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Alalawi A, Blank L, Goyder E. Umbrella review of international evidence for the effectiveness of school-based physical activity interventions. PLoS One 2024; 19:e0304513. [PMID: 38870155 PMCID: PMC11175402 DOI: 10.1371/journal.pone.0304513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 05/14/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Obesity and physical inactivity among children and young people are public health concerns. Despite the wide variety of interventions available to promote physical activity, little is known about which interventions are most effective. This review aimed to evaluate the existing literature on school-based interventions that aim to increase physical activity among children and young people aged 6 to 18 years. METHODS A systematic review of reviews was undertaken. We searched for systematic reviews and meta-analyses published between December 2017 and January 2024 using databases such as PubMed, Scopus, and CINAHL. Titles and abstracts were independently screened by two reviewers, who also conducted data extraction and quality assessments. We focused on outcomes like changes in physical activity levels and body mass index to assess the effectiveness of the interventions. RESULTS A total of 23 reviews examining school-based physical activity interventions met the inclusion criteria, comprising 15 systematic reviews and 8 meta-analyses. All reviews (N = 23) were implemented in the school setting: three in primary schools, seven in secondary schools, and thirteen targeted both primary and secondary schools. The findings demonstrated that six reviews reported a statistical increase in physical activity levels among the target population, and one review found a decrease in body mass index. The most promising interventions focused on physical activity included within the school curriculum and were characterised as long-term interventions. 20 out of 23 reviews assessed the quality of primary studies. CONCLUSION Some interventions were promising in promoting physical activity among school-aged children and young people such as Daily Mile, Active Break, and Active transport while multi-component interventions seem to be positively effective in reducing BMI. Future efforts should focus on long-term, theory-driven programmes to ensure sustainable increases in physical activity.
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Affiliation(s)
- Abdullah Alalawi
- Health and Related Research, University of Sheffield, Sheffield, United Kingdom
- Al Qunfudah Health Sciences College, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Lindsay Blank
- Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Elizabeth Goyder
- Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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Drouka A, Brikou D, Causeret C, Al Ali Al Malla N, Sibalo S, Ávila C, Alcat G, Kapetanakou AE, Gurviez P, Fellah-Dehiri N, Masson M, Kontogianni MD, Yannakoulia M. Effectiveness of School-Based Interventions in Europe for Promoting Healthy Lifestyle Behaviors in Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1676. [PMID: 37892339 PMCID: PMC10605522 DOI: 10.3390/children10101676 10.3390/儿童10101676] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 06/30/2024]
Abstract
The objective of this narrative review was to summarize existing literature on the effectiveness of school-based interventions, implemented in Europe, under the aim of promoting healthy lifestyle behaviors in children (6-10 years old). A search of PubMed, Scopus, EFSA and Google Scholar databases was performed for studies published from January 2016 to June 2022. Specific search terms and exclusion criteria were used. Based on the results, diet and physical activity interventions had favorable effects on a series of health outcomes, including anthropometric parameters, biomarkers, eating behavior and self-efficacy. Diet-only interventions had a positive impact specifically on eating habits, mostly on water consumption. Most successful interventions lasted for 1 school year, and they were characterized by parental involvement and teachers' training.
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Affiliation(s)
- Archontoula Drouka
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | - Dora Brikou
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | | | | | | | - Concha Ávila
- Federación Española de Industrias de Alimentación y Bebidas, 28001 Madrid, Spain; (C.Á.); (G.A.)
| | - Gabriela Alcat
- Federación Española de Industrias de Alimentación y Bebidas, 28001 Madrid, Spain; (C.Á.); (G.A.)
| | | | - Patricia Gurviez
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Nawel Fellah-Dehiri
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Marine Masson
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Meropi D. Kontogianni
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | - Mary Yannakoulia
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
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3
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Drouka A, Brikou D, Causeret C, Al Ali Al Malla N, Sibalo S, Ávila C, Alcat G, Kapetanakou AE, Gurviez P, Fellah-Dehiri N, Masson M, Kontogianni MD, Yannakoulia M. Effectiveness of School-Based Interventions in Europe for Promoting Healthy Lifestyle Behaviors in Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1676. [PMID: 37892339 PMCID: PMC10605522 DOI: 10.3390/children10101676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
The objective of this narrative review was to summarize existing literature on the effectiveness of school-based interventions, implemented in Europe, under the aim of promoting healthy lifestyle behaviors in children (6-10 years old). A search of PubMed, Scopus, EFSA and Google Scholar databases was performed for studies published from January 2016 to June 2022. Specific search terms and exclusion criteria were used. Based on the results, diet and physical activity interventions had favorable effects on a series of health outcomes, including anthropometric parameters, biomarkers, eating behavior and self-efficacy. Diet-only interventions had a positive impact specifically on eating habits, mostly on water consumption. Most successful interventions lasted for 1 school year, and they were characterized by parental involvement and teachers' training.
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Affiliation(s)
- Archontoula Drouka
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | - Dora Brikou
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | | | | | | | - Concha Ávila
- Federación Española de Industrias de Alimentación y Bebidas, 28001 Madrid, Spain; (C.Á.); (G.A.)
| | - Gabriela Alcat
- Federación Española de Industrias de Alimentación y Bebidas, 28001 Madrid, Spain; (C.Á.); (G.A.)
| | | | - Patricia Gurviez
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Nawel Fellah-Dehiri
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Marine Masson
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Meropi D. Kontogianni
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | - Mary Yannakoulia
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
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Suminski RR, Obrusnikova I, Kelly K, Heagbetus ST, Williams M. Small Business Support Is Associated with the Quantity, Quality, and Usage of Youth Physical Activity Opportunities in Urban, Low-Income, African American Neighborhoods. J Urban Health 2022; 99:1104-1114. [PMID: 36222975 PMCID: PMC9727054 DOI: 10.1007/s11524-022-00694-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 12/31/2022]
Abstract
Evidence suggests small businesses could play a significant role in bringing quality youth physical activity opportunities (YPAOs) to urban areas. Knowing more about their involvement with YPAOs in African American neighborhoods would be of significant value given the relatively low PA rates of African American youth. The current study examined associations between small businesses and YPAOs in low-income, African American urban neighborhoods. Surveys were conducted with 46.4% (n = 223) of eligible small business owners/managers and 44.2% (n = 38) of eligible YPAO providers in 20 low-income, African American urban neighborhoods to ascertain business and YPAO characteristics. Audits were conducted at the YPAOs and parks (n = 28) in the study areas to obtain counts of users and data on amenities/incivilities. Analyses included multiple linear regression. Only 33.6% of all businesses were currently supporting YPAOs. The percentage of businesses supporting only local YPAOs (YPAOs near the business) was significantly associated with the number of YPAOs in the area, number of YPAO amenities, youth participants, teams, amenity quality, and the severity of incivilities after controlling for neighborhood demographics. Businesses supporting only local YPAOs were at their location longer, and their owners were more likely to have a sports background, children, and believe small businesses should support YPAOs than business not supporting local YPAOs. This study provides evidence that YPAOs in low-income, African American urban neighborhoods are improved by support from small businesses. Efforts to enhance PA among African American youth living in low-income urban neighborhoods could benefit from involving small businesses.
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Affiliation(s)
- Richard R. Suminski
- Department of Behavioral Health and Nutrition, University of Delaware, 019 Carpenter Sports Building, Newark, DE 19716 USA
| | - Iva Obrusnikova
- Department of Behavioral Health and Nutrition, University of Delaware, 019 Carpenter Sports Building, Newark, DE 19716 USA
| | - Kristin Kelly
- Department of Behavioral Health and Nutrition, University of Delaware, 019 Carpenter Sports Building, Newark, DE 19716 USA
| | | | - Matthew Williams
- Conscious Connections, 802 West 29th Street, Wilmington, DE 19802 USA
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Timpel P, Herrmann S, Flößel P, Beck H, Schwarz PE. Effectiveness of digital primary prevention interventions targeting physical activity, motor skills and nutrition in children aged 3-10 years in the setting of day care and primary school: protocol for a systematic review. BMJ Open 2021; 11:e053628. [PMID: 34949625 PMCID: PMC8705251 DOI: 10.1136/bmjopen-2021-053628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Available evidence points to an association of increased screen time and the availability of digital tools during childhood with negative health outcomes in later life. For many years, public discourse focused on restricting access and use of digital technologies below certain ages. However, little is known about the specific benefit of a responsible use of digital primary prevention in the setting of (early) childhood education. The objective of this evidence synthesis is to investigate the effectiveness of digital primary prevention interventions targeting physical activity, motor skills and/or nutrition in children aged 3-10 years in day-care facilities and (pre-) schools. METHODS AND ANALYSIS We present the rationale and methodological steps of a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures. Automated searches will be conducted by applying a pretested search strategy to the databases MEDLINE/PubMed, EMBASE and PsycInfo to identify relevant interventional (randomised controlled trials, controlled trials, crossover trials and pilot and feasibility) and observational (case-control, cohort) studies in English or German, with no date restrictions. The overall search will be complemented by backward, forward and additional hand searches. Two researchers will independently screen titles/abstracts and assess full texts by applying predefined eligibility criteria. Data extraction will be conducted by using a pretested data extraction sheet. The assessment of methodological quality will be performed independently by two review authors using the Critical Appraisals Skills Programme relevant to the study design applied in the given study. Additionally, qualitative content analysis will be conducted to analyse priorities for future research extracted from the discussion sections and conclusions of included studies. PROSPERO REGISTRATION NUMBER CRD42020207682.
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Affiliation(s)
- Patrick Timpel
- Medical Faculty Carl Gustav Carus, Department of Medicine III, Prevention and Care of Diabetes, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Sandra Herrmann
- Medical Faculty Carl Gustav Carus, Department of Medicine III, Prevention and Care of Diabetes, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Philipp Flößel
- UniversityCenter for Orthopedics, Trauma & Plastic Surgery, Section Sports Medicine and Rehabilitation, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Heidrun Beck
- UniversityCenter for Orthopedics, Trauma & Plastic Surgery, Section Sports Medicine and Rehabilitation, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Peter Eh Schwarz
- Medical Faculty Carl Gustav Carus, Department of Medicine III, Prevention and Care of Diabetes, Technische Universität Dresden, Dresden, Sachsen, Germany
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Temam S, Billaudeau N, Kab S, Zins M, Alexander S, Vercambre MN. Health behaviours of teachers and other education professionals in France: can we do better? Health Promot Int 2021; 37:6372722. [PMID: 34542611 DOI: 10.1093/heapro/daab151] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Education professionals play a critical role in health education, both as knowledge providers and as role-models. Drawing on the CONSTANCES French cohort (baseline 2012-19) and adjusting for important confounders, we compared education professionals (n = 14 730) with a random sample of non-education sector employees (n = 34 244) on three indicators of high-risk behaviour (at-risk drinking, current smoking, past-year cannabis use) and three indicators of unhealthy lifestyle (low physical activity, poor adherence to nutritional guidelines, overweight/obesity). Among education professionals, we distinguished between teachers (n = 12 820), school principals (n = 372), senior education advisers (n = 189), school health professionals (n = 128) and school service staff (n = 1221). Compared with non-education sector employees with similar demographic and socioeconomic profiles, teachers were less likely to be at-risk drinkers, to smoke, to have used cannabis in the past year and to be overweight/obese. Other non-teaching education professionals were also less involved in high-risk behaviours than non-education employees, but results were more mixed concerning some lifestyle indicators, with certain non-teaching education professional groups showing a higher likelihood of being physically inactive or overweight/obese. In this nationwide French study, our results suggest a window of opportunity to promote school staff health but also indirectly, that of the youth with whom they interact daily. We suggest that school staff should be supported in health matters not only through the provision of health information but also most importantly, through the development of a favourable and supportive environment enabling them to put health knowledge into practice.
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Affiliation(s)
- Sofia Temam
- MGEN Foundation for Public Health, 3 square Max-Hymans, 75748 Paris Cedex 15, France
| | - Nathalie Billaudeau
- MGEN Foundation for Public Health, 3 square Max-Hymans, 75748 Paris Cedex 15, France
| | - Sofiane Kab
- Inserm UMS 011, 16 avenue Paul Vaillant-Couturier, 94 807 Villejuif, France
| | - Marie Zins
- Inserm UMS 011, 16 avenue Paul Vaillant-Couturier, 94 807 Villejuif, France.,Université Paris Descartes, Faculty of Medicine, 15 rue de l'École de Médecine, 75006 Paris, France
| | - Stéphanie Alexander
- MGEN Foundation for Public Health, 3 square Max-Hymans, 75748 Paris Cedex 15, France
| | - Marie-Noël Vercambre
- MGEN Foundation for Public Health, 3 square Max-Hymans, 75748 Paris Cedex 15, France
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7
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Opportunities for and Limits to Cooperation between School and Families in Sustainable Public Food Procurement. SUSTAINABILITY 2021. [DOI: 10.3390/su13168808] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper describes a research project, carried out in an Italian public school, to assess whether parents were willing to take part in food procurement decisions, as well as their ability to accurately predict what foods children would pick at school lunch and their propensity to support sustainable food choices made by the school. The methodology included a questionnaire, issued to 500 parents, and an in-depth study of 138 child/parent pairs. The study comprised: (i) presentation of an innovative recipe in the weekly menu of the school canteen; (ii) meal observations of children’s intake at school lunch during the week of the menu modification; (iii) collection of both parents’ and children’s reports on their choices of recipes from the modified weekly menu. The results are commented in light of two important changes that have recently affected Italian public school food procurement: the opening of school canteens to lunches brought from home and the measures adopted since 2020 to contain the COVID-19 pandemic. Both events go in the direction of delegating to parents the multifaceted role of the school in the food arena. The article concludes that the results of the study should discourage this approach.
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Motevalli M, Drenowatz C, Tanous DR, Khan NA, Wirnitzer K. Management of Childhood Obesity-Time to Shift from Generalized to Personalized Intervention Strategies. Nutrients 2021; 13:1200. [PMID: 33917383 PMCID: PMC8067342 DOI: 10.3390/nu13041200] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 02/07/2023] Open
Abstract
As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-component strategies but various prohibitory limitations have been reported in practice. This review seeks to (i) provide a brief overview of the current preventative and therapeutic approaches towards childhood obesity, (ii) discuss the complexity and limitations of research in the childhood obesity area, and (iii) suggest an Etiology-Based Personalized Intervention Strategy Targeting Childhood Obesity (EPISTCO). This purposeful approach includes prioritized nutritional, educational, behavioral, and physical activity intervention strategies directly based on the etiology of obesity and interpretation of individual characteristics.
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Affiliation(s)
- Mohamad Motevalli
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University College of Teacher Education Upper Austria, A-4020 Linz, Austria;
| | - Derrick R. Tanous
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
| | - Naim Akhtar Khan
- Nutritional Physiology & Toxicology Division, INSERM UMR 1231, Université de Bourgogne, F-21000 Dijon, France;
| | - Katharina Wirnitzer
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
- Department of Subject Didactics and Educational Research & Development, University College of Teacher Education Tyrol, A-6020 Innsbruck, Austria
- Life and Health Science Cluster Tirol, Subcluster Health/Medicine/Psychology, A-6020 Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria
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9
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Management of Childhood Obesity—Time to Shift from Generalized to Personalized Intervention Strategies. Nutrients 2021. [DOI: 10.3390/nu13041200
expr 902416715 + 844236509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-component strategies but various prohibitory limitations have been reported in practice. This review seeks to (i) provide a brief overview of the current preventative and therapeutic approaches towards childhood obesity, (ii) discuss the complexity and limitations of research in the childhood obesity area, and (iii) suggest an Etiology-Based Personalized Intervention Strategy Targeting Childhood Obesity (EPISTCO). This purposeful approach includes prioritized nutritional, educational, behavioral, and physical activity intervention strategies directly based on the etiology of obesity and interpretation of individual characteristics.
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10
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Motevalli M, Drenowatz C, Tanous DR, Khan NA, Wirnitzer K. Management of Childhood Obesity-Time to Shift from Generalized to Personalized Intervention Strategies. Nutrients 2021; 13:1200. [PMID: 33917383 PMCID: PMC8067342 DOI: 10.3390/nu13041200&set/a 931824908+802380262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-component strategies but various prohibitory limitations have been reported in practice. This review seeks to (i) provide a brief overview of the current preventative and therapeutic approaches towards childhood obesity, (ii) discuss the complexity and limitations of research in the childhood obesity area, and (iii) suggest an Etiology-Based Personalized Intervention Strategy Targeting Childhood Obesity (EPISTCO). This purposeful approach includes prioritized nutritional, educational, behavioral, and physical activity intervention strategies directly based on the etiology of obesity and interpretation of individual characteristics.
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Affiliation(s)
- Mohamad Motevalli
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
- Correspondence:
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University College of Teacher Education Upper Austria, A-4020 Linz, Austria;
| | - Derrick R. Tanous
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
| | - Naim Akhtar Khan
- Nutritional Physiology & Toxicology Division, INSERM UMR 1231, Université de Bourgogne, F-21000 Dijon, France;
| | - Katharina Wirnitzer
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
- Department of Subject Didactics and Educational Research & Development, University College of Teacher Education Tyrol, A-6020 Innsbruck, Austria
- Life and Health Science Cluster Tirol, Subcluster Health/Medicine/Psychology, A-6020 Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria
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11
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Guirguis LM, Singh RL, Fox LL, Neufeld SM, Bond I. Medication Education Provided to School-Aged Children: A Systematic Scoping Review. THE JOURNAL OF SCHOOL HEALTH 2020; 90:887-897. [PMID: 32959364 DOI: 10.1111/josh.12953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 03/28/2020] [Accepted: 05/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To characterize the educational interventions regarding prescription and nonprescription medication use for school-aged children, we systematically reviewed evidence of programs available for this age group. METHODS Searches in PubMed, CINAHL, EMBASE, ERIC, and International Pharmaceutical Abstracts were conducted. Search terms focused on: population education, school-age children, and medications. Studies were excluded if they were specific to a particular disease state or class of medication, drugs of misuse and illicit drugs. Data extraction included study design, location, educational intervention and duration, research methods, and main findings. RESULTS We found 14 studies representing 8 separate projects. Six projects were identified in the gray literature. Projects ranged from individual sessions to national programs. Quantitative studies showed improvement in knowledge, medication literacy, and confidence. The adoption of medication education strategies was dependent on the educator's comfort level and beliefs regarding medication safety. CONCLUSIONS Credible medication education resources are available and have been shown to improve students' knowledge. There remains a need for multifaceted implementation and evaluation strategies. Strategies and resources are available to implement interventions in communities to address medication education in school-age children. Frameworks should be used to facilitate the implementation of effective health promotion strategies around safe-medication use for school-aged children.
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Affiliation(s)
- Lisa M Guirguis
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 3-171, Edmonton Clinic Health Academy, Edmonton, Alberta T6G 1C9, Canada
| | - Reshmi L Singh
- School of Pharmacy, College of Health Sciences, University of Wyoming, Laramie, WY, 82071-2000
| | - Lanae L Fox
- School of Pharmacy, College of Health Sciences, University of Wyoming, Laramie, WY, 82071-2000
| | - Susan M Neufeld
- Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, Edmonton, Alberta T6G 1C9B, Canada
| | - Irena Bond
- Library and Learning Resources, MCPHS University, Worcester, Massachusetts
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12
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Lifestyle Changes Observed among Adults Participating in a Family- and Community-Based Intervention for Diabetes Prevention in Europe: The 1 st Year Results of the Feel4Diabetes-Study. Nutrients 2020; 12:nu12071949. [PMID: 32629949 PMCID: PMC7399917 DOI: 10.3390/nu12071949] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/17/2020] [Accepted: 06/28/2020] [Indexed: 01/06/2023] Open
Abstract
The Feel4Diabetes intervention was a school and community-based intervention aiming to promote healthy lifestyle and tackle obesity and obesity-related metabolic risk factors for the prevention of type 2 diabetes (T2D) among families at risk of developing this disease. The current study aims to present the results on lifestyle behaviors obtained from parents during the first year of the Feel4Diabetes intervention. This multicomponent intervention had a cluster randomized design and was implemented in Belgium, Bulgaria, Finland, Greece, Hungary and Spain over two years (2016-2018). Standardized protocols and procedures were used by the participating centers in all countries to collect data on parents' lifestyle behaviors (diet, physical activity, sedentary behavior). The Feel4Diabetes intervention was registered at clinicaltrials.gov (registration number: NCT02393872). In total, 2110 high-risk parents participated in the baseline and 12-month follow-up examination measurements. Participants allocated to the intervention group reduced their daily consumption of sugary drinks (p = 0.037) and sweets (p = 0.031) and their daily screen time (p = 0.032), compared with the control group. In addition, participants in the intervention group in Greece and Spain increased their consumption of breakfast (p = 0.034) and fruits (p = 0.029), while in Belgium and Finland they increased their water intake (p = 0.024). These findings indicate that the first year of the Feel4Diabetes intervention resulted in the improvement of certain lifestyle behaviors in parents from high-risk families.
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Lambrinou CP, Androutsos O, Karaglani E, Cardon G, Huys N, Wikström K, Kivelä J, Ko W, Karuranga E, Tsochev K, Iotova V, Dimova R, De Miguel-Etayo P, M. González-Gil E, Tamás H, JANCSÓ Z, Liatis S, Makrilakis K, Manios Y. Effective strategies for childhood obesity prevention via school based, family involved interventions: a critical review for the development of the Feel4Diabetes-study school based component. BMC Endocr Disord 2020; 20:52. [PMID: 32370795 PMCID: PMC7201517 DOI: 10.1186/s12902-020-0526-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 03/23/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although there are many interventions targeting childhood obesity prevention, only few have demonstrated positive results. The current review aimed to gather and evaluate available school-based intervention studies with family involvement targeting dietary, physical activity and sedentary behaviors among primary schoolchildren and their families, in order to identify the most effective strategies. METHODS Studies published between 2000 and January 2015 were retrieved from scientific electronic databases and grey literature. The databases used included MEDLINE/PubMed, Web-of-Science, CINAHL and Scopus. Included studies had to be experimental controlled studies and had duration over 1 school year, had family involvement, combined PA and dietary behaviors and were implemented in school setting. A complementary search was executed to update the review to cover the period from February 2015 to January 2019. RESULTS From the studies examined (n = 425), 27 intervention programs (33 publications) fulfilled the inclusion criteria. Among these, 15 presented significant effect on weight status and/ or overweight/ obesity or clinical indices, 3 presented significant effect on most energy balance-related behaviors (EBRBs) while 9 presented significant effect on some/few EBRBs or determinants. Strategies implemented in effective interventions were: teachers acting as role-models and being actively involved in the delivery of the intervention, school policies supporting the availability of healthy food and beverage choices and limiting unhealthy snacks, changes in the schoolyard, in the recess rules and in the physical education classes to increase physical activity, and involving parents in the intervention via assignments, meetings, informative material and encouraging them to improve the home environment. Use of incentives for children, social marketing techniques, collaboration with local stakeholders were found to increase effectiveness. Programs that focused only on educational sessions and material for parents, without promoting relevant environmental and policy changes, were found to be less effective. Cultural adaptations have been suggested to increase the intervention's acceptance in specific or vulnerable population groups. CONCLUSIONS Several effective strategies were identified in the reviewed programs. Outcomes of the current review were taken into account in developing the Feel4Diabetes-intervention and summed up as recommendations in the current work in order to facilitate other researchers designing similar childhood obesity prevention initiatives.
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Affiliation(s)
- Christina-Paulina Lambrinou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Nele Huys
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Katja Wikström
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Jemina Kivelä
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Winne Ko
- International Diabetes Federation European Region, Brussels, Belgium
| | - Ernest Karuranga
- International Diabetes Federation European Region, Brussels, Belgium
| | - Kaloyan Tsochev
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Violeta Iotova
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Roumyana Dimova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, Bulgaria
| | - Pilar De Miguel-Etayo
- Growth, Exercise, NUtrition and Development (GENUD) Research Group. Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Zaragoza, Spain
| | - Esther M. González-Gil
- Growth, Exercise, NUtrition and Development (GENUD) Research Group. Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Zaragoza, Spain
- Institute of Nutrition and Food Technology. Department of Biochemistry and Molecular Biology II, Center of Biomedical Research, University of Granada, Granada, Spain
| | - Hajnalka Tamás
- University of Debrecen, Department of Family and Occupational Medicine, Debrecen, Hungary
| | - Zoltán JANCSÓ
- University of Debrecen, Department of Family and Occupational Medicine, Debrecen, Hungary
| | - Stavros Liatis
- National and Kapodistrian University of Athens, Athens, Greece
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
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Laxer RE, Dubin JA, Brownson RC, Cooke M, Chaurasia A, Leatherdale ST. Noncomprehensive and Intermittent Obesity-Related School Programs and Policies May Not Work: Evidence from the COMPASS Study. THE JOURNAL OF SCHOOL HEALTH 2019; 89:818-828. [PMID: 31364181 DOI: 10.1111/josh.12820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 02/22/2018] [Accepted: 07/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The school environment has the potential to influence student body mass index (BMI) through programs and policies. Our objective was to examine the effect of modifying obesity-related school policies and programs on youths' BMI trajectories. METHODS Obesity-related school policies and programs related to physical activity and healthy eating were collected from 41 schools across Ontario at baseline (2012-2013) and year 2 (2013-2014) of the COMPASS study. Self-reported height and weight were collected from the 4951 grades 9 and 10 students who attended those schools for 3 years. Linear mixed effects regression models examined the effect of modifying obesity-related school policies and programs on youths' BMI trajectories. RESULTS Between Y1 and Y2 , 26 of the 41 schools implemented distinct new obesity-related programs or policies related to physical activity or healthy eating. Five of the interventions were associated with BMI trajectories of students attending those schools compared to students attending a pooled sample of control schools, predicting a higher BMI trajectory. CONCLUSIONS Isolated programs and policies may not successfully improve youths' BMI trajectories. Further research is required to test the implementation of policies and programs that follow a comprehensive school health (CSH) approach, targeting BMI and associated behaviors.
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Affiliation(s)
- Rachel E Laxer
- 200 University Avenue W, University of Waterloo, Waterloo, ON N2L3G1
| | - Joel A Dubin
- 200 University Avenue W, University of Waterloo, Waterloo, ON N2L3G1
| | - Ross C Brownson
- Prevention Research Center, Brown School, Washington University, Campus Box 1196, One Brookings Drive, St. Louis, MO
| | - Martin Cooke
- 200 University Avenue W, University of Waterloo, Waterloo, ON N2L3G1
| | - Ashok Chaurasia
- 200 University Avenue W, University of Waterloo, Waterloo, ON N2L3G1
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Suminski RR, Robson S, Turner J, Plautz E. Promoting Small Business Support of Youth Physical Activity in Low-Income, Minority Neighborhoods: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e13141. [PMID: 31364602 PMCID: PMC6691677 DOI: 10.2196/13141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/08/2019] [Accepted: 05/10/2019] [Indexed: 01/26/2023] Open
Abstract
Background An unacceptably high percentage of our nation’s low-income, minority youth (age<18 years) are not regularly physically active. One reason for this could be their lack of access to quality youth physical activity opportunities (YPAOs). Our previous research found that small businesses (<500 employees), which represent over 99.64% (27.9/28.0 million businesses in United States) of all employers, are powerful resources for creating and improving YPAOs. In accordance with the socioecological model and established philanthropic principles, we developed an alpha version of an intervention (alpha-i) for increasing small businesses’ involvement with YPAOs. Objective The aims of this proposed study are to (1) create a beta version (beta-i) of the intervention and (2) conduct a pilot study of its impact on small business support for YPAOs and YPAO utilization by the youth in low-income, minority neighborhoods. Methods The alpha-i will be refined using information from focus groups and surveys conducted with small business owners and managers, YPAO providers, and parents and guardians of the youths from low-income, predominantly minority neighborhoods. A cluster randomized controlled trial will then be conducted for 1 year to examine the effects of the refined intervention (beta-i) on small business support for YPAOs in 10 low-income, minority neighborhoods. The control group of neighborhoods (n=10) will be provided with a standard practice intervention. The primary outcome for aim 2 will be the percentage of small businesses not supporting YPAOs at baseline that subsequently provide support for YPAOs at follow-up. We also will consider the US dollar equivalent of all types of support (monetary, goods/services, and time) donated for YPAOs by small businesses. In addition, we will examine the impact of the increased small business support for YPAOs on YPAO utilization by the youth. Results As of May 1, 2019, all YPAOs and small businesses in the study neighborhoods have been identified, and surveys have begun with these groups. In addition, 9 focus groups were completed, and the data have been transcribed. We anticipate that manuscripts regarding these aspects of the study will be submitted in fall 2019. Conclusions The proposed study is significant because it will provide evidence that an easily replicated approach can be used to increase small business support for YPAOs and that this support results in greater use of the YPAOs by youth. A logical next step will be to determine if YPAO changes resulting from increased small business support positively influence youth physical activity levels. ClinicalTrial ClinicalTrials.gov NCT03936582; https://clinicaltrials.gov/ct2/show/NCT03936582. International Registered Report Identifier (IRRID) DERR1-10.2196/13141
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Affiliation(s)
- Richard Robert Suminski
- Center for Innovative Health Research, Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, United States
| | - Shannon Robson
- Center for Innovative Health Research, Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, United States
| | - Jennie Turner
- Center for Innovative Health Research, Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, United States
| | - Eric Plautz
- Center for Innovative Health Research, Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, United States
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Safan M, Murillo AL, Wadhera D, Castillo-Chavez C. Modeling the Diet Dynamics of Children: the Roles of Socialization and the School Environment. LETTERS IN BIOMATHEMATICS 2018; 5:275-306. [PMID: 30705968 PMCID: PMC6349252 DOI: 10.1080/23737867.2018.1552543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 11/16/2018] [Indexed: 06/09/2023]
Abstract
Childhood obesity is a health emergency in many parts of the world including the U.S. and, consequently, identifying local, regional or national intervention models capable, of altering the dynamics of obesity at scales that make a difference remains a challenge. The fact that consumption of healthful foods among most youth has yet to meet recommended nutritional standards highlights a lack of effective policies aimed at addressing the epidemic of obesity. Mathematical models are used to evaluate the roles of socialization and school environment on the diet dynamics of children. Data suggest that standard nutrition education programs may have, at best, minimal impact in altering diet dynamics at the population-level. Inclusion of peer influence (model as contagion) reinforced by the use of culturally-sensitive school menus (environmental disruption) may prove capable of modifying obesity enhancing diet dynamics; altering the diets of a significant (critical) proportion of youngsters. A framework is introduced to explore the value of behavior-based interventions and policies that account for the sociocultural environments of at risk communities. These models capture carefully choreographed scenarios to account for the fact that when dealing with diet-dynamics systems, thinking additively is not enough as it cannot account for the power of nonlinear effects.
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Affiliation(s)
- Muntaser Safan
- Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe, AZ, United States
- Mathematics Department, Faculty of Science, Mansoura University, Mansoura, Egypt
- Department of Mathematical Sciences, Faculty of Applied Science, Umm Al-Qura University, 21955 Makkah, Saudi Arabia
| | - Anarina L. Murillo
- Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe, AZ, United States
- Conditioned Feeding Lab, Behavioral Neuroscience, Department of Psychology, Arizona State University, Tempe, AZ, United States
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Devina Wadhera
- Conditioned Feeding Lab, Behavioral Neuroscience, Department of Psychology, Arizona State University, Tempe, AZ, United States
| | - Carlos Castillo-Chavez
- Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe, AZ, United States
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Rodericks R, Vu U, Holmes JR, Ryan J, Sentell T, Saka S. Insights in Public Health: Data Highlights from the Hawai'i Youth Risk Behavior Survey: Links Between Academic Achievement and Health Behaviors. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2018; 77:297-304. [PMID: 30416874 PMCID: PMC6218687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The Youth Risk Behavior Survey is administered biennially in odd years to public middle and high school students in Hawai'i. Data highlights are presented from Hawaii's 2017 high school survey results to enhance understanding of the relationship between health and academic achievement. This article reviews a select set of health-risk behaviors and their association with academic grades for Hawai'i public school students. The findings demonstrate that students who self-reported engaging in health protective behaviors also reported higher academic grades in school, while those who engaged in health-risk behaviors were more likely to report lower grades in school. This discussion can provide useful background information and benchmarks for research, policy, and local initiatives. It also supports the need for continued collaboration and a synergistic approach between education and health partners in Hawai'i in order to improve the health and academic achievement of our youth.
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Affiliation(s)
- Rebekah Rodericks
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI (RR, UV, TS)
- Hawai'i Department of Health, Chronic Disease Prevention and Health Promotion Division, Honolulu, HI (JRH, JR)
| | - Uyen Vu
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI (RR, UV, TS)
- Hawai'i Department of Health, Chronic Disease Prevention and Health Promotion Division, Honolulu, HI (JRH, JR)
| | - Joshua Ryan Holmes
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI (RR, UV, TS)
- Hawai'i Department of Health, Chronic Disease Prevention and Health Promotion Division, Honolulu, HI (JRH, JR)
| | - Jennifer Ryan
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI (RR, UV, TS)
- Hawai'i Department of Health, Chronic Disease Prevention and Health Promotion Division, Honolulu, HI (JRH, JR)
| | - Tetine Sentell
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI (RR, UV, TS)
- Hawai'i Department of Health, Chronic Disease Prevention and Health Promotion Division, Honolulu, HI (JRH, JR)
| | - Susan Saka
- University of Hawai'i at Manoa College of Education Curriculum Research & Development Group, is a contributing editor on this month's column
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Mondragon NI, Txertudi MB. Understanding fatness in the public sphere of young students: social representations and emotional response. CAD SAUDE PUBLICA 2018; 34:e00197917. [PMID: 30208183 DOI: 10.1590/0102-311x00197917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 05/02/2018] [Indexed: 11/22/2022] Open
Abstract
This study examines how youth collectively represent fatness and determines the emotions it arouses. Understanding how fatness is socially constructed by young people is crucial to create programs that better deal with it. A free association exercise elicited by the word "fatness" was answered by 200 people of the Autonomous Community of the Basque Country (Spain), and the content was analyzed by its lexicon using Alceste software. The results showed that health-related representation of fatness was mostly descriptive, and it was not connected to risky or any emotional response. But fatness was also completely represented as a social pressure issue related to stigmatization and highly correlated with negative emotions, such as sadness, insecurity, embarrassment, anguish, lonesomeness, pity or anger. That is, risky and negative emotions were linked to social non-acceptance, and not with health problems. Thus, the conclusion is that fatness is transmitted from fear and not from a positive construction of the health.
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The fight against overweight and obesity in school children: Public policy in Mexico. J Public Health Policy 2018; 38:407-428. [PMID: 28860550 DOI: 10.1057/s41271-017-0090-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Excess weight in schoolchildren is a serious health problem in Mexico. In 2010, the government established General Guidelines for Dispensing or Distribution of Foods and Beverages at School Food Establishments (SFEs) in Elementary Schools with the objective of stopping the epidemic of overweight and obesity. This study aimed to evaluate compliance with the Guidelines during two academic years. With a sample of 39 schools already randomly selected, we carried out a follow-up study. The research team recorded foods and beverages available at schools in two academic years, and compared their nutritional characteristics to those established in the Guidelines. At the schools in both stages of the study, we found broad availability of energy-dense foods not allowed in the SFEs. Vegetables, fruits, and plain water accounted for less than 7 per cent of the foods and drinks. We observed no changes between stages in the compliance the Guidelines.
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Pittman DW, Bland IR, Cabrera ID, Franck KE, Perkins EL, Schmidt NA, Allen HN, Atkins SR, Pittman SB. The Boss' Healthy Buddies Nutrition Resource Is Effective for Elementary School Students. J Obes 2018; 2018:4659874. [PMID: 29854438 PMCID: PMC5954886 DOI: 10.1155/2018/4659874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/27/2018] [Accepted: 04/12/2018] [Indexed: 12/02/2022] Open
Abstract
Previously we have shown that our Healthy Eating Decisions school-based intervention can influence students' selections of the healthiest foods available in their elementary school cafeterias through positive reinforcement techniques. Although effective, we recognized that students were missing fundamental nutrition knowledge necessary to understand why the Healthy Eating Decisions program identified particular beverages and foods as the healthiest in the cafeteria. Therefore, we developed the Boss' Healthy Buddies nutrition education resource as a freely available curriculum matched with South Carolina education standards and designed for elementary school students from kindergarten through fourth grade. The current study implemented Boss' Healthy Buddies and compared its efficacy to a commercially available nutrition program, CATCH. Elementary school students in Spartanburg, South Carolina, received weekly twenty-minute Boss' Healthy Buddies lessons for eight weeks. Results from preassessment and postassessment surveys were compared with a positive control elementary school using the CATCH program and a negative control school receiving no nutrition education. Results show that Boss' Healthy Buddies was equally effective as the CATCH program in improving the nutrition attitudes regarding healthiest beverages and food selections with the advantage of being freely available and minimizing the impact on classroom instruction time. In order to reduce most effectively the high prevalence of childhood overweight and obesity, it is crucial that children are taught nutrition education to support healthy eating habits at an early age. Both the Healthy Eating Decisions school-based intervention and the Boss' Healthy Buddies nutrition education program are available online for use as free resources to aid in reducing childhood overweight and obesity within elementary schools.
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Affiliation(s)
- David W. Pittman
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Ida R. Bland
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Isai D. Cabrera
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Kassie E. Franck
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Emily L. Perkins
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Nicole A. Schmidt
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Heather N. Allen
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Savanah R. Atkins
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Sharyn B. Pittman
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
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Maatoug J, Fredj SB, Msakni Z, Dendana E, Sahli J, Harrabi I, Chouikha F, Boughamoura L, Slama S, Farpour-Lambert N, Ghannem H. Challenges and results of a school-based intervention to manage excess weight among school children in Tunisia 2012-2014. Int J Adolesc Med Health 2017; 29:/j/ijamh.2017.29.issue-2/ijamh-2015-0035/ijamh-2015-0035.xml. [PMID: 26360490 DOI: 10.1515/ijamh-2015-0035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 07/02/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Obesity is a serious health issue and predisposes individuals to an increased risk of morbidity and mortality. Its prevalence in children has increased worldwide. OBJECTIVE To demonstrate the feasibility and effectiveness of a school-based management program based on healthy lifestyle promotion for obese and overweight adolescents in Sousse, Tunisia. METHODS We conducted a quasi-experimental study among overweight and obese school children enrolled in 7th and 8th grades in Sousse, Tunisia with two groups, intervention and control. The 1-year intervention was based on promoting healthy eating and physical activity through a collective intervention for all recruited children and an individual intervention only for obese children who require intensive managing. Data collection was done before, at the end and at a 4-month follow up of the intervention, both in intervention and control groups. RESULTS The body mass index Z score decreased significantly from pre-intervention to post-intervention (1.89±0.57 to 1.76±0.63, p<0.001) and from post-intervention to the follow-up (1.76±0.63 to 1.55±0.68, p<0.001) in the intervention group. In the control group, it decreased significantly from pre-intervention to post-intervention but not significantly from post-intervention to follow-up assessment. Calorie intake decreased significantly both in intervention and control groups. CONCLUSION This project began with introducing a new culture of health management in schools on one side and with increasing awareness of the importance of obesity prevention and treatment. The support of authorities for this type of action is very important to guarantee its sustainability.
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Affiliation(s)
- Jihen Maatoug
- Department of Epidemiology, University Hospital Farhat Hached, Sousse
| | - Sihem Ben Fredj
- Department of Epidemiology, University Hospital Farhat Hached, Sousse
| | - Zeineb Msakni
- Department of Epidemiology, University Hospital Farhat Hached, Sousse
| | - Emna Dendana
- Department of Epidemiology, University Hospital Farhat Hached, Sousse
| | - Jihene Sahli
- Department of Epidemiology, University Hospital Farhat Hached, Sousse
| | - Imed Harrabi
- Department of Epidemiology, University Hospital Farhat Hached, Sousse
| | - Firas Chouikha
- Department of Epidemiology, University Hospital Farhat Hached, Sousse
| | | | - Slim Slama
- Department of Community Medicine, Primary Care and Emergency, University Hospitals of Geneva, Geneva
| | | | - Hassen Ghannem
- Department of Epidemiology, University Hospital Farhat Hached, Sousse
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Karczewski SA, Carter JS, DeCator DD. The Role of Ethnicity in School-Based Obesity Intervention for School-Aged Children: A Pilot Evaluation. THE JOURNAL OF SCHOOL HEALTH 2016; 86:778-786. [PMID: 27714874 DOI: 10.1111/josh.12433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 02/29/2016] [Accepted: 04/29/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Rates of obesity have risen disproportionately for ethnic minority youth in the United States. School-based programs may be the most comprehensive and cost-effective way to implement primary prevention in children. In this study we evaluated the effect of a school-based obesity prevention on the outcome of body mass index percentile (BMI%), with baseline weight class and ethnicity examined as moderators. METHODS Participants (N = 125), ages 7-11 (56% female) from 4 urban, low-income, ethnic minority (58% black, 42% Latino) schools were recruited. Two schools received the Urban Initiatives Work to Play health intervention, and 2 demographically matched schools served as wait-list controls. RESULTS Hierarchical multiple regression was used to analyze the independent and interactive effects of key variables on BMI%. An interaction between intervention status and ethnicity revealed Latino youth in the intervention had lower BMI% than those in the control group. Participation did not cause BMI% outcomes to decrease for black participants. CONCLUSIONS The study demonstrates the intervention is effective, but that the effectiveness varies across ethnicity. Interventions can be made more efficient and cost-effective by targeting youth of a common ethnicity that has shown empirical responsiveness to certain program elements.
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Affiliation(s)
- Sabrina A Karczewski
- Stanford University School of Medicine, Stanford Children's Health, Lucile Packard Children's Hospital, 401 Quarry Road, Palo Alto, CA 94304.
| | - Jocelyn S Carter
- Department of Psychology, DePaul University, 2219 N. Kenmore Avenue, Suite 530, Chicago, IL 60614.
| | - Draycen D DeCator
- Department of Psychology, DePaul University, 2219 N. Kenmore Avenue, Suite 400, Chicago, IL 60614.
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Murillo AL, Safan M, Castillo-Chavez C, Phillips EDC, Wadhera D. Modeling eating behaviors: The role of environment and positive food association learning via a Ratatouille effect. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2016; 13:841-855. [PMID: 27775387 DOI: 10.3934/mbe.2016020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Eating behaviors among a large population of children are studied as a dynamic process driven by nonlinear interactions in the sociocultural school environment. The impact of food association learning on diet dynamics, inspired by a pilot study conducted among Arizona children in Pre-Kindergarten to 8th grades, is used to build simple population-level learning models. Qualitatively, mathematical studies are used to highlight the possible ramifications of instruction, learning in nutrition, and health at the community level. Model results suggest that nutrition education programs at the population-level have minimal impact on improving eating behaviors, findings that agree with prior field studies. Hence, the incorporation of food association learning may be a better strategy for creating resilient communities of healthy and non-healthy eaters. A Ratatouille effect can be observed when food association learners become food preference learners, a potential sustainable behavioral change, which in turn, may impact the overall distribution of healthy eaters. In short, this work evaluates the effectiveness of population-level intervention strategies and the importance of institutionalizing nutrition programs that factor in economical, social, cultural, and environmental elements that mesh well with the norms and values in the community.
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Affiliation(s)
- Anarina L Murillo
- Simon A Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe, AZ, United States.
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Fedewa AL, Ahn S, Erwin H, Davis MC. A randomized controlled design investigating the effects of classroom-based physical activity on children’s fluid intelligence and achievement. SCHOOL PSYCHOLOGY INTERNATIONAL 2015. [DOI: 10.1177/0143034314565424] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Existing literature shows promising effects of physical activity on children’s cognitive outcomes. This study assessed via a randomized, controlled design whether additional curricular physical activity during the school day resulted in gains for children’s fluid intelligence and standardized achievement outcomes. Participants were children ( N = 460) from four urban schools in the Southeast United States. Schools were randomly assigned to treatment and control conditions. Treatment schools received additional physical activity breaks throughout the school day while control schools maintained a typical schedule without curricular activity breaks. Results from the one-year study show positive effects for children’s mathematics and reading achievement but no differences across treatment and control groups for children’s fluid intelligence scores. Implications for school psychologists in promoting physical activity breaks on a systems-wide level are discussed.
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Gilbert F, Richard JB, Lapie-Legouis P, Beck F, Vercambre MN. Health behaviors: is there any distinction for teachers? A cross-sectional nationwide study. PLoS One 2015; 10:e0120040. [PMID: 25793968 PMCID: PMC4368614 DOI: 10.1371/journal.pone.0120040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 01/19/2015] [Indexed: 11/19/2022] Open
Abstract
Background Health behaviors, as important modifiable determinants of health, are consistently targeted by prevention messages. Teachers, as educators and role models, may play a key-role in bringing such messages to children and adolescents. It is not clear which areas of prevention could be improved in collaboration with teachers to promote healthy behaviors at the population level through health education in schools. Methods to evaluate teacher’s health awareness, we compared their health/risk behaviors to those of non-teachers, taking into account demographic and socioeconomic factors that could confound crude differences. We used data from the 2010 Health Barometer, a cross-sectional nationally-representative French survey conducted by telephone among 27,653 persons aged 15–85. Adjusting sequentially for potential confounders, we compared six indicators of lifestyle and risky conducts (at-risk drinking, current smoking, cannabis use, gambling, corpulence, sleep duration) between teachers (n = 725) and two comparison groups: other occupations (n = 12,483) on the one hand, and other intermediate and managerial/professional occupations (n = 6,026) on the other. Results In the fully-adjusted models, teachers were less likely than other occupations to smoke, to have used cannabis in the last 12 months, to gamble regularly and to be overweight or obese. When restricting the comparison group to other occupations belonging to the same socio-professional category, differences were attenuated, but remain highly significant for tobacco, cannabis and gambling. No significant differences were observed between teachers and non-teachers regarding alcohol use and sleep duration, once important confounders had been adjusted for. Conclusions Our results suggest that teachers behave on the whole more healthily than other adults with a similar demographic and socioeconomic profile. The absence of a teacher distinction toward at-risk drinking needs to be examined in more detail.
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Affiliation(s)
| | | | | | - François Beck
- French Monitoring Center for Drugs and Drug Addiction (OFDT), St Denis, France
- Centre de recherche Psychotropes, Santé mentale, Société (CESAMES), CNRS UMR 8136, INSERM U611, Université René Descartes Paris V / Sorbonne Paris Cité, Paris, France
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The HOT (Healthy Outcome for Teens) project. Using a web-based medium to influence attitude, subjective norm, perceived behavioral control and intention for obesity and type 2 diabetes prevention. Appetite 2014; 72:82-9. [DOI: 10.1016/j.appet.2013.09.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 07/30/2013] [Accepted: 09/23/2013] [Indexed: 11/18/2022]
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Moore MM, Robinson JC, Rachel MM, Boss BJ. Barriers to physical activity and healthy diet among children ages 6 through 13 in a Mississippi elementary school. J Pediatr Nurs 2014; 29:74-82. [PMID: 24071620 DOI: 10.1016/j.pedn.2013.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Revised: 08/11/2013] [Accepted: 08/29/2013] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to identify barriers to adequate physical activity and a healthy diet, investigate differences in the perceived barriers among subgroups, and determine predictors of high versus low total barrier scores in one inner-city elementary school. A mixed method design was used and included students ages 6 through 13 (n=110) and parents, teachers, and community leaders (n=20). Data were collected using questionnaires and focus groups. Quantitative findings revealed no differences in total barriers based on age, gender, number of parents, or household income; however, subscale differences among groups were noted. Qualitative findings indicated that perceived barriers to physical activity were knowledge-related, and barriers to healthy diet concerned access to healthy foods.
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Affiliation(s)
- Molly M Moore
- School of Nursing, University of Mississippi Medical Center, Jackson, MS.
| | | | - Marcia M Rachel
- School of Nursing, University of Mississippi Medical Center, Jackson, MS
| | - Barbara J Boss
- School of Nursing, University of Mississippi Medical Center, Jackson, MS
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Drenowatz C, Erkelenz N, Wartha O, Brandstetter S, Steinacker JM. Parental characteristics have a larger effect on children's health behaviour than their body weight. Obes Facts 2014; 7:388-98. [PMID: 25434370 PMCID: PMC5644800 DOI: 10.1159/000369984] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 08/25/2014] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Parents take an important role in a child's development, but there is currently limited information on parental correlates with children's health behaviour. The purpose of this study, therefore, was to examine whether parental characteristics, such as body weight, TV consumption and sport participation, affect children's body weight and health behaviour. METHODS To examine the effects of parental characteristics on children's body weight and health behaviour, baseline data of 1,118 elementary school children (7.6 ± 0.4 years) participating in a school-based intervention in southwest Germany was used. Children's height and weight were measured and parent as well as child behaviour was assessed via questionnaire. RESULTS BMI percentiles of children were positively associated with parental BMI (r = 0.2, p <0.01). Further, high parental TV time increased the odds for high TV time in children (OR mother= 2.2, OR father = 2.3) and parental club sport participation increased the odds for club sport participation in children (OR mother = 1.9, OR father = 1.7). The relationship between parental and child behaviour was stronger than the relationship between parental BMI and BMI percentiles of the child. CONCLUSION These results suggest that parental behaviour and role modeling provide an important contribution to childrens' health behaviour, especially at younger ages.
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Affiliation(s)
- Clemens Drenowatz
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Centre, Ulm, Germany
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
- *Nanette Erkelenz, Division of Sport and Rehabilitation Medicine, Ulm University Medical Centre, Frauensteige 6, 89075 Ulm (Germany),
| | - Nanette Erkelenz
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Centre, Ulm, Germany
| | - Olivia Wartha
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Centre, Ulm, Germany
- Institute for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Susanne Brandstetter
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Centre, Ulm, Germany
- Institute for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Jürgen M. Steinacker
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Centre, Ulm, Germany
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Effects of migration background on weight status and motor performance of preschool children. Wien Klin Wochenschr 2013; 126:95-100. [DOI: 10.1007/s00508-013-0474-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 11/13/2013] [Indexed: 10/25/2022]
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Moreno JP, Johnston CA, Woehler D. Changes in weight over the school year and summer vacation: results of a 5-year longitudinal study. THE JOURNAL OF SCHOOL HEALTH 2013; 83:473-7. [PMID: 23782089 DOI: 10.1111/josh.12054] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 05/14/2012] [Accepted: 06/19/2012] [Indexed: 05/23/2023]
Abstract
BACKGROUND Evidence suggests that children gain more weight during the summer months compared with the school year. To examine the impact of the school and summer environment on children's weight further, we conducted a 5-year longitudinal study examining changes in standardized BMI (zBMI) of students entering kindergarten. METHODS Heights and weights were obtained at the beginning and end of each school year for 3,588 ethnically diverse (Caucasian: 27.2%, Black: 29.0%, Hispanic: 26.4%, and Asian 17.4%) students aged 5-7. RESULTS A significant difference in change in zBMI during the school and summer months was found (-0.52, 95% CI: -0.59 to -0.45, p < .001; Wald χ2 = 171.89, p < .001). Overall, children decreased BMI percentile during time spent in school by 1.5 percentile points and increased by 5.2 percentile points during summer months. Differences in the velocity of weight gain were found across weight classification categories with only overweight and obese children decreasing their zBMI during the school year. CONCLUSION Time spent in school was shown to have a beneficial impact on students' weight, especially for students who were overweight or obese. However, these results are alarming because weight gain during elementary school occurs primarily during the relatively short span of summer break.
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Affiliation(s)
- Jennette P Moreno
- Department of Pediatrics-Nutrition, Baylor College of Medicine, 6655 Travis Street, Mailstop 320, Houston, TX 77030, USA.
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Anderson LM, Aycock KE, Mihalic CA, Kozlowski DJ, Detschner AM. Geographic differences in physical education and adolescent BMI: have legal mandates made a difference? J Sch Nurs 2012; 29:52-60. [PMID: 22815346 DOI: 10.1177/1059840512453602] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The school environment is an ideal setting for healthy weight programming with adolescents. The federal government has reinforced the importance of school-based health promotion. The current study examined the preliminary influence of the 2006 school wellness policy requirement of the Child Nutrition and WIC Reauthorization Act (CNWICRA) on adolescent Body Mass Index (BMI) and physical education participation. Nationally representative data from the 2003 and 2007 Youth Risk Behavior Surveillance Survey (YRBSS) were used. The authors examined BMI percentile and physical education participation based on survey year and geographic region. Results suggest a slight decrease in BMI with no changes in physical education participation. A main effect for geographic region was found for both physical education participation and BMI percentile, while a geographic region-by-survey year interaction was discovered when analyzing BMI percentiles. Results suggest a need for continued investigation and may inform future healthy weight programming and geographically tailored wellness policies.
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Affiliation(s)
- Laura M Anderson
- Department of Counseling, School, & Educational Psychology, University at Buffalo, SUNY, Buffalo, NY, USA.
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MacCann C, Roberts RD. Just as smart but not as successful: obese students obtain lower school grades but equivalent test scores to nonobese students. Int J Obes (Lond) 2012; 37:40-6. [PMID: 22531092 DOI: 10.1038/ijo.2012.47] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The obesity epidemic in industrialized nations has important implications for education, as research demonstrates lower academic achievement among obese students. The current paper compares the test scores and school grades of obese, overweight and normal-weight students in secondary and further education, controlling for demographic variables, personality, ability and well-being confounds. PARTICIPANTS This study included 383 eighth-grade students (49% female; study 1) and 1036 students from 24 community colleges and universities (64% female, study 2), both drawn from five regions across the United States. MEASURES In study 1, body mass index (BMI) was calculated using self-reports and parent reports of weight and height. In study 2, BMI was calculated from self-reported weight and height only. Both samples completed age-appropriate assessments of mathematics, vocabulary and the personality trait conscientiousness. Eighth-grade students additionally completed a measure of life satisfaction, with both self-reports and parent reports of their grades from the previous semester also obtained. Higher education students additionally completed measures of positive and negative affect, and self-reported their grades and college entrance scores. RESULTS Obese students receive significantly lower grades in middle school (d=0.83), community college (d=0.34) and university (d=0.36), but show no statistically significant differences in intelligence or achievement test scores. Even after controlling for demographic variables, intelligence, personality and well-being, obese students obtain significantly lower grades than normal-weight students in the eighth grade (d=0.39), community college (d=0.42) and university (d=0.31). CONCLUSION Lower grades may reflect peer and teacher prejudice against overweight and obese students rather than lack of ability among these students.
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Dreyhaupt J, Koch B, Wirt T, Schreiber A, Brandstetter S, Kesztyüs D, Wartha O, Kobel S, Kettner S, Prokopchuk D, Hundsdörfer V, Klepsch M, Wiedom M, Sufeida S, Fischbach N, Muche R, Seufert T, Steinacker JM. Evaluation of a health promotion program in children: Study protocol and design of the cluster-randomized Baden-Württemberg primary school study [DRKS-ID: DRKS00000494]. BMC Public Health 2012; 12:157. [PMID: 22394693 PMCID: PMC3351371 DOI: 10.1186/1471-2458-12-157] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 03/06/2012] [Indexed: 11/16/2022] Open
Abstract
Background Increasing prevalences of overweight and obesity in children are known problems in industrialized countries. Early prevention is important as overweight and obesity persist over time and are related with health problems later in adulthood. "Komm mit in das gesunde Boot - Grundschule" is a school-based program to promote a healthier lifestyle. Main goals of the intervention are to increase physical activity, decrease the consumption of sugar-sweetened beverages, and to decrease time spent sedentary by promoting active choices for healthy lifestyle. The program to date is distributed by 34 project delivery consultants in the state of Baden-Württemberg and is currently implemented in 427 primary schools. The efficacy of this large scale intervention is examined via the Baden-Württemberg Study. Methods/Design The Baden-Württemberg Study is a prospective, stratified, cluster-randomized, and longitudinal study with two groups (intervention group and control group). Measurements were taken at the beginning of the academic years 2010/2011 and 2011/2012. Efficacy of the intervention is being assessed using three main outcomes: changes in waist circumference, skinfold thickness and 6 minutes run. Stratified cluster-randomization (according to class grade level) was performed for primary schools; pupils, teachers/principals, and parents were investigated. An approximately balanced number of classes in intervention group and control group could be reached by stratified randomization and was maintained at follow-up. Discussion At present, "Komm mit in das Gesunde Boot - Grundschule" is the largest school-based health promotion program in Germany. Comparative objective main outcomes are used for the evaluation of efficacy. Simulations showed sufficient power with the existing sample size. Therefore, the results will show whether the promotion of a healthier lifestyle in primary school children is possible using a relatively low effort within a school-based program involving children, teachers and parents. The research team anticipates that not only efficacy will be proven in this study but also expects many other positive effects of the program. Trial registration German Clinical Trials Register (DRKS), DRKS-ID: DRKS00000494
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Affiliation(s)
- Jens Dreyhaupt
- Institute of Epidemiology and Medical Biometry, Ulm University, Schwabstr, 13, D-89075 Ulm, Germany.
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Brandstetter S, Klenk J, Berg S, Galm C, Fritz M, Peter R, Prokopchuk D, Steiner RP, Wartha O, Steinacker J, Wabitsch M. Overweight prevention implemented by primary school teachers: a randomised controlled trial. Obes Facts 2012; 5:1-11. [PMID: 22433612 DOI: 10.1159/000336255] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 09/20/2011] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To describe the effects of URMEL-ICE, a German school-based intervention for overweight prevention, on children's BMI and other measures of fat mass. METHODS A cluster-randomised controlled design was used. The intervention which focused on physical activity, TV time and soft drink consumption was integrated into a second-grade curriculum and was implemented by classroom teachers themselves. It comprised 29 teaching lessons, 2 short exercise blocks per day and 6 family homework lessons. BMI was assessed as primary outcome measure, waist circumference and skinfold thickness as secondary outcomes. Data of 945 children were analysed. RESULTS Multivariate analyses adjusted for baseline values showed no statistically significant effect of the intervention on BMI, but on waist circumference (-0.85; 95% confidence interval (95% CI) -1.59 to -0.12) and subscapular skinfold thickness (-0.64; 95% CI -1.25 to -0.02). After additional adjustment for individual time lag between baseline and follow-up, these effects were reduced to -0.60 (95% CI -1.25 to 0.05) and -0.61 (95% CI -1.26 to 0.04) and lost their statistical significance. CONCLUSION This study contributes to the field of randomised school-based studies on overweight prevention and shows that within a 1-year, integrated intervention no effect on BMI, but a tendency towards effects on fat mass can be achieved.
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Affiliation(s)
- Susanne Brandstetter
- Division of Sports and Rehabilitation, Department of Internal Medicine II-Cardiology, Ulm University Medical Centre, Eythstrasse 24, Ulm, Germany
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Cost-free and sustainable incentive increases healthy eating decisions during elementary school lunch. Int J Obes (Lond) 2011; 36:76-9. [PMID: 22041982 DOI: 10.1038/ijo.2011.205] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We aimed to develop a cost-free and sustainable program to influence healthier eating decisions during elementary school lunch. Baseline food and beverage choices were assessed for 9 days during lunch service at two racially and economically diverse elementary schools in Spartanburg County, SC, USA. After being informed that the labeled items on the daily lunch menu represented the healthiest choice, students were allowed to ring a call bell in the cafeteria for public recognition when they chose all of the identified healthiest food and beverage items during lunch service. Using menus matched to the baseline phase, food and beverage choices were measured during a 9-day intervention phase. After 30 days, food and beverage choices were reassessed during a 3-day follow-up phase. Healthiest food & beverage choices increased 49% with >60% of students choosing non-flavored milk over flavored milk during the intervention phase. There was no difference in the success of the program between the two schools. The program continued and healthy eating decisions were significantly sustained at a 30-day follow-up assessment. Public recognition through bell ringing appears to be an effective practice to sustain increases in healthy eating decisions during elementary school lunch and warrants expansion to larger scale, longitudinal trials.
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Developing and applying a socio-ecological model to the promotion of healthy eating in the school. Public Health Nutr 2011; 16:1101-8. [PMID: 22014870 DOI: 10.1017/s1368980011002655] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To develop and apply a socio-ecological model (SEM) for healthy eating in school students, to better understand the association between factors at different levels of the SEM and pupils' dietary choices. DESIGN Student-level data, collected through anonymised questionnaires, included reported dietary choices and correlates to these; data on school approaches to food were collected through postal surveys. We used multilevel analysis to study the association of each level of the SEM on student dietary choice while controlling for factors found at other levels. SETTING Data were collected from secondary schools in Wales that were a part of the 2005/2006 Health Behaviour in School-aged Children (HBSC) study. SUBJECTS The final sample for analysis included data from 6693 students aged 11-16 years and 289 teachers from sixty-four secondary schools in Wales. RESULTS Student interpersonal factors, an individual's social environment, had a greater association with the dietary choices students made for lunch than student intrapersonal characteristics, those that reside within the person, which were found to have a greater association with the dietary choices made outside school. School organisational factors, such as rules and policies, had a greater association with whether students ate unhealthy foods, whereas the community nature of the school had a greater association with the choosing of healthy foods. CONCLUSIONS Using the SEM and multilevel analysis allowed us to study how factors were associated with the choice of different foods at different times of the day by students. Interventions can use an SEM to target specific correlates and change health outcomes in the school.
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Welk GJ, Jackson AW, Morrow JR, Haskell WH, Meredith MD, Cooper KH. The association of health-related fitness with indicators of academic performance in Texas schools. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2010; 81:S16-S23. [PMID: 21049834 DOI: 10.1080/02701367.2010.10599690] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study examined the associations between indicators of health-related physical fitness (cardiovascular fitness and body mass index) and academic performance (Texas Assessment of Knowledge and Skills). Partial correlations were generally stronger for cardiovascular fitness than body mass index and consistently stronger in the middle school grades. Mixed-model regression analyses revealed modest associations between fitness and academic achievement after controlling for potentially confounding variables. The effects of fitness on academic achievement were positive but small. A separate logistic regression analysis indicated that higher fitness rates increased the odds of schools achieving exemplary/recognized school status within the state. School fitness attainment is an indicator of higher performing schools. Direction of causality cannot be inferred due to the cross-sectional nature of the data.
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Affiliation(s)
- Gregory J Welk
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA.
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Johnston CA, Tyler C, Fullerton G, McFarlin BK, Poston WSC, Haddock CK, Reeves RS, Foreyt JP. Effects of a school-based weight maintenance program for Mexican-American children: results at 2 years. Obesity (Silver Spring) 2010; 18:542-7. [PMID: 19661957 DOI: 10.1038/oby.2009.241] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The prevalence of childhood overweight has increased significantly, with the highest rates noted among Mexican Americans. Many negative health outcomes are associated with overweight; thus, there is a need for effective weight-loss interventions tailored to this group. This study evaluated 24-month outcomes of a randomized, controlled trial involving an intensive lifestyle-based weight maintenance program targeting overweight Mexican-American children at a charter school in Houston, Texas. A total of 60 children (33 males, 55%) between the ages of 10 and 14 at or >85th percentile for BMI were recruited. Participants were randomized to an instructor-led intervention (ILI) or a self-help (SH) program, both aimed at modifying eating and physical activity behaviors using behavior modification strategies. Changes in participants' standardized BMI (zBMI) were assessed at baseline, 1, and 2 years. Tricep skinfold, total cholesterol, triglycerides, high-density lipoprotein cholesterol, and calculated low-density lipoprotein were assessed at baseline and 1 year. ILI participants showed significantly greater decreases in zBMI at 1 and 2 years (F = 26.8, P < 0.001, F = 4.1, P < 0.05, respectively) compared to SH controls. ILI participants showed greater improvements in body composition, as measured by tricep skinfold (F = 9.75, P < 0.01). Children in the ILI condition experienced benefits with respect to total cholesterol (F = 7.19, P < 0.05) and triglycerides (F = 4.35, P < 0.05) compared to children in the SH condition. Overall, the school-based intervention resulted in improved weight and clinical outcomes in overweight Mexican-American children, and zBMI was maintained over 2 years.
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Affiliation(s)
- Craig A Johnston
- Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Department of Pediatrics-Nutrition, Houston, Texas, USA.
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Holcomb MJ, Pufpaff LA, McIntosh DE. Obesity rates in special populations of children and potential interventions. PSYCHOLOGY IN THE SCHOOLS 2009. [DOI: 10.1002/pits.20418] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Thunfors P, Collins BN, Hanlon AL. Health behavior interests of adolescents with unhealthy diet and exercise: implications for weight management. HEALTH EDUCATION RESEARCH 2009; 24:634-645. [PMID: 19181908 DOI: 10.1093/her/cyn064] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This study sought to determine individual factors that may influence adolescents' interests in various health behaviors and, by extension, their potential interest in programs that promote healthy lifestyles and reduce obesity. The sample consisted of 737 rural Pennsylvania (United States) middle and high school students not involved in either healthy exercise or dietary behaviors (a target group for health-promoting interventions). Participants completed a self-report measure of their general health functioning, including their interests in sports programs, outdoor recreation programs, weightlifting, weight loss and healthy eating/cooking. Nurses measured body mass indices (BMIs). The vast majority of the sample endorsed self-efficacy in healthy eating and physical activity, and this self-efficacy was associated with interest in a healthy diet and outdoor recreation. Interest in healthy activities was consistently higher among 7th graders (age mean = 12.6 years) than 11th graders (age mean = 16.3 years). Females were more interested in weight loss and healthy eating/cooking, whereas males were more interested in weightlifting. Higher BMI only predicted interest in weight loss. These results indicate that adolescent health interests vary on the basis of their gender, grade level, BMI and self-efficacy. These trends are potentially important to consider when seeking to match intervention programs to adolescent interests.
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Affiliation(s)
- Peter Thunfors
- Child Behavioral Health, Baystate Medical Center, 3300 Main Street, 4th Floor, Springfield, MA 01199, USA.
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Zenzen W, Kridli S. Integrative review of school-based childhood obesity prevention programs. J Pediatr Health Care 2009; 23:242-58. [PMID: 19559992 DOI: 10.1016/j.pedhc.2008.04.008] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Revised: 04/20/2008] [Accepted: 04/22/2008] [Indexed: 10/21/2022]
Abstract
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's eating and physical activity patterns. While school-based programs may affect a student'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'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.
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Johnston CA, Tyler C, McFarlin BK, Poston WSC, Haddock CK, Reeves R, Foreyt JP. Weight loss in overweight Mexican American children: a randomized, controlled trial. Pediatrics 2007; 120:e1450-7. [PMID: 18055663 DOI: 10.1542/peds.2006-3321] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Childhood overweight has increased significantly in the past 20 years, with the highest rates noted among Mexican Americans. Although this minority group is in significant need of intervention, few programs have demonstrated actual decreases in weight. In this study we evaluated an intensive healthy lifestyle program designed to result in weight reduction for overweight Mexican American children. We hypothesized that children randomly assigned to an intensive intervention would significantly reduce their standardized BMI when compared with children randomly assigned to a self-help condition. PATIENTS AND METHODS A total of 60 children (33 boys; 55%) between the ages of 10 and 14 years at or above the 85th percentile for BMI were randomly assigned to a 6-month intensive-intervention or self-help condition. RESULTS Children in the intensive-intervention condition significantly reduced their standardized BMI when compared with the children in the self-help condition. The change in standardized BMI was significantly different at both 3 and 6 months, with intensive-intervention participants showing greater decreases in weight. CONCLUSIONS Overall, the results were promising, suggesting that an intensive, individualized intervention may be an effective means for promoting weight loss in overweight Mexican American children.
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Affiliation(s)
- Craig A Johnston
- Department of Pediatrics-Nutrition, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA.
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Gittelsohn J, Kumar MB. Preventing childhood obesity and diabetes: is it time to move out of the school? Pediatr Diabetes 2007; 8 Suppl 9:55-69. [PMID: 17991134 DOI: 10.1111/j.1399-5448.2007.00333.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Childhood obesity interventions in the USA and Europe have predominantly focused on the school environment for over two decades with mixed or modest success. The focus on school--while intuitive, apparently efficient, and convenient--does not address larger upstream environmental factors, which affect obesity among youth. In this article, we examine potential drawbacks and limitations of previous school-based obesity and diabetes prevention programs. The future of school-based obesity and diabetes interventions and potential strategies for improvement is explored. Increased use and reporting of diversified theoretical frameworks, formative research to inform the interventions, and process evaluations to improve programs are recommended. More importantly, addressing the broader issue of the overall food environment and its impact on children's diet with intensified involvement of key stakeholders, including families, supermarkets, and corner stores is essential. We discuss the development of healthy eating zones around schools as a potential tool in the fight to reduce childhood obesity.
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Affiliation(s)
- Joel Gittelsohn
- Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Dollman J, Lewis F. Trends in health attitudes and self-perceptions among school-age South Australians between 1985 and 2004. Aust N Z J Public Health 2007; 31:407-13. [DOI: 10.1111/j.1753-6405.2007.00109.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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