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Kurtzhals M, Bjerregaard AL, Hybschmann J, Müllertz ALO, DeSilva B, Elsborg P, Timm A, Petersen TL, Thygesen LC, Kurtzhals P, Flensborg-Madsen T, Bentsen P, Mygind L. A systematic review and meta-analysis of the child-level effects of family-based interventions for the prevention of type 2 diabetes mellitus. Obes Rev 2024; 25:e13742. [PMID: 38684203 DOI: 10.1111/obr.13742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/31/2024] [Accepted: 02/28/2024] [Indexed: 05/02/2024]
Abstract
AIMS The purpose of this systematic review and meta-analysis was to investigate the effects of family-based health promotion interventions on child-level risk factors for type 2 diabetes in vulnerable families. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for systematic reviews formed the methodological framework. CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science were searched on January 12, 2024. The NTP-OHAT Risk of Bias Assessment Tool was used to assess the risk of bias in the individual studies, and meta-analyses were performed. RESULTS The 4723 studies were identified, and 55 studies met the inclusion criteria. Results showed significant effects on children's body mass index (mean difference [MD], -0.18, 95% CI [-0.33 to -0.03], p = 0.02), body fat percentage (MD, -2.00, 95% CI [-3.31 to -0.69], p = 0.003), daily activity (standardized mean difference [SMD], 0.23, 95% CI [0.01; 0.44], p = 0.04), physical activity self-efficacy (SMD, 0.73, 95% CI [0.36 to 1.10], p < 0.01), intake of snacks (MD, -0.10, 95% CI [-0.17 to -0.04], p = 0.002), and sugar-sweetened beverages (SMD, -0.21, 95% CI [-0.42 to -0.01], p = 0.04). Subgroup analyses suggested that interventions aiming to change child and parent behavior simultaneously have larger effect on fasting glucose and nutrition consumption, and that interventions longer than 26 weeks have larger effects on body composition and physical activity behavior than shorter interventions.
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Affiliation(s)
- Mette Kurtzhals
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | | | - Jane Hybschmann
- Children's Hospital Copenhagen and Juliane Marie Centre, Copenhagen University Hospital, Copenhagen, Denmark
| | - Alberte Laura Oest Müllertz
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Bianca DeSilva
- School of Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Peter Elsborg
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Health Promotion Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Anne Timm
- Health Promotion Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | | | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Peter Kurtzhals
- Novo Nordisk A/S, Global Chief Medical Office, Soeborg, Denmark
| | | | - Peter Bentsen
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Geoscience and Natural Resource Management, University of Copenhagen, Frederiksberg, Denmark
| | - Lærke Mygind
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- School of Psychology, Deakin University, Geelong, Australia
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2
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Zang W, Zhu J, Xiao N, Fang M, Li D, Li H, Yan J, Jing H, Wang S. Effects of aerobic exercise on children's executive function and academic performance: A systematic review and meta-analysis. Heliyon 2024; 10:e28633. [PMID: 38586404 PMCID: PMC10998207 DOI: 10.1016/j.heliyon.2024.e28633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 03/21/2024] [Accepted: 03/21/2024] [Indexed: 04/09/2024] Open
Abstract
Objective To investigate the effects of exercise on executive function in children, providing an evidence-based foundation to inform future research in school physical education and health education. Methods We searched ten databases: Cochrane Library, Scopus, OVID, Web of Science, PubMed, EBSCOhost, SPORTDiscus, PsycINFO, CNKI, WANFANG DATA, VIP, and SinoMed, and eight articles were included. Applying the revised Cochrane Risk of Bias Tool for Randomized Trials (RoB2), funnel plots and Egger regression analysis were integrated with R meta-analysis to screen for publication bias. The quality of the evidence was appraised using the Grading system. Results The included literature contained 2655 participants, with 1308 in the experimental group and 1347 in the control group. The results indicated that the aerobic exercise group considerably improved inhibitory control in children compared to the control group [SMD = 0.29, 95% CI (0.05, 0.54), P = 0.018]; working memory [SMD = 0.25, 95% CI (0.07, 0.42), P = 0.005]; and cognitive flexibility [SMD = 0.36, 95% CI (0.17, 0.54), P < 0.001]. However, the findings indicated that only aerobic exercise interventions extending beyond 50 weeks positively influenced academic performance in children [SMD = 1.19, 95% CI (0.34, 2.04), P = 0.006]. The results of an Egger regression analysis revealed that the p-values for inhibitory control, working memory, cognitive flexibility, and academic performance were more significant than 0.1. The Grade system said that the quality of evidence was all low regarding the level of evidence. Conclusion Aerobic exercise enhanced executive function but only aerobic exercise interventions extending beyond 50 weeks demonstrated a significant effect on the academic performance of children. Due to the low quality of evidence presented in this study, additional high-quality randomized controlled trials are needed to confirm these findings.
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Affiliation(s)
- Wanli Zang
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Jinyi Zhu
- Affiliated Hospital of Weifang Medical University, School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Ningkun Xiao
- Department of Psychology, Ural Federal University, Yekaterinburg, Russia
| | - Mingqing Fang
- Xiangya Hospital, Central South University, Changsha, China
| | - Dong Li
- Department of International Culture Education, Cho dang University, Republic of Korea
| | - Haiming Li
- Institution of Physical Education, China University of Mining and Technology, 221116, Xuzhou, China
| | - Jin Yan
- School of Physical Education and Sports, Soochow University, Suzhou, China
| | - Hongying Jing
- Department of Sports Science, University of Harbin Sport, Harbin, China
| | - Su Wang
- Department of Sports Science, University of Harbin Sport, Harbin, China
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3
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Arnaiz P, Bergman MM, Seelig H, Adams L, Dolley D, Gerber M, Joubert N, Nqweniso S, Steinmann P, Utzinger J, Randt RD, Walter C, Pühse U, Müller I. Acceptability and perceived feasibility of the KaziKidz health promotion intervention among educators and caregivers in schools from South Africa: a qualitative descriptive study. BMC Public Health 2024; 24:934. [PMID: 38561742 PMCID: PMC10985953 DOI: 10.1186/s12889-024-18456-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Despite the uncontested benefits of physical activity, its promotion lags behind in the public health agenda of low- and middle-income countries (LMICs). School-based interventions are promising strategies to foster health during childhood, but evidence of their effectiveness is limited and inconclusive for LMICs. Thus, further investigation is needed on contextual factors associated with intervention implementation in low-resource settings. We studied the acceptability and feasibility of the KaziKidz health promotion intervention and its implementation and make recommendations to improve future adoption and sustainability. METHODS KaziKidz was implemented in four primary schools from low-income communities in South Africa in 2019. Semi-structured interviews with four school principals, three focus group interviews with 16 educators, and another three with 16 caregivers were conducted between October and November 2021. Participants were purposively recruited. Interview transcripts were analyzed via thematic analysis using a deductive and reflexive approach. RESULTS Three main themes influencing intervention implementation and adoption were identified: (1) prioritizing teachers' needs (2), integrating the program into the school structure, and (3) creating opportunities in the community. Supporting recommendations included: (theme 1) adopting intervention approaches that are inclusive of educators' health and providing them with capacity development and external support; (theme 2) fostering a feeling of ownership and belonging among school stakeholders to adapt interventions to specific resources and needs; and (theme 3) raising community awareness to encourage individuals to claim power over and actively engage with the program. CONCLUSIONS Comprehensive interventions comprising health support, adequate training, and ongoing assistance for educators combined with school-wide and community outreach actions seeking to strengthen program ownership, accountability, and engagement can enhance uptake of school-based interventions and long-term maintenance. TRIAL REGISTRATION ISRCTN15648510, registered on 17/04/2020.
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Affiliation(s)
- Patricia Arnaiz
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
| | | | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Larissa Adams
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Danielle Dolley
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Nandi Joubert
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Siphesihle Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Van Biesen D, Van Damme T, Morgulec-Adamowicz N, Buchholz A, Anjum M, Healy S. A Systematic Review of Digital Interventions to Promote Physical Activity in People With Intellectual Disabilities and/or Autism. Adapt Phys Activ Q 2024; 41:330-350. [PMID: 37793654 DOI: 10.1123/apaq.2023-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/13/2023] [Accepted: 08/29/2023] [Indexed: 10/06/2023] Open
Abstract
This systematic review synthesized the literature on digital health interventions for the promotion of physical activity (PA) among people with intellectual disabilities and/or autism. From an initial screening of 553 records, 10 studies underwent full-text review. Data were extracted relating to study, intervention, and sample characteristics and PA-related findings. Methodological quality was evaluated using the Crowe Critical Appraisal Tool. There were mixed findings pertaining to the effectiveness of digital health interventions for promoting PA among these populations. Positive results were reported for three of five active-video-game interventions, two of three social-media-based interventions, and one of two e-learning/multicomponent interventions. Digital health interventions can potentially be effective for promoting PA among people with intellectual disabilities and/or autism. However, the large variation in the samples and intervention types and a reliance on pre- and quasi-experimental research designs suggest that inferences should be made with caution and additional research is needed.
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Affiliation(s)
| | - Tine Van Damme
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Center KU Leuven, Leuven, Belgium
| | | | | | - Momna Anjum
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Séan Healy
- Physical Education and Sports Science, University of Limerick, Limerick, Ireland
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Chan CMJ, Müller-Riemenschneider F, Chia MYH, Hildon ZJL, Chong MFF. Promoting hEalthy Diet and Active Lifestyle (PEDAL): a protocol for the development and feasibility study of a multicomponent intervention among primary school children in Singapore. Pilot Feasibility Stud 2024; 10:52. [PMID: 38521958 PMCID: PMC10960416 DOI: 10.1186/s40814-024-01479-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/12/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Setting healthy lifestyle habits during the formative years of childhood is critical as habits can track to adulthood and help prevent obesity and chronic disease risks in later life. While multicomponent interventions have been shown to be effective in changing the lifestyle behaviours of children, there is a limited understanding of the feasibility of such interventions in primary schools in Singapore. A multiphase mixed method study was conducted to develop and examine the feasibility of a theory-based multicomponent school-based intervention-Promoting hEatlthy Eating and Active Lifestyle (PEDAL). METHODS Underpinned by Kincaid's ideation model, the PEDAL intervention was developed to increase fruit and vegetable consumption and decrease sedentary behaviours among children. This study consists of three phases. Phase 1 details the development of PEDAL, which consists of four components: (A) a series of interactive health education lessons, (B) actionable home activities to support habit formation, (C) parental/guardian engagement, and (D) optimising the school environment. In Phase 2, components A and B of PEDAL were implemented in two public, co-educational primary schools among Primary 5 students (aged 10-12 years) in Singapore. Data was collected quantitatively using questionnaires and qualitatively using focus group discussions (FGDs) with students and teachers. The feasibility dimensions of components A and B, including recruitment capability, data collection, social validity, and practicality were examined, and ideation on healthy eating and physical activity was explored. In Phase 3, the full PEDAL intervention was pilot-tested in two other public, co-education primary schools with the same target population, using a concurrent mixed method quasi-experimental study design. Feasibility dimensions and potential effectiveness of the intervention will be assessed. DISCUSSION This study will provide insights into the feasibility of PEDAL and inform its refinement. Findings from the pilot test will guide the planning of a larger-scale definitive trial. TRIAL REGISTRATION Registered with ISRCTN registry (ISRCTN16114046) on 16 October 2022.
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Affiliation(s)
- Cindy Mei Jun Chan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
- Center for Digital Health, Berlin Institute of Health (BIH), Charité-Universitatsmedizin Berlin, Berlin, Germany
| | - Michael Yong Hwa Chia
- Physical Education & Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Zoe Jane-Lara Hildon
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore.
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.
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6
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Rhodes RE, Hollman H, Sui W. Family-based physical activity interventions and family functioning: A systematic review. FAMILY PROCESS 2024; 63:392-413. [PMID: 36748347 DOI: 10.1111/famp.12864] [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: 05/20/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
Family physical activity (PA) can confer multiple health benefits, yet whether PA interventions affect general family functioning has not been appraised. The purpose of this review was to evaluate studies that have examined the effect of family PA interventions, where child PA was the focus of the intervention, on constructs of family functioning. Literature searches were concluded on January 11, 2022 using seven common databases. Eligible studies were in English, utilized a family PA intervention, and assessed a measure of family functioning as a study outcome. The initial search yielded 8413 hits, which was reduced to 20 independent PA interventions of mixed quality after screening for eligibility criteria. There was mixed evidence for whether family PA interventions affected overall family functioning; however, analyses of subdomains indicated that family cohesion is improved by PA interventions when children are in the early school years (aged 5-12). High-quality studies also showed an impact of family PA interventions on family organization. Targeted interventions at specific family subsystems (e.g., father-son, mother-daughter), characteristics (low-income, clinical populations, girls), and broad multibehavioral interventions may have the most reliable effects. Overall, the findings show that family PA interventions can promote family cohesion and organization, particularly among families with children in the early school years. Higher quality research, employing randomized trial designs and targeting specific intervention and sample characteristics (e.g., different clinical conditions, specific parent-child dyads), is recommended in order to better ascertain the effectiveness of these approaches.
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Affiliation(s)
- Ryan E Rhodes
- University of Victoria, Victoria, British Columbia, Canada
| | | | - Wuyou Sui
- University of Victoria, Victoria, British Columbia, Canada
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7
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Butscher F, Ellinger J, Singer M, Mall C. Influencing factors for the implementation of school-based interventions promoting obesity prevention behaviors in children with low socioeconomic status: a systematic review. Implement Sci Commun 2024; 5:12. [PMID: 38347649 PMCID: PMC10860312 DOI: 10.1186/s43058-024-00548-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/13/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Health inequity (HI) remains a major challenge in public health. Improving the health of children with low socioeconomic status (SES) can help to reduce overall HI in children. Childhood obesity is a global problem, entailing several adverse health effects. It is crucial to assess the influencing factors for adoption, implementation, and sustainment of interventions. This review aims to identify articles reporting about influencing factors for the implementation of school-based interventions promoting obesity prevention behaviors in children with low SES. It aims to critically appraise the articles' quality, assess influencing factors, categorize and evaluate them, and to discuss possible implications. METHODS A systematic search was conducted in 7 databases with the following main inclusion criteria: (1) school-based interventions and (2) target group aged 5-14 years. The Consolidated Framework for Implementation Research, its five domains (intervention characteristics, inner setting, outer setting, characteristics of individuals, process) along with 39 categories within these domains were used as deductive category system for data analysis. We grouped the articles with regard to the characteristics of the interventions in simple and complex interventions. For each domain, and for the groups of simple and complex interventions, the most commonly reported influencing factors are identified. RESULTS In total, 8111 articles were screened, and 17 met all eligibility criteria. Included articles applied mixed methods (n=11), qualitative (n=5), and quantitative design (n=1). Of these, six were considered to report simple interventions and eleven were considered to report complex interventions. In total, 301 influencing factors were assessed. Aspects of the inner setting were reported in every study, aspects of the outer setting were the least reported domain. In the inner setting, most reported influencing factors were time (n=8), scheduling (n=6), and communication (n=6). CONCLUSION This review found a wide range of influencing factors for implementation and contributes to existing literature regarding health equity as well as implementation science. Including all stakeholders involved in the implementation process and assessing the most important influencing factors in the specific setting, could enhance implementation and intervention effectiveness. More empirical research and practical guidance are needed to promote obesity prevention behaviors among children with low SES. REGISTRATION CRD42021281209 (PROSPERO).
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Affiliation(s)
- Friederike Butscher
- TUM School of Medicine and Health, Department Health and Sport Sciences, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany.
| | - Jan Ellinger
- TUM School of Medicine and Health, Department Health and Sport Sciences, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany
| | - Monika Singer
- TUM School of Medicine and Health, Department Health and Sport Sciences, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany
| | - Christoph Mall
- TUM School of Medicine and Health, Department Health and Sport Sciences, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany
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8
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Ulker MT, Simsek A, Hacioglu GE, Kurt A, Erken S, Yildiz B. Growth and development impact of sustainable nutrition education: An experimental study. J Food Sci 2024; 89:1294-1302. [PMID: 38161281 DOI: 10.1111/1750-3841.16891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/06/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024]
Abstract
Healthy societies are formed by learning and maintaining sustainable healthy eating behaviors from childhood. The aim of this study was to determine the effect of short-term sustainable nutrition education on growth and development parameters of preschool children. This study is an experimental design with pretest-posttest control group. This study was carried out in two kindergartens between February 2022 and June 2023 in Turkey. The education group received 4 months of dietary behavior training. The dietary scale and anthropometric measurements were administered at the first and last meetings. Data were analyzed with 95% confidence interval. The study was completed with 174 children. A statistically significant difference was found, especially in body weight (p < 0.05) and body weight percentile values (p < 0.05) in the posttest of the education group. A statistically significant difference (p < 0.05) was found between the groups in the eating behavior scale posttest score. Nutrition education in schools is important in promoting healthy eating habits. Nutrition education improves eating behavior positively. To maintain healthy eating behaviors, however, the continuity of education is necessary. In addition, as growth and development are physical processes, it is recognized that growth and development cannot be assessed by nutrition alone.
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Affiliation(s)
- Mutlu Tuce Ulker
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istinye University, Istanbul, Turkey
| | - Aysegul Simsek
- Department of Midwifery, Faculty of Health Sciences, Istinye University, Istanbul, Turkey
| | - Gizem Elvan Hacioglu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istinye University, Istanbul, Turkey
| | - Aysu Kurt
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istinye University, Istanbul, Turkey
| | - Serra Erken
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istinye University, Istanbul, Turkey
| | - Beyza Yildiz
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istinye University, Istanbul, Turkey
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9
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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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10
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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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11
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Renard M, Kelly DT, Ní Chéilleachair N, Lavelle F, Ó Catháin C. Cooking and food skills confidence of team sport athletes in Ireland. NUTR BULL 2023; 48:329-342. [PMID: 37435875 DOI: 10.1111/nbu.12625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/13/2023]
Abstract
Nutritional support often focuses on cooking and food skills such as food selection, recipe planning and meal preparation. Individuals with greater cooking and food skills confidence have previously displayed higher diet quality scores and lower intakes of overall calories, saturated fat and sugar. Despite this, the cooking and food skills of team sport athletes have yet to be investigated. This study aimed to evaluate the relationship between cooking and food skills confidence and athletes' demographic characteristics. A validated measure for the assessment of cooking and food skills confidence was distributed via an online survey. Participants were required to rate their confidence on a Likert scale (1 "very poor" - 7 "very good") for 14 items related to cooking skills and 19 items for food skills. Food engagement, general health interest and self-reported fruit and vegetable consumption as a measure of diet quality were also measured. The survey was completed by 266 team sport athletes (male: 150, female: 116, age: 24.8 ± 6.1 years). Group differences were explored using t-tests and ANOVA and associations were evaluated using Spearman's correlation and hierarchical multiple regressions. Athletes' total cooking and food skills confidence was 62.7 ± 17.4 (64.0 ± 17.8%) and 83.8 ± 20.1 (63.0 ± 15.1%), respectively. Females reported greater confidence in both cooking (+20.3%, p < 0.01) and food skills (+9.2%, p < 0.01). Hierarchical multiple regressions explained 48.8% of the variance in cooking skills confidence and 44% of the variance in food skills confidence with gender, previous culinary training, cooking learning stage, general health interest and food engagement all remaining significant in the cooking skills confidence model and cooking frequency, previous culinary training, general health interest and food engagement remaining significant in the food skills confidence model. Male team sport athletes may benefit the most from educational interventions designed to increase cooking and food skills confidence.
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Affiliation(s)
- Michèle Renard
- Department of Sport and Health Sciences, Technological University of the Shannon, Westmeath, Ireland
- SHE Research Group, Technological University of the Shannon, Westmeath, Ireland
| | - David T Kelly
- Department of Sport and Health Sciences, Technological University of the Shannon, Westmeath, Ireland
- SHE Research Group, Technological University of the Shannon, Westmeath, Ireland
| | - Niamh Ní Chéilleachair
- Department of Sport and Health Sciences, Technological University of the Shannon, Westmeath, Ireland
- SHE Research Group, Technological University of the Shannon, Westmeath, Ireland
| | - Fiona Lavelle
- Department of Nutritional Sciences, School of Life Course & Population Sciences, Kings College London, London, UK
| | - Ciarán Ó Catháin
- Department of Sport and Health Sciences, Technological University of the Shannon, Westmeath, Ireland
- SHE Research Group, Technological University of the Shannon, Westmeath, Ireland
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Michael SL, Barnes SP, Wilkins NJ. Scoping Review of Family and Community Engagement Strategies Used in School-Based Interventions to Promote Healthy Behaviors. THE JOURNAL OF SCHOOL HEALTH 2023; 93:828-841. [PMID: 37670597 PMCID: PMC11181466 DOI: 10.1111/josh.13367] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/02/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND School efforts to promote health among students are more successful when families and community members are involved. METHODS We conducted a scoping review to summarize and categorize family and community engagement strategies used in US school and out-of-school time (OST) interventions to address physical activity (PA) and nutrition in kindergarten through 12th grade students. RESULTS The National Network of Partnership Schools' Six Keys to Success framework was useful in organizing the types of family and community engagement strategies used in included interventions. Many interventions used multiple family and community engagement strategies, with the most common being communicating with families and community members; providing support or education to families; and collaborations among school/OST program and community to support students and their families. CONCLUSIONS This review identified six common family and community engagement strategies used in school and OST interventions for PA and nutrition. Including family and community engagement strategies in school and OST interventions could play an important role in maximizing support, resources, and expertise to promote healthy behaviors among all students.
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Affiliation(s)
- Shannon L. Michael
- Senior Health Scientist, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Seraphine Pitt Barnes
- Senior Health Scientist, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Natalie J. Wilkins
- Health Scientist, TeamLead, Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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13
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Börnhorst C, Pigeot I, De Henauw S, Formisano A, Lissner L, Molnár D, Moreno LA, Tornaritis M, Veidebaum T, Vrijkotte T, Didelez V, Wolters M. The effects of hypothetical behavioral interventions on the 13-year incidence of overweight/obesity in children and adolescents. Int J Behav Nutr Phys Act 2023; 20:100. [PMID: 37620898 PMCID: PMC10463721 DOI: 10.1186/s12966-023-01501-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND In view of the high burden of childhood overweight/obesity (OW/OB), it is important to identify targets for interventions that may have the greatest effects on preventing OW/OB in early life. Using methods of causal inference, we studied the effects of sustained behavioral interventions on the long-term risk of developing OW/OB based on a large European cohort. METHODS Our sample comprised 10 877 children aged 2 to < 10 years at baseline who participated in the well-phenotyped IDEFICS/I.Family cohort. Children were followed from 2007/08 to 2020/21. Applying the parametric g-formula, the 13-year risk of developing OW/OB was estimated under various sustained hypothetical interventions on physical activity, screen time, dietary intake and sleep duration. Interventions imposing adherence to recommendations (e.g. maximum 2 h/day screen time) as well as interventions 'shifting' the behavior by a specified amount (e.g. decreasing screen time by 30 min/day) were compared to 'no intervention' (i.e. maintaining the usual or so-called natural behavior). Separately, the effectiveness of these interventions in vulnerable groups was assessed. RESULTS The 13-year risk of developing OW/OB was 30.7% under no intervention and 25.4% when multiple interventions were imposed jointly. Meeting screen time and moderate-to-vigorous physical activity (MVPA) recommendations were found to be most effective, reducing the incidence of OW/OB by -2.2 [-4.4;-0.7] and -2.1 [-3.7;-0.8] percentage points (risk difference [95% confidence interval]), respectively. Meeting sleep recommendations (-0.6 [-1.1;-0.3]) had a similar effect as increasing sleep duration by 30 min/day (-0.6 [-0.9;-0.3]). The most effective intervention in children of parents with low/medium educational level was being member in a sports club; for children of mothers with OW/OB, meeting screen time recommendations and membership in a sports club had the largest effects. CONCLUSIONS While the effects of single behavioral interventions sustained over 13 years were rather small, a joint intervention on multiple behaviors resulted in a relative reduction of the 13-year OW/OB risk by between 10 to 26%. Individually, meeting MVPA and screen time recommendations were most effective. Nevertheless, even under the joint intervention the absolute OW/OB risk remained at a high level of 25.4% suggesting that further strategies to better prevent OW/OB are required.
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Affiliation(s)
- C Börnhorst
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr 30, 28359, Bremen, Germany.
| | - I Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr 30, 28359, Bremen, Germany
- Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - S De Henauw
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - A Formisano
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - L Lissner
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - D Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Saragossa, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad Y Nutrición (CIBERObn), Madrid, Spain
| | - M Tornaritis
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - T Veidebaum
- National Institute for Health Development, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia
| | - T Vrijkotte
- Department of Public and Occupational Health, Amsterdam University Medical Center (Amsterdam UMC), University of Amsterdam, Amsterdam, The Netherlands
| | - V Didelez
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr 30, 28359, Bremen, Germany
- Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - M Wolters
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr 30, 28359, Bremen, Germany
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Abu Shihab KHN, Dodge E, Benajiba N, Chavarria EA, Aboul-Enein BH, Faris MAIE. Effectiveness of school-based nutrition interventions promoted in the League of Arab States: a systematic review. Health Promot Int 2023; 38:daad094. [PMID: 37611160 PMCID: PMC10446142 DOI: 10.1093/heapro/daad094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Abstract
Arab countries are doubly burdened with undernutrition as well as overweight and obesity. To provide guidance to those looking to address concerns of obesity and overweight among children in this region, the current review bridges an existing knowledge gap and systematically characterizes and evaluates the available scientific evidence pertaining to school-based nutrition interventions completed to date across the Arab world. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and relevant keywords, terms and phrases, a search of the literature across 14 databases for school-based nutrition interventions implemented in this region was conducted. Out of 1568 articles from 14 databases, 38 full-text articles meeting the inclusion criteria were retrieved. Further assessment for eligibility excluded 23 articles and included one article from hand-searching references, leaving 16 articles in the final analysis. Most articles (n = 7) with the implementation of 5 months or longer found strong positive and significant impacts on limiting sweets consumption, increased dietary knowledge, self-efficacy, breakfast and fruit and vegetable consumption, among others. We also found evidence (n = 5) that teachers trained by experts such as dietitians and pediatricians can effectively implement nutrition interventions that achieve the intended outcomes. Training teachers to implement theory-based nutrition and health promotion curricula serves as a potential solution to improving nutrition knowledge, health behaviors and dietary practices among children living in Arab countries. Appropriately designed and implemented nutrition interventions can positively impact nutrition knowledge, health and diet-related behaviors in children and adolescents in this region.
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Affiliation(s)
- Katia Hazim N Abu Shihab
- Department of Clinical Nutrition and Dietetics Sharjah, University of Sharjah College of Health Sciences, Sharjah, United Arab Emirates
| | - Elizabeth Dodge
- Applied Nutrition Graduate Program, University of New England College of Professional Studies, 716 Stevens Ave. Portland, ME 04103, USA
| | - Nada Benajiba
- Ibn Tofail University-CNESTEN Joint Research Unit in Nutrition and Food, RDC-Nutrition AFRA/IAEA, Rabat, 14000 Kenitra, Morocco
| | - Enmanuel A Chavarria
- Department of Behavioral, Social, and Health Education Science, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Basil H Aboul-Enein
- London School of Hygiene & Tropical Medicine, Faculty of Public Health and Policy, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Moez Al-Islam E Faris
- Department of Clinical Nutrition and Dietetics Sharjah, University of Sharjah College of Health Sciences, Sharjah, United Arab Emirates
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Kamionka A, Lipowska M, Lizińczyk S, Lipowski M. The impact of parents' physical activity goals and parental attitudes on physical activity during leisure time among children in middle childhood. Front Public Health 2023; 11:1170413. [PMID: 37465176 PMCID: PMC10350508 DOI: 10.3389/fpubh.2023.1170413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/25/2023] [Indexed: 07/20/2023] Open
Abstract
Introduction Parents' supportiveness and health-promoting habits significantly affect the intensity of children's physical activity (PA) and the involvement of parents in their engagement in PA; in this domain, both the hours devoted to PA and PA goals can be assessed. The family plays an important role in shaping the physical and social organization of the environment for children aged 4-6 years. Methods A total of 680 families with 5-year-old children (330 girls, 350 boys) took part in the study. Data were collected from these participants, who were recruited from preschools and primary schools in the Pomeranian region of Poland. The aim of this study was to determine whether the involvement of parents in PA mediates the influence of parental attitudes on the ways in which their children spend their leisure time. Results The results showed that not all parental attitudes had direct impact on children's leisure time in PA and outside PA. Other aspects parental attitude had no significant impact on offspring's free time. Among fathers, only four aspects of parental attitude (namely, acceptance-rejection, inconsistency, autonomy, and overprotectiveness) had an impact on PA goals. Mothers' goals were influenced by the strength of a larger number of aspects of attitude (namely, acceptance-rejection, autonomy, inconsistency, over-demandingness, and overprotectiveness). Similarly, the strength of mothers' and fathers' acceptance-rejection attitudes, attitudes of autonomy, and overprotectiveness had an impact on their PA goals but were not directly linked to their children's leisure-time engagement in PA. Discussion Not all parental attitudes have a direct impact on children's PA or non-PA leisure time. However, the goals of PA parents have been recognized influence the leisure time of children in PA and outside PA. The most statistically significant relationship for both mothers and fathers was between parental attitudes and PA goals. Parental attitudes do not play a significant role in explaining involvement in PA or lack of it in leisure time among 5-year-old children.
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Affiliation(s)
- Agata Kamionka
- Faculty of Physical Culture, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | | | | | - Mariusz Lipowski
- Faculty of Physical Culture, Gdansk University of Physical Education and Sport, Gdańsk, Poland
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Clinical Evolution of Preschool Picky Eater Children Receiving Oral Nutritional Supplementation during Six Months: A Prospective Controlled Clinical Trial. CHILDREN 2023; 10:children10030495. [PMID: 36980052 PMCID: PMC10047348 DOI: 10.3390/children10030495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/09/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023]
Abstract
Objective: To determine if oral nutritional supplementation of picky eater children has a beneficial effect in addition to nutritional guidance on anthropometric parameters, nutrient intake, appetite, physical activity, and health complications. Methods: This is a randomized, single-blind, controlled clinical trial that included Brazilian picky eater children aged 24 to 60 months. The individuals were randomized into a control group (CG) (n = 17) and an intervention group (IG) (n = 18), and were followed up in seven meetings for 180 days (baseline plus one meeting every 30 days). The CG received nutritional guidance for food selectivity, while the IG received the same guidance plus oral nutritional supplementation. Anthropometric and nutrient intake assessments were carried out, and appetite, physical activity and health complications were investigated. Results: In the IG, the z-score of weight and height increased significantly over time (p < 0.05), while the body fat percentage (BFP) and BMI z-score remained unchanged. The percentage of inadequate intake of vitamins D, C and folate reduced in the IG over time compared to the CG (p < 0.05). In the IG, the score assigned by parents to the appetite scale increased over time (p < 0.05). There was no difference between the groups in the scores on the physical activity and global health scales, and in the number of health complications. Conclusions: Picky eater children that were supplemented increased their weight not by gaining fat, but due to an increase in stature, as shown by BMI z-score and BFP, that remained unchanged. Furthermore, they showed a decrease in inadequate micronutrient intake during the intervention. An improvement in appetite was also observed over time, attesting to the benefit of supplementation.
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17
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Kanchanachitra M, Angeles G. Impact of a School-Based Nutrition Intervention in Preventing Overweight and Obesity in Children in Thailand. THE JOURNAL OF SCHOOL HEALTH 2023; 93:140-147. [PMID: 36217922 PMCID: PMC10092697 DOI: 10.1111/josh.13253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 08/03/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND This study evaluated the impact of a school-based nutrition program on preventing overweight and obesity in children in Thailand from 2014 to 2019. METHODS We used difference-in-differences with matched comparison group to evaluate program impact. Treatment schools were categorized into those that participated in phase 1 only, and those that participated in phase 1 and 2. We matched 311 treatment schools in phase 1 only with 1504 comparison schools, and 75 treatment schools in both phases with 216 comparison schools. Administrative data from Thailand Office of Basic Education Commission were used from 2014 (baseline), 2016 (first follow-up), and 2019 (second follow-up). RESULTS Program resulted in a 0.6-1.1 percentage point reduction in the students' probability of overweight by the end of phase 1, and 1.7 percentage points by the end of phase 2. Impact on obesity was found only for schools participating in both phases (0.4 and 0.9 percentage points by the end of phase 1 and 2, respectively). IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Program continuity and intensity are key to achieve a reduction in overweight and obesity in schoolchildren. CONCLUSIONS The program was successful in reducing overweight and/or obesity given appropriate level of continuity and intensity.
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Affiliation(s)
- Manasigan Kanchanachitra
- Institute for Population and Social ResearchMahidol University999 Phuttamonthon Sai 4, Salaya, PhuttamonthonNakhon Pathom73170Thailand
| | - Gustavo Angeles
- Department of Maternal and Child Health, Gillings School of Global Public HealthUniversity of North Carolina at Chapel Hill400 Meadowmont CircleChapel HillNC27599
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Toft U, Buch-Andersen T, Bloch P, Reinbach HC, Jensen BB, Mikkelsen BE, Aagaard-Hansen J, Glümer C. A Community-Based, Participatory, Multi-Component Intervention Increased Sales of Healthy Foods in Local Supermarkets-The Health and Local Community Project (SoL). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2478. [PMID: 36767845 PMCID: PMC9915330 DOI: 10.3390/ijerph20032478] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Project SoL was a 19-month (September 2012 to April 2014) community-based multi-component intervention based on the supersetting approach that was designed to promote healthier eating and physical activity among children and their families. The aim of this study was to examine the effects of a multi-component intervention (level 1) and a mass media intervention alone (level 2) compared to a control area (level 3) on food sales. The design was quasi-experimental. Weekly sales data for all Coop supermarkets in the intervention and control areas were analysed via longitudinal linear mixed-effects analyses. Significant increases in the sales of fish (total) (29%; p = 0.003), canned fish (31%; p = 0.025) and oatmeal (31%; p = 0.003) were found for the level 1 intervention area compared to the control area. In the level 2 intervention area, significant increases in the sales of vegetables (total) (17%; p = 0.038), fresh vegetables (20%; p = 0.01), dried fruit (51%; p = 0.022), oatmeal (19%; p = 0.008) and wholegrain pasta (58%; p = 0.0007) were found compared to the control area. The sales of canned fish increased by 30% in the level 1 area compared to the level 2 area (p = 0.025). This study demonstrated significant increases in the sales of healthy foods, both in the areas with multi-component and mass media interventions alone compared to the control area.
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Affiliation(s)
- Ulla Toft
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen, Denmark
| | - Tine Buch-Andersen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
| | - Paul Bloch
- Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
| | - Helene Christine Reinbach
- Department of Food Science, Section for Food Design and Consumer Behaviour, University of Copenhagen, Rolighedsvej 30, Building 2-74, 5th Floor, Room C505, 1958 Frederiksberg C, Denmark
| | - Bjarne Bruun Jensen
- Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
| | - Bent Egberg Mikkelsen
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark
| | - Jens Aagaard-Hansen
- Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
- SA MRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Charlotte Glümer
- Center for Diabetes, Copenhagen Municipality, Vesterbrogade 121, 1620 Copenhagen, Denmark
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Alberty R, Čillík I. Effect of after-school physical activity on body composition in primary school children: The Slovak "PAD" project. Physiol Rep 2023; 11:e15540. [PMID: 36597192 PMCID: PMC9810785 DOI: 10.14814/phy2.15540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/24/2022] [Accepted: 11/25/2022] [Indexed: 01/05/2023] Open
Abstract
Physical activity is associated with many physical and mental health benefits. This study aimed to investigate the effect of a 24-month after-school physical activity intervention on body composition in normal-weight children. Participating students (6-7 years of age at baseline) were divided by reason of their parental preference to intervention and control groups. Children in the intervention group (n = 20; 10 boys and 10 girls) followed an aerobic training program (two 60-min sessions per week), whereas children in the control group (n = 20; 10 boys and 10 girls) participated in the usual practice. Body composition characteristics were repeatedly measured by means of bioelectrical impedance method. At 2 years, finally, intervention boys had a smaller rise in BMI (mean difference, MD: -0.97 kg/m2 , p < 0.05), BMI z-score (-0.44, p < 0.09), body fat % (BF%) (-6.47%, p < 0.01), and fat mass index (FMI) (-1.32 kg/m2 , p < 0.001) than controls. In girls, however, the intervention program induced no significant differences (p > 0.9) in the measured variables compared to controls at the final follow-up (MD: -0.04 kg/m2 for BMI and -0.01 for BMI z-score). Changes in BF% and FMI in a positive direction occurred at 18 months (MD: -3.38%, p < 0.05 and -0.99 kg/m2 , p < 0.01, respectively), but did not persist over time (p > 0.07). In addition, no significant changes (p > 0.07) in the fat-free mass index were associated with the physical activity intervention in either boys or girls. In conclusion, compared to the controls, a long-term physical activity intervention in boys was associated with a significantly smaller rise in BMI and improvement of body composition by reducing both BF % and FMI. In girls, however, this intervention did not result in any statistically significant changes in body composition variables.
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Affiliation(s)
- Roman Alberty
- Department of Biology and Ecology, Faculty of Natural Sciences of Matej Bel University, Banská Bystrica, Slovakia
| | - Ivan Čillík
- Department of Physical Education and Sports, Faculty of Arts of Matej Bel University, Banská Bystrica, Slovakia
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20
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Khaliltahmasebi R, Minasian V, Hovsepian S. Effects of Two Different School-Based Training on Serum miR15b Expression and Lipid Profile of Adolescents with Obesity. Int J Prev Med 2022; 13:139. [PMID: 36618534 PMCID: PMC9811960 DOI: 10.4103/ijpvm.ijpvm_6_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 09/28/2021] [Indexed: 01/10/2023] Open
Abstract
Background Some circulating microRNAs, such as miR15b, are predictors of diseases associated with adulthood obesity. This study aimed to evaluate the effect of two selected school-based and high-intensity interval training (HIT) on miR15b expression and lipid profile of obese adolescents. Methods Thirty-eight adolescent males (12 ± 1 years) with obesity (body mass: 74.7 ± 13.2 kg, body mass index (BMI): 26.0 ± 2.3 kg/m2, and body fat (BF): 27.2 ± 3.6%) were randomly assigned to the following based on the age-related body mass index: (i) HIT (n = 13), (ii) school-based exercises (SBE, n = 13), and (iii) control (n = 12) groups. Mir15b was extracted using the RT-PCR system, and lipid profile was studied using the enzymatic colorimetric method before and after 12 weeks. Three training sessions were held each week during the course. Results Following the exercise interventions, in both training groups, miR15b (HIT: -63.8 vs. SBE: -56. 7%; P = 0.001), cholesterol (HIT: -8.8 vs. SBE: -9.2%; P = 0.025), and low-density lipoproteins levels (SBE: -13.1 vs. -20.8%; P = 0.48) decreased; however, the peak oxygen uptake of subjects increased (HIT: 4.0 vs. SBE: 4.0%; P = 0.003). However, there were no significant differences in triglyceride (HIT: -16.9 vs. SBE: -8.3%; P = 0.134), and high-density lipoprotein (HIT: 3.1 vs. SBE: 4.8%; P = 0.479) levels between both intervention and control groups (P > 0.05). Conclusions The results showed that both types of exercises had almost similar effects on reducing miR15b expression and improving the lipid profile. Hence, based on the difficult nature of HIT for children with obesity, further use of school-based exercises is suggested.
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Affiliation(s)
- Rasol Khaliltahmasebi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Vazgen Minasian
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran,Address for correspondence: Dr. Vazgen Minasian, Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran. E-mail:
| | - Silva Hovsepian
- Metabolic Liver Diseases Research Center, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Ho YCL, Chew MSL, Ho CZH, Latib AB, Lee VSY, Lin GJ, Thumboo J, Doshi K. The validation of culturally appropriate scales to assess the family health climate in a multi-ethnic Asian population. Front Public Health 2022; 10:988525. [PMID: 36276392 PMCID: PMC9584639 DOI: 10.3389/fpubh.2022.988525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/12/2022] [Indexed: 01/26/2023] Open
Abstract
Background The Family Health Climate (FHC) is a family environment attribute postulated to influence the health behaviors of family members. It can be measured by domain scales for physical activity (FHC-PA) and nutrition (FHC-NU), which have been validated and used to identify health climate patterns in families in Western populations. To extend the use of the scales to Asian settings, this study aimed to adapt and validate the instruments for use in the multi-ethnic population of Singapore, accounting for language and cultural differences. Methods In Part A (n = 40) to adapt the scales for the Singapore population, we performed cognitive interviews, face validity testing and pre-testing of the instruments (n = 40). Besides English, the scales were translated into Chinese and Malay. In Part B (n = 400), we performed exploratory and confirmatory factor analyses respectively on two random samples. We also tested for item discriminant validity, internal consistency reliability, construct validity, and measurement invariance. Results The findings from the cognitive interviews in Part A led to scale adaptations to accommodate cultural and linguistic factors. In Part B, EFA on Sample I resulted in a three-factor model for the PA scale (accounting for 71.2% variance) and a four-factor model for the NU scale (accounting for 72.8% variance). CFA on Sample II indicated acceptable model fits: FHC-PA: χ2 = 192.29, df = 101, p < 0.001, χ2/df = 1.90; SRMR = 0.049; RMSEA = 0.067; CFI = 0.969; TLI = 0.963; FHC-NU: χ2 = 170.46, df = 98, p < 0.001, χ2/df = 1.74; SRMR = 0.036; RMSEA = 0.061; CFI = 0.967; TLI = 0.960. The scores of family members demonstrated significant agreement on the FHC-PA (Sg) [ICC(2, 2) = 0.77] and FHC-NU (Sg) [ICC(2, 2) = 0.75] scales. Findings suggest good evidence for item discriminant validity, internal consistency reliability, construct validity, and measurement invariance. Short versions of the scales were also developed. Conclusion We adapted, translated and validated the scales for assessing the health climate of families in Singapore, including the development of short versions. The results showed good psychometric properties and the constructs had significant relationships with health behaviors and routines. Improving our understanding of family influences on individual health behavior will be important in developing multi-level strategies for health promotion and chronic disease prevention.
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Affiliation(s)
- Yi-Ching Lynn Ho
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore,*Correspondence: Yi-Ching Lynn Ho
| | - Mary Su-Lynn Chew
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
| | - Clement Zhong-Hao Ho
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
| | - Aisyah Binte Latib
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
| | - Vivian Shu-Yi Lee
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
| | - Gladis Jing Lin
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Julian Thumboo
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore,Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore,Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Kinjal Doshi
- Department of Neurology, Singapore General Hospital, Singapore, Singapore
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Blonde L, Umpierrez GE, Reddy SS, McGill JB, Berga SL, Bush M, Chandrasekaran S, DeFronzo RA, Einhorn D, Galindo RJ, Gardner TW, Garg R, Garvey WT, Hirsch IB, Hurley DL, Izuora K, Kosiborod M, Olson D, Patel SB, Pop-Busui R, Sadhu AR, Samson SL, Stec C, Tamborlane WV, Tuttle KR, Twining C, Vella A, Vellanki P, Weber SL. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract 2022; 28:923-1049. [PMID: 35963508 PMCID: PMC10200071 DOI: 10.1016/j.eprac.2022.08.002] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The objective of this clinical practice guideline is to provide updated and new evidence-based recommendations for the comprehensive care of persons with diabetes mellitus to clinicians, diabetes-care teams, other health care professionals and stakeholders, and individuals with diabetes and their caregivers. METHODS The American Association of Clinical Endocrinology selected a task force of medical experts and staff who updated and assessed clinical questions and recommendations from the prior 2015 version of this guideline and conducted literature searches for relevant scientific papers published from January 1, 2015, through May 15, 2022. Selected studies from results of literature searches composed the evidence base to update 2015 recommendations as well as to develop new recommendations based on review of clinical evidence, current practice, expertise, and consensus, according to established American Association of Clinical Endocrinology protocol for guideline development. RESULTS This guideline includes 170 updated and new evidence-based clinical practice recommendations for the comprehensive care of persons with diabetes. Recommendations are divided into four sections: (1) screening, diagnosis, glycemic targets, and glycemic monitoring; (2) comorbidities and complications, including obesity and management with lifestyle, nutrition, and bariatric surgery, hypertension, dyslipidemia, retinopathy, neuropathy, diabetic kidney disease, and cardiovascular disease; (3) management of prediabetes, type 2 diabetes with antihyperglycemic pharmacotherapy and glycemic targets, type 1 diabetes with insulin therapy, hypoglycemia, hospitalized persons, and women with diabetes in pregnancy; (4) education and new topics regarding diabetes and infertility, nutritional supplements, secondary diabetes, social determinants of health, and virtual care, as well as updated recommendations on cancer risk, nonpharmacologic components of pediatric care plans, depression, education and team approach, occupational risk, role of sleep medicine, and vaccinations in persons with diabetes. CONCLUSIONS This updated clinical practice guideline provides evidence-based recommendations to assist with person-centered, team-based clinical decision-making to improve the care of persons with diabetes mellitus.
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Affiliation(s)
| | | | - S Sethu Reddy
- Central Michigan University, Mount Pleasant, Michigan
| | | | | | | | | | | | - Daniel Einhorn
- Scripps Whittier Diabetes Institute, La Jolla, California
| | | | | | - Rajesh Garg
- Lundquist Institute/Harbor-UCLA Medical Center, Torrance, California
| | | | | | | | | | | | - Darin Olson
- Colorado Mountain Medical, LLC, Avon, Colorado
| | | | | | - Archana R Sadhu
- Houston Methodist; Weill Cornell Medicine; Texas A&M College of Medicine; Houston, Texas
| | | | - Carla Stec
- American Association of Clinical Endocrinology, Jacksonville, Florida
| | | | - Katherine R Tuttle
- University of Washington and Providence Health Care, Seattle and Spokane, Washington
| | | | | | | | - Sandra L Weber
- University of South Carolina School of Medicine-Greenville, Prisma Health System, Greenville, South Carolina
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23
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Preliminary Effectiveness of a Strategy to Promote Healthy Lifestyle Habits in Schoolchildren. CHILDREN 2022; 9:children9091402. [PMID: 36138711 PMCID: PMC9497957 DOI: 10.3390/children9091402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022]
Abstract
Purpose: To measure the preliminary effectiveness of a strategy to promote healthy lifestyle habits in schoolchildren, aged 6 to 12 years, living in the Andean region of Colombia, 2018–2021. Design and Methods: This is a Nursing Methodological Research, developed in phases: (1) Context and schoolchildren characterization; (2) Strategy design guided by the Whittemore and Grey criteria and the Bronfenbrenner ecological conceptual model; (3) Strategy validation with 11 experts; (4) Trial to evaluate preliminary effectiveness. We applied the strategy in seven different schools with the educational community including 955 schoolchildren between 6 and 12 years of age, 551 parents, 130 teachers and 7 members of the food staff. Results: Our health promotion strategy “Prosalud” has five components: citizenship feeding and nutrition, physical activity, and rest; environment protection, and directing one’s own life. It includes all the participants of the educational community. Conclusions: According to experts, the health promotion strategy “Prosalud” is valid to help promoting healthy lifestyle habits among schoolchildren. This strategy demonstrates its preliminary effectiveness in a group of school children from 6 to 12 years of age, their parents, teachers, and school food staff, in the Andean region of Colombia.
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24
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Venkatraman T, Honeyford K, Ram B, M F van Sluijs E, Costelloe CE, Saxena S. Identifying local authority need for, and uptake of, school-based physical activity promotion in England-a cluster analysis. J Public Health (Oxf) 2022; 44:694-703. [PMID: 33942861 PMCID: PMC9424056 DOI: 10.1093/pubmed/fdab138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 01/21/2021] [Accepted: 01/29/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND School-based physical activity interventions such as The Daily Mile (TDM) are widely promoted in children's physical activity guidance. However, targeting such interventions to areas of greatest need is challenging since determinants vary across geographical areas. Our study aimed to identify local authorities in England with the greatest need to increase children's physical activity and assess whether TDM reaches school populations in areas with the highest need. METHODS This was a cross-sectional study using routinely collected data from Public Health England. Datasets on health, census and the built environment were linked. We conducted a hierarchical cluster analysis to group local authorities by 'need' and estimated the association between 'need' and registration to TDM. RESULTS We identified three clusters of high, medium and low need for physical activity interventions in 123 local authorities. Schools in high-need areas were more likely to be registered with TDM (incidence rate ratio 1.25, 95% confidence interval: 1.12-1.39) compared with low-need areas. CONCLUSIONS Determinants of children's physical activity cluster geographically across local authorities in England. TDM appears to be an equitable intervention reaching schools in local authorities with the highest needs. Health policy should account for clustering of health determinants to match interventions with populations most in need.
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Affiliation(s)
- Tishya Venkatraman
- Department of Primary Care and Public Health, Imperial College London, London, W6 8RP, UK
| | - Kate Honeyford
- Department of Primary Care and Public Health, Imperial College London, London, W6 8RP, UK
| | - Bina Ram
- Department of Primary Care and Public Health, Imperial College London, London, W6 8RP, UK
| | - Esther M F van Sluijs
- MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Céire E Costelloe
- Department of Primary Care and Public Health, Imperial College London, London, W6 8RP, UK
| | - Sonia Saxena
- Department of Primary Care and Public Health, Imperial College London, London, W6 8RP, UK
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25
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Mugler N, Baurecht H, Lam K, Leitzmann M, Jochem C. The Effectiveness of Interventions to Reduce Sedentary Time in Different Target Groups and Settings in Germany: Systematic Review, Meta-Analysis and Recommendations on Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10178. [PMID: 36011821 PMCID: PMC9408392 DOI: 10.3390/ijerph191610178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/07/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Sedentary behavior is an important risk factor for several chronic diseases and is associated with an increased risk of mortality. We assessed the effectiveness of interventions to reduce sedentary time in Germany and provide recommendations on interventions to reduce sedentary time in children and adults. METHODS We comprehensively searched PubMed, Web of Science and the German Clinical Trials Register up to April 2022 for intervention studies targeting sedentary behavior in Germany. We performed a systematic review and qualitative synthesis of the interventions and a meta-analysis in children. RESULTS We included 15 studies comprising data from 4588 participants. The results of included primary studies in adults and children showed inconsistent evidence regarding change in sedentary time, with a majority of studies reporting non-significant intervention effects. The meta-analysis in children showed an increase in sedentary time for children in the control and intervention groups. CONCLUSION We found inconsistent evidence regarding the effectiveness of interventions to reduce time spent sedentary and our meta-analysis showed an increase in sedentary time in children. For children, we recommend physical and social environment interventions with an active involvement of families. For adults, we recommend physical environment interventions, such as height-adjustable desks at work.
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26
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Koivusilta L, Alanne S, Kamila M, Ståhl T. A qualitative study on multisector activities to prevent childhood obesity in the municipality of Seinäjoki, Finland. BMC Public Health 2022; 22:1298. [PMID: 35794541 PMCID: PMC9258052 DOI: 10.1186/s12889-022-13658-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/16/2022] [Indexed: 11/26/2022] Open
Abstract
Background Multisector activities are needed to prevent childhood obesity due to its multifactorial background. The first aim was to identify the activities that had been undertaken for obesity prevention and deduce their main targets. Second, we analyzed the public health policy approaches (upstream, midstream, and downstream) which were followed. Finally, we studied the perception of interviewees regarding their sectors’ roles in implementing the local obesity program. Methods Deductive content analysis was used to analyze semi-structured interviews with 34 key professionals (from seven administrative sectors) who had participated in multisector health promotion during 2009–2016 and five representatives of other core parties. Results Several midstream and upstream activities were targeted at making physical activity (PA) and healthy eating (HE) integral parts of children’s lifestyle. One long-term strategy was to create environments for PA accessible to every inhabitant and build and renovate the interiors and yards of schools and day-care centers. The healthiness of meals was increased progressively. In addition to midstream and upstream activities, as a downstream activity, an intervention targeting children at risk of obesity was implemented. The impact of management on the activities was considerable; childhood obesity prevention was included in the city strategy and systematically coordinated at the highest managerial level. Altogether, various sectors operated efficiently to promote obesity-preventing lifestyles; however, not all (important) sectors recognized their role in the multisector process. Conclusion Most of the activities to guide children towards obesity-preventing lifestyles were either at the midstream or upstream level. Among the latter, considerable work is aimed at creating opportunities to practice PA and making it a natural part of the daily life. The aim of familiarizing children with lifestyles that include PA and HE was shared across sectors, including sectors that had not yet acknowledged their role in obesity prevention. Strong support from city management and systematic coordination of the activity are important factors that contribute to the engagement of several administrative sectors in working towards a shared aim, such as the prevention of childhood obesity.
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Prince SA, Lancione S, Lang JJ, Amankwah N, de Groh M, Jaramillo Garcia A, Merucci K, Geneau R. Examining the state, quality and strength of the evidence in the research on built environments and physical activity among children and youth: An overview of reviews from high income countries. Health Place 2022; 76:102828. [PMID: 35700605 DOI: 10.1016/j.healthplace.2022.102828] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Built environments have shown to be associated with health, with physical activity (PA) considered one of the critical pathways for achieving benefits. Navigating available evidence on the built environment and PA is challenging given the number of reviews. OBJECTIVE Examine the current state and quality of research looking at associations between built environments and total PA and domains of PA (i.e., leisure/recreation, transportation, school) among children and youth (1-18 years). METHODS We systematically searched the grey literature and six bibliographic databases from January 2000 to May 2020. Review quality was assessed using the AMSTAR2. Results by age group were synthesized using narrative syntheses and harvest plots, and certainty of the evidence was assessed using a modified GRADE approach. RESULTS This overview included 65 reviews. Most reviews were of very low-to-low quality. High certainty was found for positive associations between transportation PA and walking/cycling/active transportation (AT) infrastructure. There was high certainty for positive associations between streets/play streets and total PA, alongside lower certainty for transportation and leisure PA. Very low-to-moderate certainty supports schoolyards designed to promote PA were positively associated with total PA, but mixed for school PA (except children). Less consistent positive associations were found for forests/trees, greenspace/open space, recreation facilities, street lighting, traffic safety, population/residential density, proximity/access to destinations, neighbourhood characteristics, and home environments. There is very low-to-moderate certainty for negative associations between greater distance to school and traffic volume and domains of PA. Generally, null or mixed associations were observed for aesthetics, parks, AT comfort infrastructure, land-use mix, street connectivity, urban/rural status, and public transit. DISCUSSION There remains a need for high quality systematic reviews and studies to evaluate the effects of environmental changes across the pediatric age spectrum and using a PA domain approach. Given the global physical inactivity crisis the built environment remains and important means to promote PA among children/youth.
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Affiliation(s)
- Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Samantha Lancione
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Justin J Lang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; School of Mathematics and Statistics, Faculty of Science, Carleton University, Ottawa, Canada
| | - Nana Amankwah
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
| | - Margaret de Groh
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
| | | | | | - Robert Geneau
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
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28
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The Impact of School-Based Nutrition Interventions on Parents and Other Family Members: A Systematic Literature Review. Nutrients 2022; 14:nu14122399. [PMID: 35745127 PMCID: PMC9231235 DOI: 10.3390/nu14122399] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/02/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022] Open
Abstract
Little is known about the impact of school-based nutrition interventions on parents and other family members. This systematic review aims to explore the impact of school-based nutrition interventions on different parental/family outcomes, mainly dietary intake, nutrition knowledge, and health outcomes. PubMed, Web of Science, PsycINFO, EconLit, Cochrane Reviews, and Google Scholar were systematically searched for controlled trials or natural experiments measuring the impact of school-based nutrition interventions, with or without parental involvement, on parents/families of school children. Twenty-two studies met the inclusion criteria. Of which, 15 studies assessed the impact of school-based nutrition interventions on parental/family dietary intake, 10 on parental/family nutrition knowledge, and 2 on parental/family health outcomes. Inconsistent results were found for parental dietary intake with six studies reporting favorable effects. Most studies found improved parental nutrition knowledge. Positive impacts were seen by both studies that assessed the impact on a parental health outcome. Overall, we found that there is potential for school-based nutrition interventions to result in positive effects for parents, in particular for nutrition knowledge. More research is needed to assess the impacts of school-based nutrition interventions on parents and other family members and to assess important intervention characteristics in creating a positive impact.
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Wanderley Júnior RDS, Queiroz DDR, Guerra PH, Martins CL, Hardman CM, Umpierre D, da Silva LR, Souza Filho AND, Azevedo Cavalcante FVS, Sandreschi PF, Barros MVGD. Correlatos de atividade física e comportamento sedentário em crianças pré-escolares sul-americanas: revisão de escopo. Rev Panam Salud Publica 2022. [PMID: 34131427 PMCID: PMC9168416 DOI: 10.26633/rpsp.2022.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objetivo.
Sintetizar os achados sobre correlatos da atividade física (AF) e do comportamento sedentário (CS) em crianças sul-americanas.
Método.
Realizou-se uma busca dos artigos no período de 24 de junho até 27 de outubro de 2020, nas bases de dados LILACS, PubMed, SciELO, Scopus e Web of Science. Para ampliar a busca, foram examinadas as referências dos artigos de revisão identificados e realizada uma consulta a um painel de especialistas. Foram incluídos estudos com delineamentos observacional e de intervenção com foco em crianças sul-americanas de zero a 5 anos de idade.
Resultados.
Dos 3 111 artigos inicialmente identificados, 18 foram elegíveis: 14 com delineamento observacional, 12 realizados no Brasil e 17 conduzidos com pré-escolares (3 a 5 anos de idade). Além do Brasil, os únicos países representados foram o Chile e o Equador. A AF e o CS foram medidos por acelerômetros em sete estudos, porém houve alta variabilidade nos instrumentos e pontos de corte usados. Embora as crianças tenham sido consideradas fisicamente ativas em 12 estudos, seis estudos mostraram que elas despendiam muito tempo em CS. Os domínios de influência mais avaliados foram o individual (14 estudos) e o interpessoal (11 estudos), seguidos pelo ambiental (oito estudos) e o político (um estudo). As intervenções no contexto escolar (quatro estudos) aumentaram os níveis de AF e diminuíram o tempo em CS. Entretanto, as evidências dos estudos transversais e de intervenção apresentaram alto risco de viés.
Conclusão.
Diante das lacunas identificadas, recomendam-se estudos com delineamentos robustos que incluam mais países sul-americanos, com foco em bebês e crianças com menos de 3 anos de idade e que investiguem correlatos dos domínios ambiental e político.
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Affiliation(s)
| | - Daniel da Rocha Queiroz
- Universidade Federal de Pernambuco (UFPE), Departamento de Educação Física, Recife (PE), Brasil
| | | | - Clarice Lucena Martins
- Universidade Federal da Paraíba (UFPB), Departamento de Educação Física, João Pessoa (PB), Brasil
| | - Carla Menêses Hardman
- Universidade Federal de Pernambuco (UFPE), Departamento de Educação Física, Recife (PE), Brasil
| | - Daniel Umpierre
- Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Saúde Coletiva, Porto Alegre (RS), Brasil
| | - Larissa Rosa da Silva
- Universidade Estadual do Oeste do Paraná (Unioeste), Departamento de Educação Física, Marechal Candido Rondon (PR), Brasil
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Weekday and Weekend Physical Activity of Preschool Children in Relation to Selected Socioeconomic Indicators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094999. [PMID: 35564395 PMCID: PMC9099735 DOI: 10.3390/ijerph19094999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 04/16/2022] [Accepted: 04/18/2022] [Indexed: 11/17/2022]
Abstract
Physical activity (PA) is as vital for improving the health of young children as it is positively associated with a broad range of psychological, cognitive, and cardio-metabolic outcomes. The aims of this study were to: (1) to assess the level of PA and meeting the WHO recommendations: moderate-to-vigorous physical activity (MVPA) and the number of steps in Polish preschool boys and girls on weekdays and on weekends; (2) to investigate the relationship between selected socioeconomic indicators (self-reported by parents) and PA, including meeting the WHO recommendation for daily MVPA and the number of steps on weekdays and on weekends among Polish preschoolers. Data were collected in the 2017/2018 school year. The study included a total of 522 boys and girls both aged between 5 and 6 years. The ActiGraph GT3X-BT tri-axial accelerometer was used to measure PA. Selected socioeconomic indicators as well as parental body weight and body height were self-reported by parents/caregivers using a questionnaire. In most of the PA indicators analyzed for girls (moderate, vigorous, total MVPA, and steps/day), the averages were higher during the week than during the weekend. Moreover, significantly more boys met the criteria of MVPA, both on weekdays and over the weekend (32.3% boys and 19.2% girls on weekdays and 31.1% boys and 18.1% girls on weekends). Additionally, more boys met the step recommendations, but only on weekends (15.5% boys and 6.6% girls). It was found that if there were two people in a household, there was an almost a three-fold greater chance (adj. OR = 2.94, p = 0.032) of meeting the MVPA criterion with an even stronger association (over fivefold greater chance) in meeting the step recommendation (adj. OR = 5.56, p = 0.033). The differences in the day schedule may potentially contribute with the level of PA in girls. Among the analyzed selected socioeconomic indicators, only the number of people in a household had a significant association on PA.
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Creaser AV, Hall J, Costa S, Bingham DD, Clemes SA. Exploring Families' Acceptance of Wearable Activity Trackers: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063472. [PMID: 35329166 PMCID: PMC8950917 DOI: 10.3390/ijerph19063472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/02/2022] [Accepted: 03/12/2022] [Indexed: 12/30/2022]
Abstract
Background: The family environment plays a crucial role in child physical activity (PA). Wearable activity trackers (wearables) show potential for increasing children’s PA; however, few studies have explored families’ acceptance of wearables. This study investigated the acceptability of using wearables in a family setting, aligning experiences with components of the Technology Acceptance Model and Theoretical Domains Framework. Methods: Twenty-four families, with children aged 5–9 years, took part in a 5-week study, where all members were provided with a Fitbit Alta HR for 4 weeks. Acceptability was measured using weekly surveys and pre-post-questionnaires. Nineteen families participated in a focus group. Quantitative and qualitative data were integrated using the Pillar Integration Process technique. Results: Pillars reflected (1) external variables impacting wearable use and PA and (2) wearable use, (3) ease of use, (4) usefulness for increasing PA and other health outcomes, (5) attitudes, and (6) intention to use a wearable, including future intervention suggestions. Conclusions: Families found the Fitbit easy to use and acceptable, but use varied, and perceived impact on PA were mixed, with external variables contributing towards this. This study provides insights into how wearables may be integrated into family-based PA interventions and highlights barriers and facilitators of family wearable use.
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Affiliation(s)
- Amy V. Creaser
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (A.V.C.); (S.C.)
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (D.D.B.)
| | - Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (D.D.B.)
| | - Silvia Costa
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (A.V.C.); (S.C.)
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (D.D.B.)
| | - Stacy A. Clemes
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (A.V.C.); (S.C.)
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, University of Leicester, Leicester LE5 4PW, UK
- Correspondence:
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Quaidoo E, Ohemeng A, Kushitor MK, Antwi J. Nutrition education incorporation into mainstream primary school curriculum in Ghana: Stakeholders' sources of nutrition information and perceived barriers. PLoS One 2022; 17:e0262359. [PMID: 34990476 PMCID: PMC8735612 DOI: 10.1371/journal.pone.0262359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/21/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Nutrition literacy has been cited as a crucial life skill. Nutrition education as a primary school subject has been treated inconsequentially when compared to other subjects. We investigated an aspect of the current state of nutrition education in Ghana by engaging stakeholders about their sources of nutrition information and the perceived barriers in implementing nutrition education in mainstream primary schools. Methods Three hundred and fifty one (351) primary school children, 121 homebased caregivers, six schoolteachers, two headteachers, two Ghana Education Service (GES) officials, and six school cooks were involved in the study. Surveys were used to collect data on nutrition information acquisition behaviors and to record perceived barriers. Key Informant Interviews were conducted among GES officials, headteachers, schoolteachers and school cooks, while Focus Group Discussions were used among homebased caregivers and children to gather qualitative information. Results Only 36.3% of the primary school children had heard about nutrition, and 71% of those got nutrition information from their family members. About 70% of homebased caregivers had heard or seen nutrition messages, and their source of nutrition information was predominantly traditional media. Schoolteachers mostly received their nutrition information from non-governmental organizations and the Internet, while most of the school cooks stated their main source of nutrition information was hospital visits. Perceived barriers included schoolteachers’ knowledge insufficiency, and lack of resources to adequately deliver nutrition education. Lack of a clear policy appeared to be an additional barrier. Conclusion The barriers to the implementation of nutrition education in the mainstream curriculum at the primary school level that were identified in this study can be resolved by: providing schoolteachers with learning opportunities and adequate nutrition education resources for practical delivery, having specific national policy framework, and including family members and school cooks in the nutrition education knowledge and information dissemination process.
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Affiliation(s)
- Esi Quaidoo
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, United States of America
| | - Agartha Ohemeng
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | - Mawuli K. Kushitor
- Department of Health Policy Planning and Management, School of Public Health, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Janet Antwi
- Department of Agriculture, Nutrition and Human Ecology, Prairie View A&M University, Prairie View, Texas, United States of America
- * E-mail:
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Herke M, Moor I, Winter K, Hack M, Hoffmann S, Spallek J, Hilger-Kolb J, Herr R, Pischke C, Dragano N, Novelli A, Richter M. Role of contextual and compositional characteristics of schools for health inequalities in childhood and adolescence: a scoping review. BMJ Open 2022; 12:e052925. [PMID: 35105578 PMCID: PMC8808395 DOI: 10.1136/bmjopen-2021-052925] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To synthesise the evidence on the role of compositional or contextual characteristics of schools in the association between students' socioeconomic position and their health in primary and secondary education in developed economies. DESIGN Scoping review. We included studies examining the role of at least one school or class characteristic on students' health inequalities and was published since 1 January 2000, in English or German. We searched PubMed/Medline, Web of Science and Education Resources Information Center. We provided a narrative synthesis and an overview of findings. School characteristics were grouped into five broad categories: school composition, school climate, school policies and organisation, food environment and facilities. RESULTS Of 8520 records identified, 26 studies were included. Twelve studies found a moderating and 3 a mediating effect. The strongest evidence came from studies examining the moderating effect of school composition, that is, the negative impact of a low individual socioeconomic position on mental health and well-being was aggravated by a low average socioeconomic position of schools. Evidence concerning the role of school climate, school stratification (eg, performance base tracking) and sponsorship, food environment and sport facilities and equipment was generally weak or very weak and mostly based on singular findings. Overall, favourable meso-level characteristics mitigated the negative impact of low individual socioeconomic position on health outcomes. CONCLUSIONS School characteristics affect health inequalities in children and adolescents to some degree, but future research is necessary to strengthen the existing evidence and address under-represented aspects in school characteristics and health outcomes.
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Affiliation(s)
- Max Herke
- Institute of Medical Sociology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Irene Moor
- Institute of Medical Sociology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Kristina Winter
- Institute of Medical Sociology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Miriam Hack
- Institute of Medical Sociology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Stephanie Hoffmann
- Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany
| | - Jennifer Hilger-Kolb
- Mannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany
| | - Raphael Herr
- Mannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany
| | - Claudia Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Anna Novelli
- Chair of Health Economics, Technical University of Munich, München, Germany
| | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
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Meshkovska B, Scheller DA, Wendt J, Jilani H, Scheidmeir M, Stratil JM, Lien N. Barriers and facilitators to implementation of direct fruit and vegetables provision interventions in kindergartens and schools: a qualitative systematic review applying the consolidated framework for implementation research (CFIR). Int J Behav Nutr Phys Act 2022; 19:11. [PMID: 35101084 PMCID: PMC8805256 DOI: 10.1186/s12966-022-01246-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 01/10/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Although children's intake of fruit and vegetables has seen a recent rise, almost half of adolescents do not eat even one piece of fruit or vegetables per day. One way to address this problem is through interventions that provide fruit and vegetables directly to children in kindergartens and schools. For such interventions to meet their intended goals, what is important to consider in addition to impact is implementation. Our objective is to systematically review qualitative results reporting on the determinants (barriers and facilitators) to implementation of interventions that entail direct provision of fruit and vegetables in kindergarten and school settings and conduct a framework analysis of those results using the Consolidated Framework for Implementation Research (CFIR). METHODS A systematic search was designed and run in November 2019 for: MEDLINE (Ovid), Embase (Ovid), PsychINFO (Ovid), ERIC (Ovid), Cochrane Library Reviews and Cochrane Library Trials. A keyword search of the journal Implementation Science was completed. Screening of titles and abstracts (n = 5427) and full texts (n = 227), led to 14 included articles. Coding and analysis were done using the framework method and CFIR. RESULTS The following CFIR constructs were found relevant: 1) intervention characteristics domain: 'design quality and packaging', 'adaptability' 'cost'; 2) outer setting: 'cosmopolitanism', 'external policy and incentives' 'patients' needs and resources'; 3) inner setting: 'implementation climate', 'readiness for implementation' and 'structural characteristics'; 4) characteristics of individuals: 'individual stage of change', 'knowledge and beliefs about the intervention' 5) process: 'engaging', 'executing' and 'reflecting and evaluating'. The review stresses the dual role of parents as both supporting the implementation and targets of the intervention, which could have implications for the design and implementation of future fruit and vegetables interventions. Positive child perceptions of the value of the intervention and perceived behavior change due to the intervention were reported as relevant facilitators to implementation across several studies, and should be taken into consideration in future design efforts. CONCLUSIONS CFIR offers a systematic way to identify and organize barriers and facilitators to implementation of interventions in the kindergarten and school setting. Revisions are encouraged to allow adequate space for perceptions of various implementation actors and the target group. PROSPERO REGISTRATION CRD42020167697.
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Affiliation(s)
| | - Daniel A. Scheller
- Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Ulm, Germany
| | - Janine Wendt
- Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Ulm, Germany
| | - Hannah Jilani
- Institute of Public Health and Nursing Research - IPP, University of Bremen and Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Marie Scheidmeir
- Department of Psychology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jan M. Stratil
- Institute for Medical Information Processing, Biometry, and Epidemiology – IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
| | - Nanna Lien
- Department of Nutrition, University of Oslo, Oslo, Norway
| | - on behalf of the PEN Consortium
- Department of Nutrition, University of Oslo, Oslo, Norway
- Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Ulm, Germany
- Institute of Public Health and Nursing Research - IPP, University of Bremen and Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Department of Psychology, Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology – IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
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Cesa CC, Molino GOG, Lima J, Pereira RB, Eibel B, Barbiero SM, Schaan BD, Pellanda LC. Physical Activity and Cardiovascular Risk Factors in Children: a Meta-Analysis Update. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20210137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Barnes C, Hall A, Nathan N, Sutherland R, McCarthy N, Pettet M, Brown A, Wolfenden L. Efficacy of a school-based physical activity and nutrition intervention on child weight status: Findings from a cluster randomized controlled trial. Prev Med 2021; 153:106822. [PMID: 34599925 DOI: 10.1016/j.ypmed.2021.106822] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 09/09/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022]
Abstract
Despite the benefits of factorial designs in quantifying the relative benefits of different school-based approaches to prevent unhealthy weight gain among students, few have been undertaken. The aims of this 2 × 2 cluster randomized factorial trial was to evaluate the impact of a physical activity and nutrition intervention on child weight status and quality of life. Twelve primary schools in New South Wales, Australia randomly allocated to one of four groups: (i.) physical activity (150 min of planned in-school physical activity); (ii.) nutrition (a healthy school lunch-box); (iii.) combined physical activity and nutrition; or (iv.) control. Outcome data assessing child weight and quality of life were collected at baseline and 9-months post-baseline. Within Grades 4-6 in participating schools, 742 students participated in anthropometric measurements, including child body mass index (BMI) and waist circumference, at baseline and follow-up. Findings indicated that students that received the nutrition intervention had higher odds of being classified in the BMI category of underweight/healthy weight (OR 1.64 95%CI 1.07, 2.50; p = 0.0220), while those who received the physical activity intervention reported a lower waist circumference (mean difference - 1.86 95%CI -3.55, -0.18; p = 0.030). There were no significant effects of the nutrition or physical activity intervention on child BMI scores or child quality of life, and no significant synergistic effects of the two interventions combined. Future research assessing the longer-term impact of both intervention strategies, alone and combined, is warranted to better understand their potential impact on child health. TRIAL REGISTRATION: Australian Clinical Trials Registry ACTRN: ACTRN12616001228471.
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Affiliation(s)
- Courtney Barnes
- Hunter New England Population Health, Wallsend 2287, New South Wales, Australia; School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, New South Wales, Australia; Hunter Medical Research Institute, New Lambton 2305, New South Wales, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan 2308, New South Wales, Australia.
| | - Alix Hall
- Hunter New England Population Health, Wallsend 2287, New South Wales, Australia; School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, New South Wales, Australia; Hunter Medical Research Institute, New Lambton 2305, New South Wales, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan 2308, New South Wales, Australia
| | - Nicole Nathan
- Hunter New England Population Health, Wallsend 2287, New South Wales, Australia; School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, New South Wales, Australia; Hunter Medical Research Institute, New Lambton 2305, New South Wales, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan 2308, New South Wales, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Wallsend 2287, New South Wales, Australia; School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, New South Wales, Australia; Hunter Medical Research Institute, New Lambton 2305, New South Wales, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan 2308, New South Wales, Australia
| | - Nicole McCarthy
- Hunter New England Population Health, Wallsend 2287, New South Wales, Australia; School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, New South Wales, Australia; Hunter Medical Research Institute, New Lambton 2305, New South Wales, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan 2308, New South Wales, Australia
| | - Matthew Pettet
- Hunter New England Population Health, Wallsend 2287, New South Wales, Australia; Hunter Medical Research Institute, New Lambton 2305, New South Wales, Australia
| | - Alison Brown
- Hunter New England Population Health, Wallsend 2287, New South Wales, Australia; School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, New South Wales, Australia; Hunter Medical Research Institute, New Lambton 2305, New South Wales, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan 2308, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Wallsend 2287, New South Wales, Australia; School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, New South Wales, Australia; Hunter Medical Research Institute, New Lambton 2305, New South Wales, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan 2308, New South Wales, Australia
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Willems R, Tsoutsoulopoulou K, Brondeel R, Cardon G, Makrilakis K, Liatis S, Lindström J, Kivelä J, González-Gil EM, Giménez-Legarre N, Usheva N, Iotova V, Tankova T, Antal E, Rurik I, Timpel P, Schwarz PEH, Manios Y, Annemans L. Cost-effectiveness analysis of a school- and community-based intervention to promote a healthy lifestyle and prevent type 2 diabetes in vulnerable families across Europe: the Feel4Diabetes-study. Prev Med 2021; 153:106722. [PMID: 34271077 DOI: 10.1016/j.ypmed.2021.106722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 06/22/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
The Feel4Diabetes-study implemented a school- and community-based intervention to promote healthy lifestyle and prevent type 2 diabetes mellitus (T2DM) in six European countries. The intervention included a special focus on families at increased T2DM risk. The current study evaluates the intervention's cost-effectiveness. A Markov-type health economic model was developed to predict the incidence of T2DM and its complications. Incremental cost-effectiveness ratios (lifetime horizon, societal perspective) were calculated based on the overall intervention effect on health behaviour, and stratified for low- and high-risk families. Sensitivity analyses captured input parameters uncertainty. A budget impact analysis was performed. The increase in children's water consumption and physical activity led to a modest gain in quality adjusted life years (QALYs) at a low intervention cost and budget impact. Medical cost savings due to avoided illness could only be achieved on the very long-term (>30 years). The intervention in its entirety was cost-effective (more QALYs at a reasonable investment) in Belgium, Finland, Bulgaria, and Hungary, while being dominant (net savings and more QALYs) in Greece and Spain. Results were cost-effective for the low-risk families, who only received the school- and community-based intervention component. Results for the high-risk families were only cost-effective (with considerable uncertainty) in Greece and Spain, but not when the intervention would need to be repeated. The Feel4Diabetes-intervention is potentially cost-effective, especially in countries with a high overweight and obesity prevalence, at a limited budget impact. The incremental financial investments to reach and support high-risk families did not result in the hoped-for health benefits.
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Affiliation(s)
- Ruben Willems
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Konstantina Tsoutsoulopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Ruben Brondeel
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | - Stavros Liatis
- Athens Medical School, National and Kapodistrian University, Athens, Greece
| | - Jaana Lindström
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jemina Kivelä
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Esther M González-Gil
- Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research (CIBM), Universidad de Granada, Granada, Spain; Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Natalia Giménez-Legarre
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón, Aragón, Spain
| | - Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, Varna, Bulgaria
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Tsvetalina Tankova
- Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Patrick Timpel
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Peter E H Schwarz
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Paul Langerhans Institute Dresden, Helmholtz Center Munich, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; German Center for Diabetes Research (DZD e V), Neuherberg, Germany
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Lieven Annemans
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Public Health Sciences, Free University of Brussels, Brussels, Belgium
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A school-based nutrition education program involving children and their guardians in Japan: facilitation of guardian-child communication and reduction of nutrition knowledge disparity. Nutr J 2021; 20:92. [PMID: 34794453 PMCID: PMC8600693 DOI: 10.1186/s12937-021-00751-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 11/09/2021] [Indexed: 11/21/2022] Open
Abstract
Background Since the risk of noncommunicable diseases is closely associated with dietary intake, it is important to establish healthy dietary habits in childhood. Although several dietary education programs for children have been attempted, their implementation at school was often difficult due to overcrowded study curricula. We developed a new program which included homework for children and guardians, and evaluated its effect. Determinants of the effect were also investigated. Methods The school-based nutrition education program including a 45-min lecture, a series of homework assignments involving children and guardians, and two handouts was implemented in 14 public primary schools in Japan. Seven schools each underwent the intervention in an alternating manner. Nutrition knowledge (percentage (%) of correct answers in the nutrition knowledge questionnaire) and attitude/behavior toward diet was evaluated three times (May (baseline), October, February) as outcomes. These factors and their changes following the intervention were assessed by linear mixed models to adjust for individual factors, with consideration to clustering of the participants and repeated measurements. Results In total, 2227 children aged 10–12 years and their guardians participated. All schools completed the program. Children’s nutrition knowledge level was significantly increased (8.7%, 95% confidence interval [7.7–9.7]) following the intervention. Communication between children and their guardians, which was positively related with nutrition knowledge, was facilitated by the intervention. The increase in nutrition knowledge was greater among children with a lower knowledge level at baseline. Conclusions This school-based nutrition education program was effective and feasible. Appropriate teaching materials for homework can reduce the burden on schools and facilitate communication between children and guardians. Public schools can be crucial venues for decreasing disparities in nutrition knowledge. Trial registration This study was registered as an intervention study in the UMIN Clinical Trials Registry (trial ID: UMIN000029252) on Sep 22, 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00751-z.
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A Natural Experiment Comparing the Effectiveness of the "Healthy Eagles" Child Weight Management Intervention in School Versus Community Settings. Nutrients 2021; 13:nu13113912. [PMID: 34836167 PMCID: PMC8623922 DOI: 10.3390/nu13113912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/25/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Abstract
Behavioural weight management interventions are recommended for the treatment of obesity in children. However, the evidence for these is limited and often generated under trial conditions with White, middle-class populations. Healthy Eagles is a behavioural weight management intervention designed to treat excess weight in children. It ran in the London Borough of Croydon from 2017 to 2020 and was delivered in both school and community settings, providing a natural experiment to compare outcomes. A total of 1560 participants started the Healthy Eagles programme; 347 were in the community setting and 703 in the school setting. Data were analysed for those who completed 70% of the programme. In the school setting, there was a small but significant reduction in BMI z-score (M = −0.04, 95% CI = −0.08, −0.01) for participants above a healthy weight, especially in those with severe obesity (M = −0.09, 95% CI = −0.15, −0.03); there was no significant change in any subgroup in the community setting. Linear regression analysis showed the school setting was associated with a 0.26 (95% CI = 0.13, 0.49) greater reduction in BMI z-score than the community setting after adjusting for ethnicity, deprivation, age and gender. Across both programmes, the effect was somewhat greater in participants from a Black (African/Caribbean/Other) ethnic background (M = −0.06, 95% CI = −0.09, −0.02) and from the two most deprived quintiles (M = −0.06, 95% CI = −0.11, −0.01). Data were limited, but minimal changes were measured in nutrition and physical activity behaviours regardless of setting. This evaluation provides indirect evidence of a small but significant benefit to running weight management interventions in a school versus community setting.
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Parent Involvement in Diet or Physical Activity Interventions to Treat or Prevent Childhood Obesity: An Umbrella Review. Nutrients 2021; 13:nu13093227. [PMID: 34579099 PMCID: PMC8464903 DOI: 10.3390/nu13093227] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 12/17/2022] Open
Abstract
Parents substantially influence children’s diet and physical activity behaviors, which consequently impact childhood obesity risk. Given this influence of parents, the objective of this umbrella review was to synthesize evidence on effects of parent involvement in diet and physical activity treatment and prevention interventions on obesity risk among children aged 3–12 years old. Ovid/MEDLINE, Elsevier/Embase, Wiley/Cochrane Library, Clarivate/Web of Science, EBSCO/CINAHL, EBSCO/PsycInfo, and Epistemonikos.org were searched from their inception through January 2020. Abstract screening, full-text review, quality assessment, and data extraction were conducted independently by at least two authors. Systematic reviews and meta-analyses of diet and physical activity interventions that described parent involvement, included a comparator/control, and measured child weight/weight status as a primary outcome among children aged 3–12 years old were included. Data were extracted at the level of the systematic review/meta-analysis, and findings were narratively synthesized. Of 4158 references identified, 14 systematic reviews and/or meta-analyses (eight treatment focused and six prevention focused) were included and ranged in quality from very low to very high. Our findings support the inclusion of a parent component in both treatment and prevention interventions to improve child weight/weight status outcomes. Of note, all prevention-focused reviews included a school-based component. Evidence to define optimal parent involvement type and duration and to define the best methods of involving parents across multiple environments (e.g., home, preschool, school) was inadequate and warrants further research. PROSPERO registration: CRD42018095360.
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Topham GL, Washburn IJ, Hubbs-Tait L, Kennedy TS, Rutledge JM, Page MC, Swindle T, Shriver LH, Harrist AW. The Families and Schools for Health Project: A Longitudinal Cluster Randomized Controlled Trial Targeting Children with Overweight and Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8744. [PMID: 34444492 PMCID: PMC8393339 DOI: 10.3390/ijerph18168744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 02/07/2023]
Abstract
This cluster randomized controlled trial aimed at overweight and obese children compared three treatments. Two psychoeducation interventions for parents and children were conducted: Family Lifestyle (FL) focused on food and physical activity; Family Dynamics (FD) added parenting and healthy emotion management. A third Peer Group (PG) intervention taught social acceptance to children. Crossing interventions yielded four conditions: FL, FL + PG, FL + FD, and FL + FD + PG-compared with the control. Longitudinal BMI data were collected to determine if family- and peer-based psychosocial components enhanced the Family Lifestyle approach. Participants were 1st graders with BMI%ile >75 (n = 538: 278 boys, 260 girls). Schools were randomly assigned to condition after stratifying for community size and percent American Indian. Anthropometric data were collected pre- and post-intervention in 1st grade and annually through 4th grade. Using a two-level random intercept growth model, intervention status predicted differences in growth in BMI or BMI-M% over three years. Children with obesity who received the FL + FD + PG intervention had lower BMI gains compared to controls for both raw BMI (B = -0.05) and BMI-M% (B = -2.36). Interventions to simultaneously improve parent, child, and peer-group behaviors related to physical and socioemotional health offer promise for long-term positive impact on child obesity.
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Affiliation(s)
- Glade L. Topham
- Department of Applied Human Sciences, Kansas State University, Manhattan, KS 66506, USA
| | - Isaac J. Washburn
- Department of Human Development & Family Science, Oklahoma State University, Stillwater, OK 74078, USA; (I.J.W.); (L.H.-T.); (A.W.H.)
| | - Laura Hubbs-Tait
- Department of Human Development & Family Science, Oklahoma State University, Stillwater, OK 74078, USA; (I.J.W.); (L.H.-T.); (A.W.H.)
| | - Tay S. Kennedy
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Julie M. Rutledge
- School of Human Ecology, Louisiana Tech University, Ruston, LA 71272, USA;
| | - Melanie C. Page
- Department of Psychology, West Virginia University, Morgantown, WV 26506, USA;
| | - Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Lenka H. Shriver
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC 27412, USA;
| | - Amanda W. Harrist
- Department of Human Development & Family Science, Oklahoma State University, Stillwater, OK 74078, USA; (I.J.W.); (L.H.-T.); (A.W.H.)
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da Silva Bandeira A, Pizani J, de Sousa ACFC, da Silva JA, Minatto G, Barbosa Filho VC, Silva KS. Implementation of a school-based physical activity intervention for Brazilian adolescents: a mixed-methods evaluation. Health Promot Int 2021; 37:6327059. [PMID: 34297827 DOI: 10.1093/heapro/daab091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The effectiveness of physical activity interventions can be improved through examining the aspects related to their implementation. However, little such evidence has been collected, particularly in low- and middle-income countries. This study aimed to evaluate the implementation of a school-based physical activity intervention with qualitative and quantitative data from different actors (students, teachers and parents) involved in developing the program. The program was conducted in 2017 with three main components: (i) teacher training, (ii) environmental changes and (iii) educational actions. Mixed-method evaluation was performed by an independent evaluation team using a validated indicator matrix for the implementation process, including the self-reported information of students, teachers and parents, as well as interviews with teachers. In the 3 eligible schools, 350 adolescents (51% girls) answered the implementation questionnaire, as did 45 parents (84% mothers), and 47 teachers (70% female). In the qualitative analysis, 18 teachers participated. Categorical analysis found that the intervention was considered feasible by teachers. In general, teachers had a more positive perception of the implementation than did students. The lack of engagement from the school community and parents and the busy schedule of teachers were indicated to be the main difficulties. In conclusion, despite the teachers' motivation, some barriers prevented the successful implementation of the program.
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Affiliation(s)
- Alexsandra da Silva Bandeira
- Research Group in Physical Activity and Health, Department of Physical Education, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina 88040-900, Brazil
| | - Juliana Pizani
- Research Group in Physical Activity and Health, Department of Physical Education, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina 88040-900, Brazil
| | - Ana Caroline Ferreira Campos de Sousa
- Research Group in Physical Activity and Health, Department of Physical Education, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina 88040-900, Brazil
| | - Jaqueline Aragoni da Silva
- Research Group in Physical Activity and Health, Department of Physical Education, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina 88040-900, Brazil
| | - Giseli Minatto
- Research Group in Physical Activity and Health, Department of Physical Education, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina 88040-900, Brazil
| | - Valter Cordeiro Barbosa Filho
- Federal Institute of Education, Science and Technology of Ceara, Aracati Campus, Rodovia CE-040, Km 137,1, s/n-Aeroporto, Aracati-CE, Ceará 62800-000, Brazil
| | - Kelly Samara Silva
- Research Group in Physical Activity and Health, Department of Physical Education, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina 88040-900, Brazil
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Cvetković B, Cvetković M, Petrušič T, Đorđić V, Bubanj S, Popović B, Andrašić S, Buišić S, Bogataj Š. Nutrition and Physical Activity Behavior in 11-14-Year-Old Schoolchildren in Serbia. CHILDREN-BASEL 2021; 8:children8080625. [PMID: 34438516 PMCID: PMC8394318 DOI: 10.3390/children8080625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022]
Abstract
Regular physical activity and healthy diet have a significant positive impact on children’s health. Lack of physical activity increases the risk of various diseases, while obesity has become an alarming health problem worldwide. The aim of this study is to investigate the patterns of physical activity and diet among 11–14-year-old school children in Serbia. The sample included 623 primary school children, of whom 333 were boys (53.45%) and 290 were girls (46.55%). The children were also divided according to their age/grade: fifth grade/11 years (24.40% (n = 152; M = 84, F = 68)), sixth grade/12 years (25.68% (n = 160; M = 91, F = 69)), seventh grade/13 years (26.81% (n = 167; M = 83, F = 84)) and eighth grade/14 years (23.11% (n = 144; M = 75, F = 69)). Children’s lifestyle was assessed using two subscales of questionnaires based on the Health-Promoting Lifestyle Profile model II. The Mann–Whitney U test showed no statistically significant difference between boys and girls in the variables Nutrition (p = 0.81) and Physical Activity (p = 0.91). The Kruskal–Wallis test was applied and showed no statistically significant differences between children of different ages, regardless of gender, in the variable Nutrition (p = 0.63). However, differences were evident in the variable Physical Activity (p < 0.001), with the highest mean scores recorded in 12- and 13-year-old children and the lowest in 14-year-old children. Additionally, no statistically significant differences were found among boys as a function of age in the variables Nutrition (p = 0.55) and Physical Activity (p = 0.15), nor among girls in the variable Nutrition (p = 0.43), but in the variable Physical Activity (p = 0.01). In general, it can be concluded that the older primary school children have relatively satisfactory dietary and physical activity habits, but that these behaviors decrease with age, especially the level of physical activity. There is a need for better and more effective education of children about the benefits and importance of proper nutrition and regular physical activity.
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Affiliation(s)
- Biljana Cvetković
- Institute of Food Technology in Novi Sad, University of Novi Sad, Bulevar Cara Lazara 1, 21101 Novi Sad, Serbia;
| | - Milan Cvetković
- Faculty of Sport and Physical Education, University of Novi Sad, 21101 Novi Sad, Serbia; (M.C.); (V.Đ.); (B.P.)
| | - Tanja Petrušič
- Faculty of Education, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Višnja Đorđić
- Faculty of Sport and Physical Education, University of Novi Sad, 21101 Novi Sad, Serbia; (M.C.); (V.Đ.); (B.P.)
| | - Saša Bubanj
- Faculty of Sport and Physical Education, University of Niš, 18000 Niš, Serbia;
| | - Boris Popović
- Faculty of Sport and Physical Education, University of Novi Sad, 21101 Novi Sad, Serbia; (M.C.); (V.Đ.); (B.P.)
| | - Slobodan Andrašić
- Faculty of Economics, University of Novi Sad, 24000 Subotica, Serbia;
| | - Svetlana Buišić
- Faculty of Education in Sombor, University of Novi Sad, 21101 Novi Sad, Serbia;
| | - Špela Bogataj
- Department of Nephrology, University Medical Centre, 1000 Ljubljana, Slovenia
- Faculty of Sport, University of Ljubljana, 1000 Ljubljana, Slovenia
- Correspondence:
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Sprow K, Perna FM, Leider J, Turner L, Piekarz-Porter EM, Michael SL, Brener N, Chriqui JF. Standards-based physical education in schools: The role of state laws. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2021; 6:e000166. [PMID: 38124718 PMCID: PMC10732540 DOI: 10.1249/tjx.0000000000000166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Purpose Examine the association of state physical education (PE) laws (https://class.cancer.gov) with school policies addressing motor skill development, physical activity (PA) participation, and health-enhancing physical fitness (https://www.cdc.gov/healthyyouth/data/shpps/data.htm). Methods National school-level data on PE standards were obtained from the 2014 School Health Policies and Practices Study (SHPPS) of US schools for analytical samples of 408-410 schools in 43 states. These data were linked to Classification of Laws Associated with School Students (CLASS) data, which reflect the strength of state-PE curriculum laws and the associated state PE curriculum standards. Logistic regressions and generalized linear models with a complementary log-log link examined associations between state law and school-level standards. Results Compared to having no state law, weak law (OR: 5.07, 95% CI: 1.02-25.27) or strong law (OR: 2.96, 95% CI: 1.04-8.37) was associated with higher odds of school PE standards addressing motor skill development, while only strong state law was associated with higher prevalence of addressing achievement and maintenance of physical fitness (coefficient: 0.63, 95% CI: 0.12, 1.14). State laws were not associated with addressing PA participation. Conclusions Schools were more likely to address motor skills and physical fitness development when states had strong PE laws.
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Affiliation(s)
- Kyle Sprow
- Division of Cancer Control and Populations Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Frank M. Perna
- Division of Cancer Control and Populations Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Julien Leider
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Lindsey Turner
- College of Education, Boise State University, Boise, Idaho
| | - Elizabeth M. Piekarz-Porter
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Shannon L. Michael
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta GA
| | - Nancy Brener
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jamie F. Chriqui
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, Illinois
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Ramdzan SN, Suhaimi J, Harris KM, Khoo EM, Liew SM, Cunningham S, Pinnock H. School-based self-management interventions for asthma among primary school children: a systematic review. NPJ Prim Care Respir Med 2021; 31:18. [PMID: 33795691 PMCID: PMC8016947 DOI: 10.1038/s41533-021-00230-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/26/2021] [Indexed: 11/09/2022] Open
Abstract
A Cochrane review of school-based asthma interventions (combining all ages) found improved health outcomes. Self-management skills, however, vary according to age. We assessed effectiveness of primary school-based self-management interventions and identified components associated with successful programmes in children aged 6-12 years. We updated the Cochrane search (March 2020) and included the Global Health database. Two reviewers screened, assessed risk-of-bias and extracted data. We included 23 studies (10,682 participants); four at low risk-of-bias. Twelve studies reported at least one positive result for an outcome of interest. All 12 positive studies reported parental involvement in the intervention, compared to two-thirds of ineffective studies. In 10 of the 12 positive studies, parental involvement was substantial (e.g. attending sessions; phone/video communication) rather than being provided with written information. School-based self-management intervention can improve health outcomes and substantial parental involvement in school-based programmes seemed important for positive outcomes among primary school children.
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Affiliation(s)
- Siti Nurkamilla Ramdzan
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Julia Suhaimi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Katherine M Harris
- Centre for Child Health, Blizard Institute, Queen Mary University of London, London, UK
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Su May Liew
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Steve Cunningham
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, Edinburgh, UK.
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Srivastav P, K V, Bhat VH, Broadbent S. Structured, multifactorial randomised controlled intervention to investigate physical activity levels, body composition and diet in obese and overweight adolescents. BMJ Open 2021; 11:e044895. [PMID: 33753442 PMCID: PMC7986955 DOI: 10.1136/bmjopen-2020-044895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/09/2021] [Accepted: 03/09/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION There has been a steep increase in the prevalence of adolescent overweight and obesity globally and in India, demonstrating that present prevention strategies are insufficient. Available evidence suggests that multifactorial interventions may improve short-term physical activity (PA), nutrition and psychological behaviour of overweight and obese adolescents but long-term follow-ups and strategies are needed. This study will investigate the effects of a structured multifactorial (school-based and family-based) intervention on adolescent obesity, compared with a single or no intervention. METHODS AND ANALYSIS A pragmatic, clustered randomised controlled trial with 12 weeks of interventions and 3-month, 6-month and 12-month follow-ups will be conducted at multiple participating schools in Karnataka, India. The participants will be overweight and obese male and female adolescents aged 11-16 years and will be randomly assigned by school into three groups: group A (multifactorial intervention, exercise and dietary advice); group B (exercise only); and group C (controls, no interventions). Primary outcome measures are the level of PA and body composition. Secondary outcomes are dietary change, behaviour change, food behaviours, cardiovascular and muscular fitness, quality of life, parental behaviours (physical and mental) and family functioning. Positive intervention results may reduce obesity in adolescents and promote a healthier lifestyle for students and families. A larger, culturally diverse population can benefit from a similar methodology. ETHICS AND DISSEMINATION The study has been approved by the Institutional Research and Ethics Committee (IEC 536-2018), Kasturba Hospital, Manipal, Udupi District, Karnataka, India. A written and verbal informed consent (supplemental material) will be provided to the participants prior to participation. On completion of the trial, the results can be communicated to adolescents and their parents on request, and will be published at national and international conferences and in peer-reviewed journals. TRIAL REGISTRATION NUMBER CTRI/2019/04/018834.
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Affiliation(s)
- Prateek Srivastav
- Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Vaishali K
- Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Vinod H Bhat
- Department of Community Medicine, Manipal Academy of Higher Education, Manipal, India
| | - Suzanne Broadbent
- School of Health & Behavioural Sciences, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia
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Røed M, Medin AC, Vik FN, Hillesund ER, Van Lippevelde W, Campbell K, Øverby NC. Effect of a Parent-Focused eHealth Intervention on Children's Fruit, Vegetable, and Discretionary Food Intake (Food4toddlers): Randomized Controlled Trial. J Med Internet Res 2021; 23:e18311. [PMID: 33591279 PMCID: PMC7925157 DOI: 10.2196/18311] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 12/08/2020] [Accepted: 01/17/2021] [Indexed: 01/16/2023] Open
Abstract
Background In Western countries, children’s diets are often low in fruits and vegetables and high in discretionary foods. Diet in early life tends to track through childhood and youth and even into adulthood. Interventions should, therefore, be delivered in periods when habitual traits are established, as in toddlerhood when children adapt to their family’s diet. Objective In this study, we assessed the effect of the Food4toddlers eHealth intervention, which aimed to enhance toddlers’ diets by shaping their food and eating environment. Methods The Food4toddlers randomized controlled trial was conducted in Norway in 2017-2018. Parent-child dyads were recruited through social media. In total, 298 parents completed an online questionnaire at baseline (mean child age 10.9 months, SD 1.2). Postintervention questionnaires were completed immediately after the intervention (ie, follow-up 1; mean child age 17.8 months, SD 1.3) and 6 months after the intervention (ie, follow-up 2; mean child age 24.2 months, SD 1.9). The intervention was guided by social cognitive theory, which targets the linked relationship between the person, the behavior, and the environment. The intervention group (148/298, 49.7%) got access to the Food4toddlers website for 6 months from baseline. The website included information on diet and on how to create a healthy food and eating environment as well as activities, recipes, and collaboration opportunities. To assess intervention effects on child diet from baseline to follow-up 1 and from baseline to follow-up 2, we used generalized estimating equations and a time × group interaction term. Between-group differences in changes over time for frequency and variety of fruits and vegetables and frequency of discretionary foods were assessed. Results At follow-up 1, a significant time × group interaction was observed for the frequency of vegetable intake (P=.02). The difference between groups in the change from baseline to follow-up 1 was 0.46 vegetable items per day (95% CI 0.06-0.86) in favor of the intervention group. No other significant between-group differences in dietary changes from baseline to follow-up 1 or follow-up 2 were observed. However, there is a clear time trend showing that the intake of discretionary foods increases by time from less than 1 item per week at baseline to more than 4 items per week at 2 years of age (P<.001), regardless of group. Conclusions A positive intervention effect was observed for the frequency of vegetable intake at follow-up 1 but not at follow-up 2. No other between-group effects on diet were observed. eHealth interventions of longer duration, including reminders after the main content of the intervention has been delivered, may be needed to obtain long-terms effects, along with tailoring in a digital or a personal form. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN) 92980420; https://doi.org/10.1186/ISRCTN92980420
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Affiliation(s)
- Margrethe Røed
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | - Anine C Medin
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | - Frøydis N Vik
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | - Elisabet R Hillesund
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | - Wendy Van Lippevelde
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway.,Department of Marketing, Innovation and Organisation, Ghent University, Ghent, Belgium
| | - Karen Campbell
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Nina C Øverby
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
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Rozga M, Handu D. Current Systems-Level Evidence on Nutrition Interventions to Prevent and Treat Cardiometabolic Risk in the Pediatric Population: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2021; 121:2501-2523. [PMID: 33495106 DOI: 10.1016/j.jand.2020.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/07/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
Improving and maintaining cardiometabolic health remains a major focus of health efforts for the pediatric population. Recent research contributes understanding of the systems-level nutrition factors influencing cardiometabolic health in pediatric individuals. This scoping review examines current evidence on interventions and exposures influencing pediatric cardiometabolic health to inform registered dietitian nutritionists working at each systems level, ranging from individual counseling to public policy. A literature search of MEDLINE, CINAHL, Cochrane Databases of Systematic Reviews, and other databases was conducted to identify evidence-based practice guidelines, systematic reviews, and position statements published in English from January 2017 until April 2020. Included studies addressed nutrition interventions or longitudinal exposures for participants 2 to 17 years of age who were healthy or had cardiometabolic risk factors. Studies were categorized according level of the social-ecological framework addressed. The databases and hand searches identified 2614 individual articles, and 169 articles were included in this scoping review, including 6 evidence-based practice guidelines, 141 systematic reviews, and 22 organization position statements. The highest density of systematic reviews focused on the effects of dietary intake (n = 58) and interventions with an individual child or family through counseling or education (n = 54). The least frequently examined levels of interventions or exposures were at the policy level (n = 12). Registered dietitian nutritionists can leverage this considerable body of recent systematic reviews to inform a systems-level, collaborative approach to prevention and treatment of pediatric cardiometabolic risk factors.
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Harrington DM, Brady EM, Weihrauch-Bluher S, Edwardson CL, Gray LJ, Hadjiconstantinou M, Jarvis J, Khunti K, Vergara I, Erreguerena I, Ribeiro RT, Troughton J, Vazeou A, Davies MJ. Development of an Interactive Lifestyle Programme for Adolescents at Risk of Developing Type 2 Diabetes: PRE-STARt. CHILDREN-BASEL 2021; 8:children8020069. [PMID: 33494347 PMCID: PMC7912284 DOI: 10.3390/children8020069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 12/26/2022]
Abstract
Background: Type 2 diabetes (T2D) is increasing in young people. Reporting on the processes used when developing prevention interventions is needed. We present the development of a family-based interactive lifestyle intervention for adolescents with risk factors for T2D in the future. Method: A multidisciplinary team in the UK site led the intervention development process with sites in Portugal, Greece, Germany and Spain. Potential programme topics and underpinning theory were gathered from literature and stakeholders. A theoretical framework based on self-efficacy theory and the COM-B (capability, opportunity, motivation, behaviour) model was developed. Sessions and supporting resources were developed and refined via two iterative cycles of session and resource piloting, feedback, reflection and refinement. Decision on delivery and content were made by stakeholders (young people, teachers, parents, paediatricians) and all sites. Materials were translated to local languages. Site-specific adaptations to the language, content and supporting resources were made. Results: The “PRE-STARt” programme is eight 90-min interactive sessions with supporting curriculum and resources. Iterative development work provided valuable feedback on programme content and delivery. Conclusion: Reporting on the intervention development process, which includes stakeholder input, could yield a flexible approach for use in this emerging ‘at risk’ groups and their families.
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Affiliation(s)
- Deirdre M. Harrington
- Diabetes Research Centre, University of Leicester, Leicester LE5 4PW, UK; (C.L.E.); (M.H.); (K.K.)
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow G1 1QE, UK
- Correspondence: ; Tel.: +44-078-4776-5092
| | - Emer M. Brady
- Cardiovascular Sciences, University of Leicester, Leicester LE3 9QP, UK;
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, UK; (J.J.); (J.T.); (M.J.D.)
| | - Susann Weihrauch-Bluher
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, 04103 Leipzig, Germany;
- Department for Operative and Nonoperative Pediatric and Adolescent Medicine, University HospitalHalle (Saale), 06120 Halle (Saale), Germany
| | - Charlotte L. Edwardson
- Diabetes Research Centre, University of Leicester, Leicester LE5 4PW, UK; (C.L.E.); (M.H.); (K.K.)
| | - Laura J. Gray
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK;
| | | | - Janet Jarvis
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, UK; (J.J.); (J.T.); (M.J.D.)
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester LE5 4PW, UK; (C.L.E.); (M.H.); (K.K.)
| | - Itziar Vergara
- Instituto de Investigación en Servicios de Salud Kronikgune, 48902 Barakaldo (Bizkaia), Spain; (I.V.); (I.E.)
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas-REDISSEC, 48902 Barakaldo (Bizkaia), Spain
| | - Irati Erreguerena
- Instituto de Investigación en Servicios de Salud Kronikgune, 48902 Barakaldo (Bizkaia), Spain; (I.V.); (I.E.)
| | - Rogério T. Ribeiro
- Education and Research Department (ERC), APDP-Portuguese Diabetes Association, 1250-189 Lisbon, Portugal;
| | - Jacqui Troughton
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, UK; (J.J.); (J.T.); (M.J.D.)
| | - Andriani Vazeou
- Diabetes Center, Department of Pediatrics, P&A Kyriakou Children’s Hospital, 115 27 Athens, Greece;
| | - Melanie J. Davies
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, UK; (J.J.); (J.T.); (M.J.D.)
- NIHR Leicester Biomedical Research Centre, Leicester LE5 4PW, UK
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Ramírez-Rivera DL, Martínez-Contreras T, Villegas-Valle RC, Henry-Mejia G, Quizán-Plata T, Haby MM, Díaz-Zavala RG. Preliminary Results of the Planet Nutrition Program on Obesity Parameters in Mexican Schoolchildren: Pilot Single-School Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E790. [PMID: 33477722 PMCID: PMC7832271 DOI: 10.3390/ijerph18020790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/08/2021] [Accepted: 01/13/2021] [Indexed: 01/22/2023]
Abstract
School-based obesity prevention programs are key to promoting healthy habits. The aim of this study was to evaluate the effect of the Planet Nutrition program on BMI z-score and other parameters compared to a control group of Mexican schoolchildren after 9 weeks of intervention. The effect of the summer holidays on the BMI z-score was also evaluated at 23 weeks. A pilot randomized controlled trial design was used and 41 schoolchildren were randomized (21 intervention group and 20 control). The program included 18 nutrition education sessions, 20 physical activity classes and six brochures for parents. At 9 weeks, no significant differences were found between the intervention and control groups in the change in BMI z-score (-0.11, 95% CI -0.23, 0.01). Significant differences were observed in some secondary outcomes: body fat percentage (-1.72, 95% CI -3.42, -0.02), waist circumference (-3.45, 95% CI -5.55, -1.36), physical activity (0.44, 95% CI 0.01, 0.88) and nutrition knowledge (1.15, 95% CI 0.27, 2.03). Summer holidays negatively affected the BMI z-score in both groups, reducing the difference observed between groups at 9 weeks (-0.07, 95% CI -0.22, 0.07). The Planet Nutrition program showed favorable effects in some obesity and lifestyle parameters in the short term.
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Affiliation(s)
- Diana L. Ramírez-Rivera
- Centro de Promoción de Salud Nutricional, Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, Sonora 83000, Mexico; (D.L.R.-R.); (T.M.-C.)
| | - Teresita Martínez-Contreras
- Centro de Promoción de Salud Nutricional, Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, Sonora 83000, Mexico; (D.L.R.-R.); (T.M.-C.)
| | - Rosa C. Villegas-Valle
- Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, Sonora 83000, Mexico; (R.C.V.-V.); (T.Q.-P.); (M.M.H.)
| | - Gricelda Henry-Mejia
- Departamento de Ciencias del Deporte y la Actividad Física, Universidad de Sonora, Hermosillo, Sonora 83000, Mexico;
| | - Trinidad Quizán-Plata
- Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, Sonora 83000, Mexico; (R.C.V.-V.); (T.Q.-P.); (M.M.H.)
| | - Michelle M. Haby
- Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, Sonora 83000, Mexico; (R.C.V.-V.); (T.Q.-P.); (M.M.H.)
| | - Rolando G. Díaz-Zavala
- Centro de Promoción de Salud Nutricional, Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, Sonora 83000, Mexico; (D.L.R.-R.); (T.M.-C.)
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