reducing excess weight gain in primary school-age children in Tehran. A cluster-randomized controlled trial was conducted in 12 primary schools in Tehran. Three hundred thirty-four pupils, 167 in the intervention and 167 in the comparison group, determined to be overweight or obese based on World Health Organization standards, were recruited for the study. The intervention included nutrition education and increased physical activity (PA) for the pupils, lifestyle modification for parents, and a change in food items sold at the schools' canteens. The entire intervention lasted approximately 18 weeks. Measures were taken before and immediately after the intervention. The intervention significantly reduced body mass index Z-score and hip circumference (p = .003 and p < .001, respectively). Waist circumference increased in both groups, but the increase was higher in the comparison group (p = .001). No significant difference w...