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Shrewsbury VA, Taylor RM, Jakstas T, Verdonschot A, Collins CE. Improving Evidence-Synthesis for School-Based Obesity Prevention Interventions. Comment on Ginell et al. Unreliable Findings Due to Miscalculations and Errors. Comment on "Nally et al. The Effectiveness of School-Based Interventions on Obesity-Related Behaviours in Primary School Children: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Children 2021, 8, 489". CHILDREN (BASEL, SWITZERLAND) 2024; 11:959. [PMID: 39201894 PMCID: PMC11352476 DOI: 10.3390/children11080959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/24/2024] [Accepted: 07/31/2024] [Indexed: 09/03/2024]
Abstract
As researchers with substantial experience in the child obesity field [...].
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Affiliation(s)
- Vanessa A. Shrewsbury
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (R.M.T.); (T.J.); (C.E.C.)
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
| | - Rachael M. Taylor
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (R.M.T.); (T.J.); (C.E.C.)
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
| | - Tammie Jakstas
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (R.M.T.); (T.J.); (C.E.C.)
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
| | - Angeliek Verdonschot
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
- School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, NSW 2308, Australia
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (R.M.T.); (T.J.); (C.E.C.)
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
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Balderas-Arteaga N, Mendez K, Gonzalez-Rocha A, Pacheco-Miranda S, Bonvecchio A, Denova-Gutiérrez E. Healthy lifestyle interventions within the curriculum in school-age children: systematic review and meta-analysis. Health Promot Int 2024; 39:daae020. [PMID: 38470184 DOI: 10.1093/heapro/daae020] [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] [Indexed: 03/13/2024] Open
Abstract
Childhood obesity is a major public health challenge. Previous research has identified the impact of school-based interventions for preventing and treating obesity; we hypothesized that when curricular changes are integrated, results could be exponentiated. This study aimed to systematically review and conduct a meta-analysis of the published literature analyzing information about school-based interventions inserted in the curriculum. The Cochrane Handbook methodology was followed. An electronic search was conducted in five databases, with a specific design strategy per database. Randomized controlled trials or quasi-experimental studies of children with nutrition and physical activity (PA) interventions inserted into the school curricula were included. The risk of bias was assessed with the Risk of Bias tool. The mean differences were pooled using a fixed-effects model for the meta-analysis. The certainty of the evidence was evaluated according to the guidelines of the Grading of the Recommendations, Assessment, Development, and Evaluations working group (Protocol ID: CRD42021270557). After the screening and selection process, 12 studies were included. The interventions identified, based on the school curricula, include classroom activities and homework, among others. A meta-analysis with five intervention groups presented an overall mean difference of -0.14 body mass index (BMI) Z-score (95% CI: -0.25, -0.03) after this intervention with high certainty of the evidence. This systematic review and meta-analysis suggest that nutrition and PA lessons inserted into the curricula and supported with additional activities (i.e. homework, workshops, etc.) could increase nutrition knowledge and improve attitudes toward fruit, vegetables, and water consumption, and BMI Z-score reduction.
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Affiliation(s)
- Nydia Balderas-Arteaga
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Kenia Mendez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Alejandra Gonzalez-Rocha
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Selene Pacheco-Miranda
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Anabelle Bonvecchio
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
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Donin AS, Goldsmith LP, Sharp C, Wahlich C, Whincup PH, Ussher MH. Identifying barriers and facilitators to increase fibre intakes in UK primary school children and exploring the acceptability of intervention components: a UK qualitative study. Public Health Nutr 2024; 27:e59. [PMID: 38299336 PMCID: PMC10897578 DOI: 10.1017/s1368980024000089] [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: 07/20/2023] [Revised: 12/01/2023] [Accepted: 01/04/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVE Within the UK, dietary fibre intakes are well below recommended intakes and associated with increased risk of obesity. This study aimed to explore the views of parents and children on barriers and facilitators to increasing fibre intakes and improving diets, alongside investigating the appropriateness of intervention components to overcome modifiable barriers. DESIGN Qualitative study including semi-structured interviews and focus groups informed by the Theoretical Domains Framework (TDF) and the Capability-Opportunity-Motivation-Behaviour (COM-B) model. PARTICIPANTS Year 5 children (aged 9-10-years) and parents, recruited through London primary schools. RESULTS A total of twenty-four participants (eleven parents and thirteen children) took part. Five key themes were identified as barriers and facilitators, namely lack of (and improving) knowledge, social factors (including parent-child conflicts, limited time for food preparation, influence of peer and family members), current eating habits, influence of the school, community and home environment in shaping eating behaviours, and the importance of choice and variety in finding foods that are healthy and tasty. Parents strongly supported school-based dietary interventions to enable consistent messaging at home and school and help support dietary behaviour change. Practical sessions (such as workshops to strengthen knowledge, taste tests and food swap ideas) were supported by parents and children. CONCLUSIONS By using a theory-driven approach to explore the barriers and facilitators to increasing fibre intake, this research identified important themes and modifiable barriers to behaviour change and identifies acceptable intervention components to overcome barriers and bring about sustained dietary behaviour change in primary school children.
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Affiliation(s)
- Angela S Donin
- Population Health Research Institute, St George’s, University of London, LondonSW17 0RE, England, UK
| | - Lucy P Goldsmith
- Population Health Research Institute, St George’s, University of London, LondonSW17 0RE, England, UK
| | - Clare Sharp
- Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland, UK
| | - Charlotte Wahlich
- Population Health Research Institute, St George’s, University of London, LondonSW17 0RE, England, UK
| | - Peter H Whincup
- Population Health Research Institute, St George’s, University of London, LondonSW17 0RE, England, UK
| | - Michael H Ussher
- Population Health Research Institute, St George’s, University of London, LondonSW17 0RE, England, UK
- Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland, UK
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Denova-Gutiérrez E, González-Rocha A, Méndez-Sánchez L, Araiza-Nava B, Balderas N, López G, Tolentino-Mayo L, Jauregui A, Hernández L, Unikel C, Bonvecchio A, Shamah T, Barquera S, Rivera JA. Overview of Systematic Reviews of Health Interventions for the Prevention and Treatment of Overweight and Obesity in Children. Nutrients 2023; 15:nu15030773. [PMID: 36771481 PMCID: PMC9921486 DOI: 10.3390/nu15030773] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/25/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
(1) Background: The importance of studying the health interventions used to prevent and treat overweight and obesity in school-aged children is imperative. This overview aimed to summarize systematic reviews that assess the effects of school-based, family, and mixed health interventions for preventing and treating overweight and obesity in school-aged children. (2) Methods: The Cochrane Collaboration methodology and PRISMA statement were followed. A search was conducted using terms adapted to 12 databases. Systematic reviews reporting interventions in children from six to 12 years old with an outcome related to preventing or treating obesity and overweight were included. Studies with pharmacological or surgical interventions and adolescents were excluded. (3) Results: A total of 15,226 registers were identified from databases and citation searching. Of those, ten systematic reviews published between 2013 and 2022 were included. After the overlap, 331 interventions for children between 6 and 12 years old were identified, and 61.6% involved physical activity and nutrition/diet intervention. Multicomponent intervention, combining physical activity with nutrition and behavioral change, school-based plus community-based interventions may be more effective in reducing overweight and obesity in children. (4) Conclusions: Plenty of interventions for childhood overweight and obesity aimed at prevention and treatment were identified, but there is a gap in the methodological quality preventing the establishment of a certain recommendation.
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Affiliation(s)
- Edgar Denova-Gutiérrez
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
- Correspondence: ; Tel.: +52-5554322986
| | - Alejandra González-Rocha
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Lucía Méndez-Sánchez
- Clinical Epidemiology Research Unit & Cochrane Mexico UNAM Center, Hospital Infantil de Mexico Federico Gomez, Mexico City 06720, Mexico
| | - Berenice Araiza-Nava
- Clinical Epidemiology Research Unit & Cochrane Mexico UNAM Center, Hospital Infantil de Mexico Federico Gomez, Mexico City 06720, Mexico
| | - Nydia Balderas
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Giovanna López
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Lizbeth Tolentino-Mayo
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Alejandra Jauregui
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Lucia Hernández
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Claudia Unikel
- Departamento de Ciencias Sociales en Salud, Dirección de Investigaciones Epidemiológica y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Anabelle Bonvecchio
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Teresa Shamah
- Center for Research in Evaluation and Surveys, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Simón Barquera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Juan A. Rivera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
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Cunningham-Sabo L, Lohse B, Clifford J, Burg A, Nigg C. Fuel for Fun Process Evaluation Reveals Strong Implementation and Approval with Varied Parent Engagement. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:16-29. [PMID: 36621265 DOI: 10.1016/j.jneb.2022.08.001] [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: 10/20/2021] [Revised: 07/25/2022] [Accepted: 08/01/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To describe the implementation and process characteristics of Fuel for Fun: Cooking with Kids Plus Parents and Play (FFF). DESIGN Mixed methods. SETTING Elementary schools in 2 Northern Colorado school districts. PARTICIPANTS Fourth graders (aged 9-11 years), parents, school staff, and implementation researchers; measured over 2 consecutive years in 8 schools (851 students, 45 classrooms). INTERVENTION(S) Social Cognitive and active learning theory-based classroom cooking with tasting lessons, active recess games, cooking with tasting food promotion during school lunch, family nights, and take-home intervention reinforcements. A 7-month program delivered by a trained intervention team. MAIN OUTCOME MEASURE(S) Implementation measures (observations and debriefings) assessed context, reach, dose delivered, fidelity, and dose received; process measures (surveys) assessed student and parent perceptions and intervention participation. ANALYSIS Descriptive statistics for quantitative and themes for qualitative data. RESULTS Minor adjustments in program delivery plans were required to accommodate changes in school schedules and policies. Process measures demonstrated > 90% achievement of goals for nearly all child-centered activities. One-quarter of eligible families participated in evening events, with strong parent and student approval. Fifty out of 116 parents (43%) completing an online survey reported preparing ≥ 1 of 5 recipes with their child. Fifty-nine percent of eligible students completed >1 of 10 take-home activity sheets with their parents. CONCLUSIONS AND IMPLICATIONS Engagement and commitment of the intervention team and school staff supported strong implementation. Participant responses were positive, but improvement in parent engagement requires investigation.
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Affiliation(s)
- Leslie Cunningham-Sabo
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Barbara Lohse
- Wegmans School of Health and Nutrition, Rochester Institute of Technology, Rochester, NY
| | - Jessica Clifford
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Alixanna Burg
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Claudio Nigg
- Department of Health Science, Institute of Sport Science, University of Bern, Bern, Switzerland
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Almutairi N, Burns S, Portsmouth L. Barriers and enablers to the implementation of school-based obesity prevention strategies in Jeddah, KSA. Int J Qual Stud Health Well-being 2022; 17:2135197. [PMID: 36263729 PMCID: PMC9590444 DOI: 10.1080/17482631.2022.2135197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Despite schools' recognised role in mitigating childhood overweight, many schools fail to implement physical activity or nutrition strategies. The current study explored
the enablers and barriers to implementing obesity prevention strategies in
Jeddah, KSA. Methods This research is based on 14 semi-structured interviews with intermediate school principals and sports teachers to gain insight into their perception of barriers and enablers to implementing obesity prevention strategies. Themes were deductively generated from the data. Results Participants estimated the prevalence of overweight and obesity among their students to be between 3 and 15% with an increasing trend, particularly among female students. Participants identified five categories of barriers to implementation of obesity prevention intervention: curriculum; schools strategies promoting healthy weight; lack of resources; student’s lifstyle; and a lack of teachers in nutrition and sports. School regulations, staff and sufficient resources were the most frequently reported enablers. Participants also identified food services, awareness, and partnerships as barriers and enablers. Conclusion There is a need for better infrastructure and financial support for schools and professional development opportunities for teachers from the Saudi Ministry of Education. The Ministry also needs to support the development of multilevel health promotion strategies at school and home and reach out to the broader community.
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Affiliation(s)
- Naif Almutairi
- School of Population Health, Curtin University Bentley Campus, Perth, Australia,Department of Public Health, College of Health Sciences at Al-Leith, Umm Al-Qura University, Al-Leith, Kingdom of Saudi Arabia,CONTACT Naif Almutairi ; School of Population Health, Curtin University, GPO Box U1987, Perth6845, Australia
| | - Sharyn Burns
- School of Population Health, Curtin University Bentley Campus, Perth, Australia,Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
| | - Linda Portsmouth
- School of Population Health, Curtin University Bentley Campus, Perth, Australia,Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
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Willeboordse M, Bartelink NHM, van Assema P, Kremers SPJ, Savelberg HHCM, Hahnraths MTH, Vonk L, Oosterhoff M, van Schayck CP, Winkens B, Jansen MWJ. Battling the obesity epidemic with a school-based intervention: Long-term effects of a quasi-experimental study. PLoS One 2022; 17:e0272291. [PMID: 36166426 PMCID: PMC9514666 DOI: 10.1371/journal.pone.0272291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 07/15/2022] [Indexed: 11/27/2022] Open
Abstract
Background School-based health-promoting interventions are increasingly seen as an effective population strategy to improve health and prevent obesity. Evidence on the long-term effectiveness of school-based interventions is scarce. This study investigates the four-year effectiveness of the school-based Healthy Primary School of the Future (HPSF) intervention on children’s body mass index z-score (BMIz), and on the secondary outcomes waist circumference (WC), dietary and physical activity (PA) behaviours. Methods and findings This study has a quasi-experimental design with four intervention schools, i.e., two full HPSFs (focus: diet and PA), two partial HPSFs (focus: PA), and four control schools. Primary school children (aged 4–12 years) attending the eight participating schools were invited to enrol in the study between 2015 and 2019. Annual measurements consisted of children’s anthropometry (weight, height and waist circumference), dietary behaviours (child- and parent-reported questionnaires) and PA levels (accelerometers). Between 2015 and 2019, 2236 children enrolled. The average exposure to the school condition was 2·66 (SD 1·33) years, and 900 participants were exposed for the full four years (40·3%). After four years of intervention, both full (estimated intervention effect (B = -0·17 (95%CI -0·27 to -0·08) p = 0·000) and partial HPSF (B = -0·16 (95%CI-0·25 to -0·06) p = 0·001) resulted in significant changes in children’s BMIz compared to control schools. Likewise, WC changed in favour of both full and partial HPSFs. In full HPSFs, almost all dietary behaviours changed significantly in the short term. In the long term, only consumption of water and dairy remained significant compared to control schools. In both partial and full HPSFs, changes in PA behaviours were mostly absent. Interpretation This school-based health-promoting intervention is effective in bringing unfavourable changes in body composition to a halt in both the short and long term. It provides policy makers with robust evidence to sustainably implement these interventions in school-based routine.
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Affiliation(s)
- M. Willeboordse
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- * E-mail:
| | - N. H. M. Bartelink
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - P. van Assema
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - S. P. J. Kremers
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - H. H. C. M. Savelberg
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM) and School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands
| | - M. T. H. Hahnraths
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - L. Vonk
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Academic Collaborative Centre for Public Health Limburg, Heerlen, The Netherlands
| | - M. Oosterhoff
- Department of Clinical Epidemiology and Medical Technology Assessment, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - C. P. van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - B. Winkens
- Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - M. W. J. Jansen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Academic Collaborative Centre for Public Health Limburg, Heerlen, The Netherlands
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Denova-Gutiérrez E, Méndez-Sánchez L, Araiza-Nava B, González-Rocha A, Shamah T, Bonvechio A, Barquera S, Rivera J. Overview of systematic reviews of health interventions that aim to prevent and treat overweight and obesity among children. Syst Rev 2022; 11:168. [PMID: 35964113 PMCID: PMC9375347 DOI: 10.1186/s13643-022-02047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood overweight and obesity is a global public health issue. Although there is evidence of a reduced prevalence in some countries, there is still much controversy about the efficacy of health interventions that aim to prevent and treat obesity in this specific population. The objective of the present study is to develop an overview of systematic reviews (OSRs) that assesses the effects of school-based, family, and multi-component health interventions for the prevention and treatment of obesity, change in physical activity, dietary, and/or hydration behaviors, and change in metabolic risk factors in school-aged children. METHODS This protocol was developed using the methodology proposed by Cochrane. It outlines a comprehensive search in 12 electronic databases to identify systematic reviews of health interventions, including studies that evaluate and how to prevent and/or treat overweight and/or obesity in children aged 6 to 12 years. The risk of bias of the included Systematic Reviews will be assessed with the ROBIS tool. DISCUSSION Since the OSRs methodology's purpose is only to harmonize evidence from open access publications, ethical consent is not necessary for the present protocol. In terms of diffusion, a paper will be submitted for publication in a scientific journal to describe the main results obtained through the OSRs. TRIAL REGISTRATION The present overview of the systematic review protocol has been registered in PROSPERO (ID number 218296).
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Affiliation(s)
- Edgar Denova-Gutiérrez
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Lucía Méndez-Sánchez
- Clinical Epidemiology Research Unit, Hospital Infantil de Mexico Federico Gomez, Faculty of Medicine of National Autonomous University of Mexico (Universidad Nacional Autónoma de México), Mexico City, Mexico.
| | - Berenice Araiza-Nava
- Clinical Epidemiology Research Unit, Hospital Infantil de Mexico Federico Gomez, Faculty of Medicine of National Autonomous University of Mexico (Universidad Nacional Autónoma de México), Mexico City, Mexico
| | | | - Teresa Shamah
- Center for Research in Evaluation and Surveys, National Institute of Public Health, Cuernavaca, Mexico
| | - Anabelle Bonvechio
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Simón Barquera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Juan Rivera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico.
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Robertson D, Carins J, Rundle‐Thiele S, Harris J. Evaluation of Social Impact Within Primary School Health Promotion: A Systematic Review. THE JOURNAL OF SCHOOL HEALTH 2022; 92:739-764. [PMID: 35365879 PMCID: PMC9544285 DOI: 10.1111/josh.13160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Health promotion programs and interventions are designed to encourage behavioral changes in children, encouraging them to make safe and healthy life choices. This systematic review seeks to examine how social impact is measured in primary school health promotion interventions. METHOD A systematic search and review process was used to identify and examine primary school health promotion interventions. The PRISMA guidelines were followed to source articles from 6 electronic databases reporting school health promotion programs or interventions in Australia, Canada, New Zealand, or the United Kingdom. RESULTS A total of 77 studies were located, representing 55 health promotion interventions delivered in primary school settings. Of these interventions, only 8 (15%) measured or attempted to measure social impact, whereas another 8 (15%) alluded to social impact. The predominant theories reported were social based theories (theories which examine the social influences on people, environments, and behaviors) (n = 17, 59%), with almost a third not informed by an overt health promotion framework or model (n = 34, 59%). A systematic rating system identified some level of stakeholder engagement (n = 30, 53%). CONCLUSIONS This systematic review highlights the need for social impact measurement within health promotion to illuminate the role of school programs in delivering lasting change.
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Affiliation(s)
- Dianne Robertson
- Social Marketing @ GriffithDepartment of Marketing, Griffith University170 Kessels RoadNathanQLD4111Australia
| | - Julia Carins
- Social Marketing @ GriffithDepartment of Marketing, Griffith University170 Kessels RoadNathanQLD4111Australia
| | - Sharyn Rundle‐Thiele
- Social Marketing @ GriffithDepartment of Marketing, Griffith University170 Kessels RoadNathanQLD4111Australia
| | - Jessica Harris
- Social Marketing @ GriffithDepartment of Marketing, Griffith University170 Kessels RoadNathanQLD4111Australia
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Welch V, Dewidar O, Tanjong Ghogomu E, Abdisalam S, Al Ameer A, Barbeau VI, Brand K, Kebedom K, Benkhalti M, Kristjansson E, Madani MT, Antequera Martín AM, Mathew CM, McGowan J, McLeod W, Park HA, Petkovic J, Riddle A, Tugwell P, Petticrew M, Trawin J, Wells GA. How effects on health equity are assessed in systematic reviews of interventions. Cochrane Database Syst Rev 2022; 1:MR000028. [PMID: 35040487 PMCID: PMC8764740 DOI: 10.1002/14651858.mr000028.pub3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Enhancing health equity is endorsed in the Sustainable Development Goals. The failure of systematic reviews to consider potential differences in effects across equity factors is cited by decision-makers as a limitation to their ability to inform policy and program decisions. OBJECTIVES: To explore what methods systematic reviewers use to consider health equity in systematic reviews of effectiveness. SEARCH METHODS We searched the following databases up to 26 February 2021: MEDLINE, PsycINFO, the Cochrane Methodology Register, CINAHL, Education Resources Information Center, Education Abstracts, Criminal Justice Abstracts, Hein Index to Foreign Legal Periodicals, PAIS International, Social Services Abstracts, Sociological Abstracts, Digital Dissertations and the Health Technology Assessment Database. We searched SCOPUS to identify articles that cited any of the included studies on 10 June 10 2021. We contacted authors and searched the reference lists of included studies to identify additional potentially relevant studies. SELECTION CRITERIA We included empirical studies of cohorts of systematic reviews that assessed methods for measuring effects on health inequalities. We define health inequalities as unfair and avoidable differences across socially stratifying factors that limit opportunities for health. We operationalised this by assessing studies which evaluated differences in health across any component of the PROGRESS-Plus acronym, which stands for Place of residence, Race/ethnicity/culture/language, Occupation, Gender or sex, Religion, Education, Socioeconomic status, Social capital. "Plus" stands for other factors associated with discrimination, exclusion, marginalisation or vulnerability such as personal characteristics (e.g. age, disability), relationships that limit opportunities for health (e.g. children in a household with parents who smoke) or environmental situations which provide limited control of opportunities for health (e.g. school food environment). DATA COLLECTION AND ANALYSIS Two review authors independently extracted data using a pre-tested form. Risk of bias was appraised for included studies according to the potential for bias in selection and detection of systematic reviews. MAIN RESULTS: In total, 48,814 studies were identified and the titles and abstracts were screened in duplicate. In this updated review, we identified an additional 124 methodological studies published in the 10 years since the first version of this review, which included 34 studies. Thus, 158 methodological studies met our criteria for inclusion. The methods used by these studies focused on evidence relevant to populations experiencing health inequity (108 out of 158 studies), assess subgroup analysis across PROGRESS-Plus (26 out of 158 studies), assess analysis of a gradient in effect across PROGRESS-Plus (2 out of 158 studies) or use a combination of subgroup analysis and focused approaches (20 out of 158 studies). The most common PROGRESS-Plus factors assessed were age (43 studies), socioeconomic status in 35 studies, low- and middle-income countries in 24 studies, gender or sex in 22 studies, race or ethnicity in 17 studies, and four studies assessed multiple factors across which health inequity may exist. Only 16 studies provided a definition of health inequity. Five methodological approaches to consider health equity in systematic reviews of effectiveness were identified: 1) descriptive assessment of reporting and analysis in systematic reviews (140 of 158 studies used a type of descriptive method); 2) descriptive assessment of reporting and analysis in original trials (50 studies); 3) analytic approaches which assessed differential effects across one or more PROGRESS-Plus factors (16 studies); 4) applicability assessment (25 studies) and 5) stakeholder engagement (28 studies), which is a new finding in this update and examines the appraisal of whether relevant stakeholders with lived experience of health inequity were included in the design of systematic reviews or design and delivery of interventions. Reporting for both approaches (analytic and applicability) lacked transparency and was insufficiently detailed to enable the assessment of credibility. AUTHORS' CONCLUSIONS There is a need for improvement in conceptual clarity about the definition of health equity, describing sufficient detail about analytic approaches (including subgroup analyses) and transparent reporting of judgments required for applicability assessments in order to consider health equity in systematic reviews of effectiveness.
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Affiliation(s)
- Vivian Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Omar Dewidar
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | | | | | | | | | - Kevin Brand
- Telfer School of Management, University of Ottawa, Ottawa, Canada
| | | | | | | | | | | | | | - Jessie McGowan
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | | | | | - Alison Riddle
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Marmora, Canada
| | - Peter Tugwell
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Mark Petticrew
- Department of Social & Environmental Health Research, Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - George A Wells
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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11
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McLoughlin GM, Sweeney R, Liechty L, Lee JA, Rosenkranz RR, Welk GJ. Evaluation of a Large-Scale School Wellness Intervention Through the Consolidated Framework for Implementation Research (CFIR): Implications for Dissemination and Sustainability. FRONTIERS IN HEALTH SERVICES 2022; 2:881639. [PMID: 36925836 PMCID: PMC10012642 DOI: 10.3389/frhs.2022.881639] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022]
Abstract
Background Numerous studies have tested school-based interventions promoting healthy behaviors in youth, but few have integrated dissemination and implementation (D&I) frameworks. Using D&I frameworks can inform if and how an evidence-based intervention is implemented and maintained and provide strategies to address contextual barriers. Such application is necessary to understand how and why interventions are sustained over time. We evaluated a school wellness initiative called SWITCH® (School Wellness Integration Targeting Child Health) to (1) assess implementation outcomes of adoption, fidelity, and penetration, (2) discern implementation determinants through the Consolidated Framework for Implementation Research (CFIR), and (3) examine differences among inexperienced and experienced schools and influential factors to sustainment. Methods A total of 52 schools from Iowa, United States enrolled in the 2019-2020 iteration of SWITCH (22 inexperienced; 30 experienced). The CFIR guided the adaptation of mixed methods data collection and analysis protocols for school settings. Specific attention was focused on (1) fidelity to core elements; (2) adoption of best practices; and (3) penetration of behavior change practices. Determinants were investigated through in-depth qualitative interviews and readiness surveys with implementation leaders. A systematic process was used to score CFIR domains (between -2 and +2) indicating positive or negative influence. Independent t-tests were conducted to capture differences between samples, followed by a cross-case analysis to compare determinants data. Inductive coding yielded themes related to sustainment of SWITCH beyond formal implementation support. Results Experienced schools had higher scores on fidelity/compliance (t = -1.86 p = 0.07) and adoption (t = -2.03 p = 0.04). CFIR determinants of innovation source, culture, relative priority, and leadership engagement were positive implementation determinants, whereas tension for change and networks and communications were negative determinants. Distinguishing factors between experienced and inexperienced schools were Readiness for Implementation and Self-efficacy (experienced significantly higher; p < 0.05). Strategies to enhance sustainability were increasing student awareness/advocacy, keeping it simple, and integrating into school culture. Conclusions Findings provide specific insights related to SWITCH implementation and sustainability but more generalized insights about the type of support needed to help schools implement and sustain school wellness programming. Tailoring implementation support to both inexperienced and experienced settings will ultimately enhance dissemination and sustainability of evidence-based interventions.
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Affiliation(s)
- Gabriella M McLoughlin
- College of Public Health, Temple University, Philadelphia, PA, United States.,Implementation Science Center for Cancer Control and Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Rachel Sweeney
- 4-H Extension and Outreach, Iowa State University, Ames, IA, United States
| | - Laura Liechty
- 4-H Extension and Outreach, Iowa State University, Ames, IA, United States
| | - Joey A Lee
- Department of Health Sciences, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - Richard R Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS, United States
| | - Gregory J Welk
- Department of Kinesiology, Iowa State University, Ames, IA, United States
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12
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Li B, Gao S, Bao W, Li M. Effectiveness of lifestyle interventions for treatment of overweight/obesity among children in China: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2022; 13:972954. [PMID: 36387871 PMCID: PMC9659900 DOI: 10.3389/fendo.2022.972954] [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: 06/19/2022] [Accepted: 10/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pediatric obesity has become a global public health problem. China has the largest population of obese children in the world. It is important to develop effective interventions to control child obesity. This systematic review summarizes proof from randomized controlled trials to assess the efficacy of lifestyle intervention to reduce BMI and metabolic risk factors for overweight/obese Chinese children. METHODS We searched studies from five databases (PubMed, MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and CNKI). Research that meets the following requirements was included: randomized controlled trials, participants are overweight/obese Chinese children aged <18 years old, and the effectiveness of lifestyle interventions is evaluated. RESULTS Eight randomized controlled trials were included. A significant difference was found between the intervention group and the control group for the BMI changes (mean difference = -1.49; 95% CI: -2.20 to -0.77; p < 0.001). Subgroup analyses consistently demonstrated that effects of lifestyle interventions on BMI change including multiple-component interventions (mean difference = -2.03 kg/m2; 95% CI: -3.62 to -0.43; p < 0.001) were stronger than those only with physical activities or health education; effects of lifestyle interventions on BMI change were also strengthened if duration of intervention last for more than 1 year (mean difference = -3.03 kg/m2; 95% CI: -4.00 to -2.06; p = 0.01) or with age during 12-18 years old (mean difference = -1.90 kg/m2; 95% CI: -3.37 to -0.43; p < 0.001). CONCLUSIONS Lifestyle interventions are effective in reducing BMI in Chinese children with overweight/obesity, and the effectiveness is more profound when the lifestyle intervention includes multiple components, lasts longer than one year, and/or is conducted among teens. These findings provide an important evidence base for developing and implementing potentially effective lifestyle interventions for the treatment of overweight/obesity among Chinese children.
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Affiliation(s)
- Bo Li
- Department of Endocrinology, National Health Commission (NHC) Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Shan Gao
- Department of Endocrinology, Xuanwu Hospital, Capital Medical University, Beijing, China
- *Correspondence: Ming Li, ; Shan Gao,
| | - Wei Bao
- Institute of Public Health, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Ming Li
- Department of Endocrinology, National Health Commission (NHC) Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Ming Li, ; Shan Gao,
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13
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Walker TJ, Craig DW, Pavlovic A, Thiele S, Natale B, Szeszulski J, DeFina LF, Kohl HW. Physical Activity and Healthy Eating Programming in Schools to Support Student's Health-Related Fitness: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111069. [PMID: 34769588 PMCID: PMC8583401 DOI: 10.3390/ijerph182111069] [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] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/09/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022]
Abstract
Centers for Disease Control (CDC) guidelines recommend schools use a coordinated health approach to support healthy eating and physical activity. This study examines whether the number of healthy eating and physical activity programs and activities used by schools and their perceived success relate to students’ health-related fitness. This observational study used data from the Healthy Zone Schools Program. Data (collected in 2017–2019) were integrated from three sources: (1) school surveys, (2) FitnessGram®, and (3) the Texas Education Agency. Independent variables were the number of health promotion programs and activities and their perceived success; dependent variables were meeting Healthy Fitness Zone Standards (HFZ) for aerobic capacity and body mass index (BMI). We used mixed-effects logistic regression models. Fifty-six schools were in the analytic sample (n = 15,096 students with aerobic capacity data and n = 19,969 with BMI data). Results indicated the perceived success of physical activity programs/activities was significantly associated with students meeting HFZ standards for aerobic capacity (OR = 1.32, CI = 1.06–1.63). There was a significant direct association between the number of physical activity and healthy eating activities implemented (OR = 1.04, CI = 1.01–1.06) and students meeting HFZ for BMI. Schools using multiple health programs and activities need to balance the number provided with their capacity to maintain success.
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Affiliation(s)
- Timothy J. Walker
- Center for Health Promotion and Prevention Research, Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin St., Houston, TX 77030, USA; (D.W.C.); (J.S.)
- Correspondence:
| | - Derek W. Craig
- Center for Health Promotion and Prevention Research, Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin St., Houston, TX 77030, USA; (D.W.C.); (J.S.)
| | - Andjelka Pavlovic
- Division of Youth Education, The Cooper Institute, 12330 Preston Road, Dallas, TX 75230, USA; (A.P.); (S.T.); (B.N.); (L.F.D.)
| | - Shelby Thiele
- Division of Youth Education, The Cooper Institute, 12330 Preston Road, Dallas, TX 75230, USA; (A.P.); (S.T.); (B.N.); (L.F.D.)
| | - Breanna Natale
- Division of Youth Education, The Cooper Institute, 12330 Preston Road, Dallas, TX 75230, USA; (A.P.); (S.T.); (B.N.); (L.F.D.)
| | - Jacob Szeszulski
- Center for Health Promotion and Prevention Research, Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin St., Houston, TX 77030, USA; (D.W.C.); (J.S.)
| | - Laura F. DeFina
- Division of Youth Education, The Cooper Institute, 12330 Preston Road, Dallas, TX 75230, USA; (A.P.); (S.T.); (B.N.); (L.F.D.)
| | - Harold W. Kohl
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Austin Regional Campus, Austin, TX 78701, USA;
- Department of Kinesiology and Health Education, The University of Texas at Austin, 1616 Guadalupe, Austin, TX 78701, USA
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Hughes SO, Power TG, Beck AD, Betz D, Goodell LS, Hopwood V, Jaramillo JA, Lanigan J, Martinez AD, Micheli N, Guerrero YO, Overath I, Parker L, Ramos G, Thompson YP, Papaioannou MA, Johnson SL. Twelve-Month Efficacy of an Obesity Prevention Program Targeting Hispanic Families With Preschoolers From Low-Income Backgrounds. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:677-690. [PMID: 34148764 DOI: 10.1016/j.jneb.2021.04.460] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 04/13/2021] [Accepted: 04/19/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Assess effects of an obesity prevention program promoting eating self-regulation and healthy preferences in Hispanic preschool children. DESIGN Randomized controlled trial with pretest, posttest, 6- and 12-month assessments. Fourteen waves, each lasting 7 weeks. SETTING Families recruited from Head Start across 2 sites. PARTICIPANTS Two hundred fifty-five families randomized into prevention (n = 136) or control (n = 119). INTERVENTION Prevention received curriculum; control received no curriculum. MAIN OUTCOME MEASURE(S) Feeding knowledge/practices/styles (parent); body mass index percentile, eating self-regulation, trying new foods, and fruit/vegetable consumption (child). ANALYSIS Multilevel analyses for nested data (time points within families; families within waves) and multinomial regression. RESULTS Program increased mothers' repeated presentation of new foods (P < 0.05), measured portion sizes (P < 0.05), child involvement in food preparation (P < 0.001), feeding responsiveness (P < 0.001), knowledge of best feeding practices (P < 0.001), and feeding efficacy (P < 0.05); reduced feeding misconceptions (P < 0.01) and uninvolved feeding (P < 0.01). Effects on child eating behavior were minimal. At 12 months, children in the prevention group were less likely to have overweight (P < 0.05) or obesity (P < 0.05). CONCLUSIONS AND IMPLICATIONS Program effects emphasize the importance of feeding approaches in reducing childhood obesity.
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Affiliation(s)
- Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA
| | | | - Drew Betz
- Whatcom County Extension, Washington State University, Bellingham, WA
| | - L Suzanne Goodell
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, NC
| | | | - J Andrea Jaramillo
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Jane Lanigan
- Department of Human Development, Washington State University, Vancouver, WA
| | | | - Nilda Micheli
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | | | - Irene Overath
- Kitsap County Extension, Washington State University, Bremerton, WA
| | - Louise Parker
- Department of Human Development, Washington State University Extension, Seattle, WA
| | - Guadalupe Ramos
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Yuri P Thompson
- College of Education, Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX
| | - Maria A Papaioannou
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Susan L Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO
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15
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Mediterranean diet adherence amongst adolescents in North Lebanon: the role of skipping meals, meals with the family, physical activity and physical well-being. Br J Nutr 2021; 128:1349-1356. [PMID: 34266518 DOI: 10.1017/s0007114521002269] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The Mediterranean diet (MD) is a model of a healthy diet and healthy lifestyle. Adherence to the MD has been correlated with a reduction in many metabolic disorders including cancers. The factors associated with adolescents' adherence to the MD in North Lebanon using the KIDMED index have never been explored. Therefore, we thought to examine these factors amongst a sample of them. A cross-sectional survey was conducted in the city of Tripoli, North Lebanon. A total of 798 adolescents aged 11-18 years were randomly selected to participate in this study. All participants completed a questionnaire assessing adherence to the MD (KIDMED index), physical activity (physical activity questionnaires for older children and adolescents), health-related quality of life (KIDSCREEN-27 index) and sociodemographic characteristics (age, sex, grade level and parents' educational status). Anthropometric measurements, including weight, height and waist circumference, were also collected. Adherence to the MD was good amongst only 13·3 % of the adolescents. The prevalence rate of overweight and obesity was elevated, affecting 36·9 % of the students. Lower adherence to the MD was significantly correlated with skipping meals (P = 0·001). Meanwhile, adolescents who were engaged in a high level of physical activity, those who consumed more meals with their families and those who benefited from better physical well-being had a better diet quality (P < 0·001). Nutrition intervention programmes, as well as public health policies, would be of interest in order to improve diet quality amongst Lebanese adolescents.
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16
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Sanders GJ, Marwa WL, Wade B, Gately P. Efficacy of a county-wide schools weight management intervention. Perspect Public Health 2021; 142:319-327. [PMID: 33998330 DOI: 10.1177/17579139211006738] [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: 11/15/2022]
Abstract
AIMS This study aimed to evaluate the effectiveness of the Local Authority commissioned large-scale public health service that provided a 6-week school-based weight management intervention for children aged 4-19 years. METHODS A quantitative retrospective cohort study identified participants from 130 schools consisting of 8550 potential children aged 4-19 years across a mixture of Lower Super Output Area (LSOA) deprivation groups. Participants were invited to take part in a 5- to 12-week Healthy Lifestyles intervention with a focus on weight management delivered by OneLife Suffolk between 1 January 2017 and 1 January 2020. This resulted in a final sample of 5163 participants. The following information for each child was collected anonymously: (1) age, (2) gender, (3) preprogramme body mass index (BMI), (4) postprogramme BMI, (5) weight category and (6) LSOA category. RESULTS Following the 6-week school-based intervention, there was a significant decrease in mean ΔBMI SDS (standardised body mass index) of -0.07 (-14.89%) among participants. Wilcoxon signed-rank test showed a significant change in weight status post 6-week weight management programme (WMP): BMI (Z = -15.87, p < .001), BMI SDS (Z = -21.54, p < .001), centile (Z = -20.12, p < .01) and weight category (Z = -7.89, p < .001), whereas Mann-Whitney U test showed no statistically significant difference in mean BMI SDS change between gender groups (p = .24) and Kruskal-Wallis test revealed no statistically significant differences in mean BMI SDS change between child LSOA groups (c2(4) = 1.67, p = .796), school LSOA groups (c2(4) = 4.72, p = .317), ethnic groups (c2(4) = 2.53, p = .640) and weight category at the start of the intervention (c2(3) = 6.20, p = .102). CONCLUSIONS This study contributes to the growing body of evidence demonstrating the efficacy of multicomponent school-based weight management interventions and demonstrates that such interventions can be successfully implemented as part of a wider healthy lifestyles service, without widening health inequalities.
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Affiliation(s)
- G J Sanders
- Carnegie School of Sport, Leeds Beckett University, Fairfax Hall Rm 230, Headingley Campus, Leeds LS6 3QS, UK
| | - W L Marwa
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - B Wade
- OneLife Suffolk, Inspire Suffolk, Ipswich, UK
| | - P Gately
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
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Cerrato-Carretero P, Roncero-Martín R, Pedrera-Zamorano JD, López-Espuela F, Puerto-Parejo LM, Sánchez-Fernández A, Canal-Macías ML, Moran JM, Lavado-García JM. Long-Term Dietary and Physical Activity Interventions in the School Setting and Their Effects on BMI in Children Aged 6-12 Years: Meta-Analysis of Randomized Controlled Clinical Trials. Healthcare (Basel) 2021; 9:396. [PMID: 33916088 PMCID: PMC8066711 DOI: 10.3390/healthcare9040396] [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: 03/04/2021] [Revised: 03/23/2021] [Accepted: 03/30/2021] [Indexed: 12/14/2022] Open
Abstract
Preventive actions and potential obesity interventions for children are mainly researched throughout the school period, either as part of the school curricula or after regular school hours, via interventions mostly lasting less than 12 months. We aimed to perform a meta-analysis on randomized controlled clinical trials to evaluate the evidence of the efficacy of long-term school-based interventions in the management of childhood obesity in terms of BMI from a dietary and physical activity-based approach. Eleven randomized controlled clinical trials were examined using the random effects model, and the results showed that there were no significant effects associated with physical activity + nutrition intervention in school children aged 6-12 years, with a pooled standardized mean difference (SMD) (95% CI) of -0.00 (-0.05, 0.04). No effects were observed after subgroup analysis based on the intervention length. The findings from our study indicate that long-term school-based interventions on physical activity and dietary habits received by children aged 6-12 years seem to have no effect on BMI. However, the promotion of such interventions should not be discouraged, as they promote additional positive health outcomes for other domains of children's health.
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Affiliation(s)
- Purificación Cerrato-Carretero
- Metabolic Bone Diseases Research Group, Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, 10003 Caceres, Spain; (P.C.-C.); (R.R.-M.); (J.D.P.-Z.); (F.L.-E.); (L.M.P.-P.); (M.L.C.-M.); (J.M.L.-G.)
| | - Raúl Roncero-Martín
- Metabolic Bone Diseases Research Group, Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, 10003 Caceres, Spain; (P.C.-C.); (R.R.-M.); (J.D.P.-Z.); (F.L.-E.); (L.M.P.-P.); (M.L.C.-M.); (J.M.L.-G.)
| | - Juan D. Pedrera-Zamorano
- Metabolic Bone Diseases Research Group, Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, 10003 Caceres, Spain; (P.C.-C.); (R.R.-M.); (J.D.P.-Z.); (F.L.-E.); (L.M.P.-P.); (M.L.C.-M.); (J.M.L.-G.)
| | - Fidel López-Espuela
- Metabolic Bone Diseases Research Group, Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, 10003 Caceres, Spain; (P.C.-C.); (R.R.-M.); (J.D.P.-Z.); (F.L.-E.); (L.M.P.-P.); (M.L.C.-M.); (J.M.L.-G.)
| | - Luis M. Puerto-Parejo
- Metabolic Bone Diseases Research Group, Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, 10003 Caceres, Spain; (P.C.-C.); (R.R.-M.); (J.D.P.-Z.); (F.L.-E.); (L.M.P.-P.); (M.L.C.-M.); (J.M.L.-G.)
| | | | - María Luz Canal-Macías
- Metabolic Bone Diseases Research Group, Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, 10003 Caceres, Spain; (P.C.-C.); (R.R.-M.); (J.D.P.-Z.); (F.L.-E.); (L.M.P.-P.); (M.L.C.-M.); (J.M.L.-G.)
| | - Jose M. Moran
- Metabolic Bone Diseases Research Group, Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, 10003 Caceres, Spain; (P.C.-C.); (R.R.-M.); (J.D.P.-Z.); (F.L.-E.); (L.M.P.-P.); (M.L.C.-M.); (J.M.L.-G.)
| | - Jesus M. Lavado-García
- Metabolic Bone Diseases Research Group, Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, 10003 Caceres, Spain; (P.C.-C.); (R.R.-M.); (J.D.P.-Z.); (F.L.-E.); (L.M.P.-P.); (M.L.C.-M.); (J.M.L.-G.)
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18
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Miyawaki A, Evans CEL, Lucas PJ, Kobayashi Y. Relationships between social spending and childhood obesity in OECD countries: an ecological study. BMJ Open 2021; 11:e044205. [PMID: 33622950 PMCID: PMC7907862 DOI: 10.1136/bmjopen-2020-044205] [Citation(s) in RCA: 3] [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: 01/22/2023] Open
Abstract
OBJECTIVES The burden of childhood obesity is clustered among children in low-socioeconomic groups. Social spending on children-public welfare expenditure on families and education-may curb childhood obesity by reducing socioeconomic disadvantages. The objective of this study was to examine the relationship between social spending on children and childhood obesity across the Organisation for Economic Cooperation and Development (OECD) countries. DESIGN Ecological study. SETTING Data on social spending on children were obtained from the OECD Social Expenditure Database and the OECD educational finance indicators dataset during 2000-2015. Data on childhood obesity were obtained from the NCD Risk Factor Collaboration database. PARTICIPANTS Aggregated statistics on obesity among children aged 5-19 years, estimated for OECD 35 countries based on the measured height and weight on 31.5 million children. OUTCOME MEASURES Country-level prevalence of obesity among children aged 5-19 years. RESULTS In cross-sectional analyses in 2015, social spending on children was inversely associated with the prevalence of childhood obesity after adjusting for potential confounders (the gross domestic product per capita, unemployment rate, poverty rate, percentage of children aged <20 years and prevalence of childhood obesity in 2000). In addition, when we focused on changes from 2000 to 2015, an average annual increase of US$100 in social spending per child was associated with a decrease in childhood obesity by 0.6 percentage points for girls (p=0.007) and 0.7 percentage points for boys (p=0.04) between 2000 and 2015, after adjusting for the potential confounders. The dimensions of social spending that contributed to these associations between the changes in social spending on children and childhood obesity were early childhood education and care (ECEC) and school education for girls and ECEC for boys. CONCLUSION Countries that increase social spending on children tend to experience smaller increases in childhood obesity.
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Affiliation(s)
- Atsushi Miyawaki
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | | | | | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Sánchez-Martínez F, Brugueras S, Serral G, Valmayor S, Juárez O, López MJ, Ariza C. Three-Year Follow-Up of the POIBA Intervention on Childhood Obesity: A Quasi-Experimental Study. Nutrients 2021; 13:453. [PMID: 33573017 PMCID: PMC7911572 DOI: 10.3390/nu13020453] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 01/08/2023] Open
Abstract
Childhood obesity has increased worldwide over the past four decades. This quasi-experimental study aimed to assess the effectiveness of a multicomponent and multilevel school-based intervention (POIBA) at 3 years of follow-up. The nutrition intervention focused on food groups, food pyramid, nutrients, portions, and balanced menus. In total, 3624 children participated in the study. Anthropometric measurements and information on food frequency and behavior, physical activity, and daily screen use were collected in the intervention (IG) and comparison group (CG). Positive unadjusted changes toward adherence to recommendations were found for water, meat, sweets, and fried potato consumption, proper breakfast, not having dinner in front of the TV, out-of-school physical activity, and daily screen use. Three scores were used to calculate the proportion of children making more than one change to improve healthy habits regarding physical activity (global Activity score), nutrition (global Nutrition score), and both (global score). Students exposed to the intervention had a significantly better global Activity score (16.2% IG vs. 11.9% CG; p = 0.012) and Global score (63.9% IG vs. 58.5% CG; p = 0.025). Intervention effects on obesity incidence at 3-year follow-up lost significance but maintained the positive trend. In conclusion, school-based interventions including a family component could be useful to address the childhood obesity problem.
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Affiliation(s)
- Francesca Sánchez-Martínez
- Agència de Salut Pública de Barcelona (Public Health Agency of Barcelona, ASPB), Pl Lesseps 1, 08023 Barcelona, Spain; (S.B.); (G.S.); (S.V.); (O.J.); (M.J.L.); (C.A.)
- Institut d’Investigació Biomèdica Sant Pau (IIIB Sant Pau), Sant Antoni Maria Claret 167, 08025 Barcelona, Spain
- Pompeu Fabra University (UPF), Health and Experimental Science Department, Doctor Aiguader 80, 08003 Barcelona, Spain
| | - Silvia Brugueras
- Agència de Salut Pública de Barcelona (Public Health Agency of Barcelona, ASPB), Pl Lesseps 1, 08023 Barcelona, Spain; (S.B.); (G.S.); (S.V.); (O.J.); (M.J.L.); (C.A.)
| | - Gemma Serral
- Agència de Salut Pública de Barcelona (Public Health Agency of Barcelona, ASPB), Pl Lesseps 1, 08023 Barcelona, Spain; (S.B.); (G.S.); (S.V.); (O.J.); (M.J.L.); (C.A.)
- Institut d’Investigació Biomèdica Sant Pau (IIIB Sant Pau), Sant Antoni Maria Claret 167, 08025 Barcelona, Spain
- Ciber de Epidemiología y Salud Pública (CIBERESP), Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Sara Valmayor
- Agència de Salut Pública de Barcelona (Public Health Agency of Barcelona, ASPB), Pl Lesseps 1, 08023 Barcelona, Spain; (S.B.); (G.S.); (S.V.); (O.J.); (M.J.L.); (C.A.)
| | - Olga Juárez
- Agència de Salut Pública de Barcelona (Public Health Agency of Barcelona, ASPB), Pl Lesseps 1, 08023 Barcelona, Spain; (S.B.); (G.S.); (S.V.); (O.J.); (M.J.L.); (C.A.)
| | - María José López
- Agència de Salut Pública de Barcelona (Public Health Agency of Barcelona, ASPB), Pl Lesseps 1, 08023 Barcelona, Spain; (S.B.); (G.S.); (S.V.); (O.J.); (M.J.L.); (C.A.)
- Institut d’Investigació Biomèdica Sant Pau (IIIB Sant Pau), Sant Antoni Maria Claret 167, 08025 Barcelona, Spain
- Pompeu Fabra University (UPF), Health and Experimental Science Department, Doctor Aiguader 80, 08003 Barcelona, Spain
- Ciber de Epidemiología y Salud Pública (CIBERESP), Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Carles Ariza
- Agència de Salut Pública de Barcelona (Public Health Agency of Barcelona, ASPB), Pl Lesseps 1, 08023 Barcelona, Spain; (S.B.); (G.S.); (S.V.); (O.J.); (M.J.L.); (C.A.)
- Institut d’Investigació Biomèdica Sant Pau (IIIB Sant Pau), Sant Antoni Maria Claret 167, 08025 Barcelona, Spain
- Ciber de Epidemiología y Salud Pública (CIBERESP), Monforte de Lemos 3-5, 28029 Madrid, Spain
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20
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Singhal J, Herd C, Adab P, Pallan M. Effectiveness of school-based interventions to prevent obesity among children aged 4 to 12 years old in middle-income countries: A systematic review and meta-analysis. Obes Rev 2021; 22:e13105. [PMID: 32725780 DOI: 10.1111/obr.13105] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/25/2020] [Accepted: 07/03/2020] [Indexed: 12/12/2022]
Abstract
Economic and accompanying nutrition transition in middle-income countries is resulting in rapidly increasing childhood obesity prevalence, exceeding acceleration rates in the West. Previous school-based obesity prevention reviews have mainly included studies from high-income countries. This review aimed to summarize the evidence from randomized controlled trials evaluating the effectiveness of school-based interventions in preventing childhood obesity in middle-income countries. Six electronic databases were searched: MEDLINE, EMBASE, CINAHL Plus, LILACS, IBECS and WPRIM. Eligibility criteria included middle-income country setting, randomized/cluster-randomized controlled trials, children aged 4-12 years and school-based interventions targeting dietary intake and/or physical activity. Twenty-one cluster-randomized controlled trials, conducted in Asia (n = 10), South America (n = 4), North America (n = 4) and the Middle East (n = 3), were included. Fifteen studies reported a significant intervention effect on at least one adiposity-related outcome. Characteristics of effective interventions included combined diet and PA interventions, school teacher-delivery, duration of >8 months, parental involvement, education sessions and school food modifications. The risk of bias in these trials was mixed. The pooled estimate of the odds ratio for obesity in intervention versus control schools (nine studies) was 0.77; 95% CI, 0.63 to 0.94; p = 0.009. In conclusion, there is some evidence to support school-based interventions in preventing childhood obesity in middle-income countries.
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Affiliation(s)
- Juhi Singhal
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Clare Herd
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Peymane Adab
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Miranda Pallan
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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21
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Nicholson LM, McLeod Loren D, Reifenberg A, Beets MW, Bohnert AM. School as a Protective Setting for Excess Weight Gain and Child Obesity: A Meta-Analysis. THE JOURNAL OF SCHOOL HEALTH 2021; 91:19-28. [PMID: 33152808 DOI: 10.1111/josh.12972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 03/30/2020] [Accepted: 09/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The structure provided by school settings even with no specific obesity-intervention may prevent weight gain. This meta-analytic study considered this premise by examining weight outcomes from control groups in published randomized controlled trials of school-year obesity-related interventions conducted in-school and out-of-school. METHODS A systematic review and random-effects meta-analysis were conducted in accordance with Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases were systematically searched and resulted in 1976 unique citations, with 14 retained for analysis. Analyses examined the change in weight outcomes among control group participants. RESULTS For studies (N = 6) reporting body mass index (BMI) (kg/m2 ) the overall standardized mean difference (SMD) from pre- to post-intervention was 0.085 (raw units 0.278 kg/m2 ); for studies (N = 9) reporting zBMI, the SMD was 0.022 (0.020 z-scores), for studies (N = 2) reporting waist circumference (cm), the SMD was 0.149 (1.609 cm); for studies (N = 2) reporting BMI percentile, the SMD was 0.064 (0.985 percentiles); and for studies (N = 1) reporting percent body fat, the SMD was 0.031 (0.30 percentage). CONCLUSIONS Children assigned to control conditions (as part of school-based obesity-related interventions) experience, on average, minimal changes in weight outcomes during the school year. Therefore, routine practices of schools may protect against unhealthy weight gains.
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Affiliation(s)
| | | | | | - Michael W Beets
- University of South Carolina, 921 Assembly St, Columbia, SC 29208
| | - Amy M Bohnert
- Loyola University Chicago, 1032 W. Sheridan Rd, Chicago, IL 60660
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22
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Thompson HR, Hewawitharana SC, Kao J, Rider C, Talmage E, Gosliner W, Whetstone L, Woodward-Lopez G. SNAP-Ed physical activity interventions in low-income schools are associated with greater cardiovascular fitness among 5th and 7th grade students in California. Prev Med Rep 2020; 20:101222. [PMID: 33088679 PMCID: PMC7566844 DOI: 10.1016/j.pmedr.2020.101222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/11/2020] [Accepted: 09/24/2020] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION California's Department of Public Health (CDPH) distributes Supplemental Nutrition Assistance Program-Education (SNAP-Ed) funding, known as CalFresh Healthy Living (CFHL) in California, to local health departments to implement school-based physical activity/nutrition interventions. We determined the association between intervention presence/dose and student cardiorespiratory fitness and BMI. METHODS This cross-sectional, observational study included 5th and 7th grade students with 2016-17 FitnessGram® results who attended SNAP-Ed eligible California schools. Intervention group students attended schools with CDPH-CFHL interventions during October 2015-September 2016 (n = 904 schools; 97,504 students, 49% female); comparison group students attended schools without CDPH-CFHL interventions (n = 3,506 schools; 372,298 students, 49% female). Adjusted multilevel models determined the association between school-level intervention presence/dose and students' cardiorespiratory fitness (estimated VO2max) and BMI z-score, and tested for effect modification by student grade and sex. RESULTS Students attending intervention schools demonstrated greater VO2max (males: 0.18 mL/kg per min, 95% CI: 0.03, 0.34; females = 0.26 mL/kg per min, 95% CI: 0.13, 0.39) and lower BMI z-scores (males: -0.03, 95% CI: -0.05, -0.02; females = -0.02, 95% CI: -0.04, -0.01) than students in comparison schools. Students in schools with the highest intervention levels demonstrated higher VO2max (0.37 (95% CI: 0.06, 0.16) and 0.22 (95% CI: 0.02, 0.42), respectively), than comparison students, with the strongest associations seen for females and 7th graders. CONCLUSION On average, students in schools with CDPH-CFHL physical activity interventions demonstrated better cardiorespiratory fitness and slightly lower BMI z-scores than students in comparable schools without such programing. Investment in these interventions may positively impact students' cardiorespiratory health, though further causal investigation is warranted.
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Affiliation(s)
- Hannah R. Thompson
- University of California, Berkeley School of Public Health 2121 Berkeley Way, 6100 Berkeley, CA 94720-7360, United States
| | - Sridharshi C. Hewawitharana
- University of California Agriculture and Natural Resources Nutrition Policy Institute 2115 Milvia Street, Third Floor Berkeley, CA 94704, United States
| | - Janice Kao
- University of California Agriculture and Natural Resources Nutrition Policy Institute 2115 Milvia Street, Third Floor Berkeley, CA 94704, United States
| | - Carolyn Rider
- University of California Agriculture and Natural Resources Nutrition Policy Institute 2115 Milvia Street, Third Floor Berkeley, CA 94704, United States
| | - Evan Talmage
- University of California Agriculture and Natural Resources Nutrition Policy Institute 2115 Milvia Street, Third Floor Berkeley, CA 94704, United States
| | - Wendi Gosliner
- University of California Agriculture and Natural Resources Nutrition Policy Institute 2115 Milvia Street, Third Floor Berkeley, CA 94704, United States
| | - Lauren Whetstone
- California Department of Public Health Nutrition Education and Obesity Prevention Branch 1616 Capitol Ave. Sacramento, CA 95814, United States
| | - Gail Woodward-Lopez
- University of California Agriculture and Natural Resources Nutrition Policy Institute 2115 Milvia Street, Third Floor Berkeley, CA 94704, United States
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Ling J, Kao TSA, Robbins LB. Body mass index, waist circumference and body fat are positively correlated with hair cortisol in children: A systematic review and meta-analysis. Obes Rev 2020; 21:e13050. [PMID: 32543094 DOI: 10.1111/obr.13050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/18/2020] [Accepted: 05/01/2020] [Indexed: 12/20/2022]
Abstract
The current body of research lacks a meta-analysis of the relationship between hair cortisol concentration (HCC) and anthropometry in children. Therefore, this systematic review and meta-analysis was conducted to examine this relationship and explore possible moderators between HCC and body mass index (BMI/BMI z-score). Eleven databases were searched: CINAHL, Cochrane, Embase, PsycEXTRA, Psychology and Behavioral Sciences, PsycINFO, PubMed, Scopus, Social Sciences Full Text, Sociological Abstracts and Web of Sciences. Random-effects models and exploratory moderator analyses with mixed-effects models were performed using the Comprehensive Meta-Analysis software. The meta-analysis showed small positive correlations between HCC and BMI (r = 0.08, 95% confidence interval [CI]: 0.02, 0.14, n = 18, p = .009), BMI z-score (r = 0.10, 95% CI: 0.03, 0.16, n = 12, p = .003), waist circumference (r = 0.10, 95% CI: 0.04, 0.17, n = 10, p = .001) and body fat including fat mass index (r = 0.06, 95% CI: 0.02, 0.11, n = 3, p = .005). The relationship between HCC and BMI/BMI z-score was significantly moderated by children's sex. Results from this meta-analysis provide initial objective support for a small positive relationship between HCC and anthropometric factors.
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Affiliation(s)
- Jiying Ling
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Tsui-Sui Annie Kao
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Lorraine B Robbins
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
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Mabli J, Bleeker M, Fox MK, Jean-Louis B, Fox M. Randomized Controlled Trial of Healthy Harlem's Get Fit Program: An After-School Intervention for Childhood Overweight and Obesity in the Harlem Children's Zone. Child Obes 2020; 16:479-487. [PMID: 33030989 DOI: 10.1089/chi.2020.0012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Although the increases in overweight and obesity observed for several decades have appeared to have leveled off, the prevalence of overweight and obesity remains exceptionally high among children of color. This article estimates the effect of Healthy Harlem's Get Fit-a 12-week after-school program aimed at helping students improve physical activity and eating habits-on BMI and weight status of adolescents. Methods: Participants were 436 students who had overweight or obesity in 12 Harlem Children's Zone after-school programs in New York. The evaluation was a randomized controlled trial where students were assigned to an intervention group that received Get Fit plus Prevention services or a control group that only received Prevention services in 2013 or 2014. Impacts were assessed on BMI z-score, percentage with overweight or obesity, and percentage with obesity using regression analysis. Results: Relative to the control group, students randomized to Get Fit experienced a decrease in BMI z-score (mean difference = -0.04; p = 0.02). The percentage of students with overweight or obesity was also lower (mean difference = -5.3; p = 0.02), but there was no effect on the percentage of students with obesity. Get Fit had an impact on BMI for girls, but not boys. Conclusions: Get Fit improved middle- and high-school students' BMI outcomes and weight status. Schools continue to face pressure to allocate time for physical education and activity while meeting their academic demands, underscoring the importance of after-school student-level interventions like Get Fit.
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Affiliation(s)
- James Mabli
- Human Services Unit, Mathematica, Cambridge, MA, USA
| | | | - Mary Kay Fox
- Human Services Unit, Mathematica, Cambridge, MA, USA
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Anselma M, Chinapaw MJM, Kornet-van der Aa DA, Altenburg TM. Effectiveness and promising behavior change techniques of interventions targeting energy balance related behaviors in children from lower socioeconomic environments: A systematic review. PLoS One 2020; 15:e0237969. [PMID: 32870928 PMCID: PMC7462275 DOI: 10.1371/journal.pone.0237969] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 08/06/2020] [Indexed: 01/22/2023] Open
Abstract
This systematic review aims to summarize the evidence regarding the effectiveness of interventions targeting energy balance-related behaviors in children from lower socioeconomic environments and the applied behavior change techniques. The literature search was conducted in Cochrane, Embase, Psycinfo and Pubmed. Articles had to be published between January 2000 and September 2019. Studies were included that i) targeted dietary behavior, physical activity and/or sedentary behavior; ii) had a controlled trial design; iii) included children aged 9–12 years old; iv) focused on lower socioeconomic environments; and v) took place in upper-middle or high income countries. Two independent researchers extracted data, identified behavior change techniques using the Behavior Change Technique Taxonomy v1, and performed a methodological quality assessment using the quality assessment tool of the Effective Public Health Practice Project. We included 24 studies, of which one received a high and three a moderate quality rating. Demonstration, practice and providing instructions on how to perform a behavior were the most commonly applied behavior change techniques. Seven studies reported significant beneficial intervention effects: five on physical activity, one on physical activity and sedentary behavior and one on dietary behavior. When comparing effective versus non-effective interventions, and comparing our review to previous reviews focusing on children from the general population, similar behavior change techniques were applied. More high quality research is needed to evaluate the effectiveness of interventions and their behavior change techniques targeting children of low socioeconomic environments. PROSPERO registration number: CRD42016052599
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Affiliation(s)
- Manou Anselma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniëlle A. Kornet-van der Aa
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teatske M. Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Hughes SO, Power TG, Beck A, Betz D, Goodell LS, Hopwood V, Jaramillo JA, Lanigan J, Martinez AD, Micheli N, Olivera Y, Overath I, Parker L, Ramos G, Thompson YP, Johnson SL. Short-Term Effects of an Obesity Prevention Program Among Low-Income Hispanic Families With Preschoolers. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:224-239. [PMID: 31917129 DOI: 10.1016/j.jneb.2019.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 11/25/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To assess the short-term effects of an obesity prevention program promoting eating self-regulation and healthy food preferences in low-income Hispanic children. DESIGN Randomized controlled trial with pretest, posttest, and 6- and 12-month assessments. SETTING AND PARTICIPANTS Head Start and similar early learning institutions in Houston, TX, and Pasco, WA. A total of 255 families with preschoolers randomized into prevention (n = 136) and control (n = 119) groups. INTERVENTION Multicomponent family-based prevention program. Fourteen waves lasted 7 weeks each with 8-10 mother-child dyads in each group. MAIN OUTCOME MEASURES Parent assessments included feeding practices, styles, and knowledge. Child assessments included child eating self-regulation, willingness to try new foods, and parent report of child fruit and vegetable preferences. Parent and child heights and weights were measured. ANALYSIS Multilevel analyses were employed to consider the nested nature of the data: time points within families within waves. RESULTS The program had predicted effects on parental feeding practices, styles, and knowledge in the pre- to post-comparisons. Effects on child eating behavior were minimal; only the number of different vegetables tried showed significant pre-post differences. CONCLUSIONS AND IMPLICATIONS Short-term effects of this prevention program highlight the importance of family-focused feeding approaches to combating child overweight and obesity.
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Affiliation(s)
- Sheryl O Hughes
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA
| | - Ashley Beck
- Department of Human Development, Washington State University, Pullman, WA
| | - Drew Betz
- Department of Human Development, Washington State University, Pullman, WA
| | - L Suzanne Goodell
- Department of Food, Bioprocessing, and Nutritional Sciences, North Carolina State University, Raleigh, NC
| | - Veronica Hopwood
- Department of Human Development, Washington State University, Pullman, WA
| | - J Andrea Jaramillo
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Jane Lanigan
- Department of Human Development, Washington State University, Pullman, WA
| | | | - Nilda Micheli
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Yadira Olivera
- Department of Human Development, Washington State University, Pullman, WA
| | - Irene Overath
- Department of Human Development, Washington State University, Pullman, WA
| | - Louise Parker
- Department of Human Development, Washington State University, Pullman, WA
| | - Guadalupe Ramos
- Department of Human Development, Washington State University, Pullman, WA
| | - Yuri Peralta Thompson
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX
| | - Susan L Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO
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Briançon S, Legrand K, Muller L, Langlois J, Saez L, Spitz E, Quinet MH, Böhme P, Lecomte E, Omorou AY. Effectiveness of a socially adapted intervention in reducing social inequalities in adolescence weight. The PRALIMAP-INÈS school-based mixed trial. Int J Obes (Lond) 2020; 44:895-907. [PMID: 31969652 DOI: 10.1038/s41366-020-0520-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 11/19/2019] [Accepted: 01/03/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND A high prevalence of overweight/obesity among low socioeconomic status adolescents contributes to health inequalities. However, evidence-based interventions for reducing social inequalities in adolescent weight are lacking. We aimed to investigate whether strengthened care management for adolescents with low socioeconomic status has an equivalent effect in reducing overweight as standard care management in adolescents with high status. METHODS PRALIMAP-INÈS was a multicentre trial including 35 state-run high and middle schools in the north-eastern France. A population-based sample of 1639 adolescents aged 13-18 years with screened and clinically confirmed overweight/obesity were proposed for inclusion and divided into two groups by the Family Affluence Scale score: advantaged (score > 5), receiving standard care management (A.S) and less-advantaged randomly assigned to two groups (1:2 ratio): standard care management (LA.S) and standard and strengthened care management (LA.S.S). Interventions were based on the proportionate universalism principle: universal standard care for all groups and proportionate care for the LA.S.S group. Main outcome was body mass index z-score (BMIz) assessed before and 1 year after inclusion. RESULTS A total of 1419 adolescents were included and 1143 followed up at 1 year: 649 in A.S, 158 in LA.S and 336 in LA.S.S groups. BMIz decreased significantly for boys (-0.11 [95% CI, -0.13 to -0.08]; p < 0.0001) and girls (-0.05 [-0.08 to -0.03]; p < 0.0001). No equivalence between LA.S.S and A.S groups was evidenced. For girls, the trend to superiority for LA.S.S was confirmed by the more favourable change (-0.06 [-0.11 to -0.01]; p = 0.01) observed on superiority analysis, with no differential change for boys (0.02 [-0.03 to 0.08]; p = 0.41). CONCLUSIONS A public health school-based intervention using the proportionate universalism principle may be effective in not worsening or even reducing overweight social inequalities in adolescents, especially for girls. Overcoming social barriers may help health professionals dealing with the burden and inequalities of overweight in adolescents.
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Affiliation(s)
- Serge Briançon
- University of Lorraine, EA 4360 APEMAC, Nancy Metz, France.
| | - Karine Legrand
- University of Lorraine, EA 4360 APEMAC, Nancy Metz, France.,CHRU-Nancy, INSERM, University of Lorraine, CIC-1433 Clinical Epidemiology, Nancy, France
| | - Laurent Muller
- University of Lorraine, EA 4360 APEMAC, Nancy Metz, France
| | | | - Laura Saez
- University of Lorraine, EA 4360 APEMAC, Nancy Metz, France
| | | | | | - Philip Böhme
- Department of endocrinology, diabetology and nutrition, Nancy University Hospital, Nancy, France
| | - Edith Lecomte
- National Conservatory of Arts and Crafts, Nancy, France
| | - Abdou Y Omorou
- University of Lorraine, EA 4360 APEMAC, Nancy Metz, France.,CHRU-Nancy, INSERM, University of Lorraine, CIC-1433 Clinical Epidemiology, Nancy, France
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Dunfee M, Cuy Castellanos D. Bridging the gaps between ecology and nutrition: a middle school–university collaboration. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2019. [DOI: 10.1080/19320248.2018.1484312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Madeline Dunfee
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
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The Importance of Self-Monitoring for Behavior Change in Youth: Findings from the SWITCH ® School Wellness Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203806. [PMID: 31658604 PMCID: PMC6843670 DOI: 10.3390/ijerph16203806] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 09/22/2019] [Accepted: 10/02/2019] [Indexed: 12/05/2022]
Abstract
School Wellness Integration Targeting Child Health (SWITCH®) is a school wellness implementation initiative focused on building capacity for schools to plan and coordinate wellness programming. Grounded in Social Cognitive Theory (SCT), the purpose of this study was to evaluate the utility of the web-based, self-regulation system on physical activity (PA) behavior outcomes. At pre-test and post-test, students in SWITCH® schools (n = 8) completed the online Youth Activity Profile (YAP) to assess PA and sedentary behavior (SB). Students (n = 513) were categorized into high or low self-monitoring groups (using a median split) based on their use of the web-based self-regulation platform. Linear mixed models were used to assess differences in moderate-to-vigorous PA (MVPA) and sedentary behavior, with school, classroom, student, time-by-school, and time-by-classroom random effects and main and interaction fixed effects for student self-monitoring, gender, and time. Significant self-monitoring-by-time interactions were observed for estimates of PA F(1, 477) = 5.55, p = 0.02 and SB F(1, 477) = 4.90, p = 0.03. Students in the high self-monitoring group had larger gains in PA per day and larger declines in hours per day of sedentary screen time behavior compared to students in the low self-monitoring group. These findings support the utility of web-based self-regulation for facilitating PA change in youth.
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Bonilla Ibañez CP, Díaz Heredia LP. Características de las intervenciones realizadas con adolescentes en condición de sobrepeso y obesidad: una revisión integrativa. REVISTA CUIDARTE 2019. [DOI: 10.15649/cuidarte.v10i3.681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: Dado que el sobrepeso y la obesidad en la población adolescente van en aumento, es necesario identificar las intervenciones para la prevención y manejo de estas condiciones en el grupo de jóvenes. Objetivo: Presentar la evidencia encontrada, en relación con las características de las intervenciones publicadas en revistas científicas indexadas, sobre la prevención y manejo del sobrepeso y de la obesidad, respecto de la nutrición y la actividad física, para ser utilizada en la toma de decisiones, en cuanto a políticas y programas de promoción y prevención de esta condición de salud. Materiales y Métodos: Se realizó la revisión sistemática de estudios cualitativos y cuantitativos (desde descriptivos hasta experimentales, que incluyeran tanto revisiones sistemáticas como meta-análisis), publicados en el período comprendido entre 2005 y 2017, a través de las bases de datos PubMed y ScienceDirect, las bibliotecas virtuales Ovid y SciELO, y el compendio de revisiones Cochrane. Resultados: Existe gran variedad en diseño e implementación de las intervenciones, en cuanto a componentes, teorías, escenarios, evaluación de los efectos, dosis, tiempo y seguimiento, que tienen efecto en los hábitos nutricionales, en la actividad física, en la autoeficacia y en el índice de masa corporal (IMC) de la población estudiada. Discusión: La efectividad de las intervenciones varía, dependiendo de los componentes y de la fidelidad en la aplicación de la misma, lo cual debe revisarse a la luz de los mejores efectos encontrados. Conclusiones: 47 estudios cumplieron los requisitos de inclusión. Las intervenciones se robustecen con el uso de una teoría que direccione y fundamente los hallazgos que permitan dar mayores y mejores resultados. Los componentes de las intervenciones incluyen: duración, dosis, intensidad de la intervención, respuesta y seguimiento. Los adolescentes prefieren metodologías participativas e interactivas; sin embargo, aún no existe una intervención concreta y claramente definida que pueda ser estandarizada para enfrentar este problema de salud.
Como citar este artículo: Bonilla CP, Díaz LP. Características de las intervenciones realizadas con adolescentes en condición de sobrepeso y obesidad: una revisión integrativa. Rev Cuid. 2019; 10(3): e681. http://dx.doi.org/10.15649/cuidarte.v10i3.681
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Budrewicz S, Banaszczak M, Piotrowski J, Czerwińska M, Stachowska E. Allergens and food additives, including potentially harmful ones, present in food products that are preferred by children and adolescents. DEVELOPMENTAL PERIOD MEDICINE 2019; 21:131-138. [PMID: 28796984 PMCID: PMC8522964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/22/2017] [Indexed: 11/08/2023]
Abstract
INTRODUCTION The proper development of a child is linked with proper nutrition, including nutritional habits which are formed from childhood. THE AIM OF THE STUDY The aim of the study was to establish a list of the most popular food products among children and to develop a register of potentially dangerous substances on a Facebook website. MATERIALS AND METHODS A website was created on Facebook. The participants provided lists of favorite dishes or products. RESULTS The study involved 264 participants. An inverse correlation was observed with reference to the age of the subjects and the occurrence of sugar syrup in their diet (R=-0.20; p<0.001), glucose-fructose (R= -0.18; p< 0.004), and glucose (R=-0.13; p< 0.039) syrups. The most common potential food allergens are: gluten (R=0.28; p<0.001), eggs (R=0.28; p<0.001), and wheat (R=0.25; p<0.001). The main substances added to food that are present in a child's diet that increase proportionally with reference to the child's age are: salicylates (R=0.37; p<0.001), iron and ammonium sulfates (R=0.21; p<0.001). CONCLUSION The choices of favorite products are related to age and sex. Products containing gluten, the consumption of which increases with age, carry a risk of undiagnosed celiac disease and non-celiac gluten sensitivity in people with a genetic predisposition. Facebook has fulfilled its role as an effective tool for gathering information about the food preferences of children and adolescents.
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Affiliation(s)
- Sandra Budrewicz
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Marcin Banaszczak
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Jakub Piotrowski
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Maja Czerwińska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Ewa Stachowska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Socioeconomic Inequalities in the Retail Food Environment around Schools in a Southern European Context. Nutrients 2019; 11:nu11071511. [PMID: 31277242 PMCID: PMC6683257 DOI: 10.3390/nu11071511] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/25/2019] [Accepted: 07/02/2019] [Indexed: 12/14/2022] Open
Abstract
Across Europe, excess body weight rates are particularly high among children and adolescents living in Southern European contexts. In Spain, current food policies appeal to voluntary self-regulation of the food industry and parents’ responsibility. However, there is no research (within Spain) assessing the food environment surrounding schools. We examined the association between neighborhood-level socioeconomic status (NSES) and the spatial access to an unhealthy food environment around schools using both counts and distance measures, across the city of Madrid. We conducted a cross-sectional study citywide (n = 2443 census tracts). In 2017, we identified all schools (n = 1321) and all food retailers offering unhealthy food and beverages surrounding them (n = 6530) using publicly available data. We examined both the counts of retailers (within 400 m) and the distance (in meters) from the schools to the closest retailer. We used multilevel regressions to model the association of neighborhood-level socioeconomic status (NSES) with both measures, adjusting both models for population density. Almost all schools (95%) were surrounded by unhealthy retailers within 400 m (median = 17 retailers; interquartile range = 8–34). After adjusting for population density, NSES remained inversely associated with unhealthy food availability. Schools located in low-NSES areas (two lowest quintiles) showed, on average, 29% (IRR (Incidence Rate Ratio) = 1.29; 95% CI (Confidence Interval) = 1.12, 1.50) and 62% (IRR = 1.62; 95% CI = 1.35, 1.95) more counts of unhealthy retailers compared with schools in middle-NSES areas (ref.). Schools in high-NSES areas were farther from unhealthy food sources than those schools located in middle-NSES areas (β = 0.35; 95% CI = 0.14, 0.47). Regulating the school food environment (within and beyond school boundaries) may be a promising direction to prevent and reduce childhood obesity.
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Gray HL, Buro AW, Barrera Ikan J, Wang W, Stern M. School-level factors associated with obesity: A systematic review of longitudinal studies. Obes Rev 2019; 20:1016-1032. [PMID: 31013544 DOI: 10.1111/obr.12852] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 02/16/2019] [Accepted: 02/25/2019] [Indexed: 01/27/2023]
Abstract
Although school has been an important intervention venue for obesity prevention, the role of school-level factors in obesity development or prevention has not been well-documented. This study aimed to systematically examine the current evidence on school-level factors associated with obesity outcomes in longitudinal studies. The literature search was performed in PubMed, EMBASE, CINHAL, and PsycINFO. Peer-reviewed articles using longitudinal study designs and published in English from 1991 to 2018 were eligible. Twelve articles met eligibility criteria for final systematic review. Nine studies reported significant long-term associations between school-level factors and obesity outcomes. Higher parental education, longer minutes of recess, meeting recommended recess and physical education time, higher socio-economic status, suburban compared with rural area, higher parental involvement in school, and healthful school food environment were significantly associated with lower rates of obesity or obesity trajectory. However, due to the small number of studies and heterogeneity of measures and variables used in their analytic models, the overall level of evidence from this review suggests the importance of further, systematic study. Empirically rigorous research is needed to identify additional aspects of the school context and environment that may contribute to the risk of obesity throughout the life course.
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Affiliation(s)
- Heewon L Gray
- College of Public Health, University of South Florida, Tampa, Florida
| | - Acadia W Buro
- College of Public Health, University of South Florida, Tampa, Florida
| | | | - Wei Wang
- College of Public Health, University of South Florida, Tampa, Florida.,Centre for Addiction and Mental Health, Ontario, Canada
| | - Marilyn Stern
- Department of Child & Family Studies, College of Behavioral & Community Sciences, University of South Florida, Tampa, Florida
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Project Spraoi: a two-year longitudinal study on the effectiveness of a school-based nutrition and physical activity intervention on dietary intake, nutritional knowledge and markers of health of Irish schoolchildren. Public Health Nutr 2019; 22:2489-2499. [PMID: 31203819 DOI: 10.1017/s1368980019001368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the effectiveness of a nutrition and physical activity (PA) intervention on dietary intake (DI), nutritional knowledge (NK), blood pressure (BP), anthropometric measures and cardiorespiratory fitness (CRF) of schoolchildren. DESIGN Longitudinal study. DI, NK, BMI, waist-to-height ratio (WHtR), BP and CRF were all measured/calculated prior to (October 2014) and at the end of (June 2016) intervention delivery. SETTING Two primary schools (one intervention and one control), Cork, Ireland. PARTICIPANTS Six-year-olds (n 49; mean age = 6·09 (sd 0·33) years) and 10-year-olds (n 52; mean age = 9·90 (sd 0·37) years). RESULTS There was a large and a moderate statistically significant difference between the change in systolic (P = 0·005, effect size (ES) = 0·165) and diastolic BP (P = 0·023, ES = 0·116), respectively, for 10-year-olds in the intervention and control groups. There was also a large statistically significant difference between the change in WHtR (P = 0·0005, ES = 0·386) and a moderate statistically significant difference between the change in NK (P = 0·027, ES = 0·107) for 10-year-olds in the intervention and control groups. There was a large statistically significant difference between the change in percentage of energy from protein in 10-year-old females (P = 0·021, ES = 0·276) in the intervention and control groups. CONCLUSIONS Project Spraoi is Ireland's first ever school-based intervention that has been evaluated and proven effective in improving DI, NK, WHtR and BP in older primary-school children in one intervention school.
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Gebremariam MK, Arah OA, Bergh IH, Andersen LF, Bjelland M, Grydeland M, Lien N. Factors affecting the dose of intervention received and the participant satisfaction in a school-based obesity prevention intervention. Prev Med Rep 2019; 15:100906. [PMID: 31194160 PMCID: PMC6551552 DOI: 10.1016/j.pmedr.2019.100906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/13/2019] [Accepted: 05/20/2019] [Indexed: 01/22/2023] Open
Abstract
This study assessed factors associated with the perceived dose of intervention received and with the participant satisfaction in a school-based obesity prevention intervention. It also explored the variance in the dose of intervention received that was at the school level. Process evaluation data from a school-based intervention study conducted in Oslo in 2007-2009 were used. A total of 542 11-year-olds from 12 intervention schools were included. A web-based questionnaire was used to collect data. Descriptive analyses and multilevel regression analyses were conducted. Females and those with medium (vs. low) parental education had higher odds of reporting a high vs. low dose of intervention received at mid-way (8 months after baseline). Perceived social capital and perceived social support for physical activity from friends at baseline were positively associated with the dose of intervention received at mid-way. Perceived social capital at mid-way was positively associated with the dose of intervention reported post-intervention (20 months after baseline). Around 20% of the variance in the perceived dose of intervention received was at the school level. Satisfaction with the intervention was high overall and higher for females for several intervention components at mid-way and at post-intervention. The factors identified in this study should be taken into consideration when planning future obesity prevention interventions among youth.
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Affiliation(s)
- Mekdes K Gebremariam
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, United States.,Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, United States.,UCLA Center for Health Policy Research, Los Angeles, CA, United States.,California Center for Population Research, UCLA, Los Angeles, CA, United States
| | - Ingunn H Bergh
- Department of Health and Inequality, Norwegian Institute of Public Health, Oslo, Norway
| | - Lene F Andersen
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mona Bjelland
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - May Grydeland
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
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Matvienko-Sikar K, Toomey E, Delaney L, Flannery C, McHugh S, McSharry J, Byrne M, Queally M, Heary C, Kearney PM. Behaviour change techniques and theory use in healthcare professional-delivered infant feeding interventions to prevent childhood obesity: a systematic review. Health Psychol Rev 2019; 13:277-294. [DOI: 10.1080/17437199.2019.1605838] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Elaine Toomey
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Lisa Delaney
- School of Public Health, University College Cork, Cork, Ireland
| | - Caragh Flannery
- School of Public Health, University College Cork, Cork, Ireland
| | - Sheena McHugh
- School of Public Health, University College Cork, Cork, Ireland
| | - Jenny McSharry
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Molly Byrne
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Michelle Queally
- Discipline of Economics, JE Cairnes School of Business and Economics, National University of Ireland Galway, Galway, Ireland
| | - Caroline Heary
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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The perception of school food-service professionals on the implementation of the Healthy, Hunger-Free Kids Act of 2010: a mixed-methods study. Public Health Nutr 2019; 22:1960-1970. [PMID: 31010453 DOI: 10.1017/s1368980019001174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To: (i) understand the nutrition attitudes, self-efficacy, knowledge and practices of school food-service personnel (SFP) in Nebraska and (ii) identify potential barriers that schools face in offering healthy school meals that meet the US Department of Agriculture (USDA) nutrition standards. DESIGN Convergent parallel mixed-methods study. SETTING Kindergarten-12th grade schools in Nebraska, USA.ParticipantsSFP (260 survey participants; fifteen focus group participants) working at schools that participate in the USDA National School Lunch Program. RESULTS Mixed-methods themes identified include: (i) 'Mixed attitudes towards healthy meals', which captured a variety of conflicting positive and negative attitudes depending on the situation; (ii) 'Positive practices to promote healthy meals', which captured offering, serving and promotion practices; (iii) 'Mixed nutrition-related knowledge', which captured the variations in knowledge depending on the nutrition concept; and (iv) 'Complex barriers', which captured challenges with time, support and communication. CONCLUSIONS The study produced relevant findings to address the barriers identified by SFP. Implementing multicomponent interventions and providing training to SFP may help reduce some of the identified barriers of SFP.
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"C.H.A.M.P. Families": Description and Theoretical Foundations of a Paediatric Overweight and Obesity Intervention Targeting Parents-A Single-Centre Non-Randomised Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122858. [PMID: 30558152 PMCID: PMC6313348 DOI: 10.3390/ijerph15122858] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 12/22/2022]
Abstract
Childhood obesity represents a significant global health challenge, and treatment interventions are needed. The purpose of this paper is to describe the components and theoretical model that was used in the development and implementation of a unique parent-focussed paediatric overweight/obesity intervention. C.H.A.M.P. Families was a single-centre, prospective intervention offered to parents of children aged between 6–14 years with a body mass index (BMI) ≥85th percentile for age and sex. The intervention included: (1) eight group-based (parent-only) education sessions over 13-weeks; (2) eight home-based activities; and (3) two group-based (family) follow-up support sessions. The first section of the manuscript contains a detailed description of each intervention component, as well as an overview of ongoing feasibility analyses. The theoretical portion details the use of evidence-based group dynamics principles and motivational interviewing techniques within the context of a broader social cognitive theory foundation. This paper provides researchers with practical examples of how theoretical constructs and evidence-based strategies can be applied in the development and implementation of parent-focussed paediatric obesity interventions. Given the need for transparent reporting of intervention designs and theoretical foundations, this paper also adds to the areas of implementation science and knowledge translation research.
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Hagedorn RL, Baker K, DeJarnett SE, Hendricks T, McGowan M, Joseph L, Olfert MD. Katalyst Pilot Study: Using Interactive Activities in Anatomy and Physiology to Teach Children the Scientific Foundation of Healthy Lifestyles. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E162. [PMID: 30487474 PMCID: PMC6306697 DOI: 10.3390/children5120162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 12/04/2022]
Abstract
This pilot study evaluated the impact of the Katalyst curriculum, a fifth-grade experiential learning program, on students' knowledge of a healthy lifestyle's impact on body functions. Katalyst's interactive curriculum spans two days and includes four, 60-min stations on body systems: cardiovascular/endocrine, gastrointestinal, neurological, and respiratory/musculoskeletal. Three schools were recruited, and two schools completed the intervention sessions. Prior to beginning the stations, fifth-grade students completed a 37-item questionnaire to assess knowledge and perceptions. Students completed the same survey at the end of the Katalyst intervention. Teachers at the school also completed a survey post intervention to provide feedback on the program. Frequency and paired analyses were conducted on student responses and summative content analysis on teacher and volunteer feedback. The School 1 completer (n = 63) baseline mean knowledge score was 66.2%. The School 2 completer (n = 47) baseline mean knowledge score was 67.3%. Following the Katalyst intervention, both schools showed a statistically significant increase in the mean post score to 70.3% (p = 0.0017) and 78.4%(p < 0.0001) at School 1 (n = 63) and School 2 (n = 47), respectively. Teacher feedback (n = 7) revealed that Katalyst was effective in meeting state educational health standards and teachers perceived that the students benefitted from the program more than "reading about the body systems in a textbook or health magazine". The Katalyst pilot study appeared to improve fifth-grade students' knowledge of body systems and health. Katalyst aligned with state educational standards and is supported by teachers for an experiential learning opportunity. The Katalyst curriculum could be a potential avenue for health educators in Appalachia.
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Affiliation(s)
- Rebecca L Hagedorn
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources & Design, West Virginia University, G025 Agricultural Science Building, Morgantown, WV 26506, USA.
| | - Kathryn Baker
- School of Medicine, West Virginia University, Morgantown, WV 26506, USA.
| | - Sara E DeJarnett
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources & Design, West Virginia University, G025 Agricultural Science Building, Morgantown, WV 26506, USA.
| | - Tyler Hendricks
- School of Medicine, West Virginia University, Morgantown, WV 26506, USA.
| | - Melissa McGowan
- School of Medicine, West Virginia University, Morgantown, WV 26506, USA.
| | - Lauren Joseph
- School of Medicine, West Virginia University, Morgantown, WV 26506, USA.
| | - Melissa D Olfert
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources & Design, West Virginia University, G025 Agricultural Science Building, Morgantown, WV 26506, USA.
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Interventions for treating children and adolescents with overweight and obesity: an overview of Cochrane reviews. Int J Obes (Lond) 2018; 42:1823-1833. [PMID: 30301964 DOI: 10.1038/s41366-018-0230-y] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 05/17/2018] [Accepted: 06/15/2018] [Indexed: 12/13/2022]
Abstract
Children and adolescents with overweight and obesity are a global health concern. This is an integrative overview of six Cochrane systematic reviews, providing an up-to-date synthesis of the evidence examining interventions for the treatment of children and adolescents with overweight or obesity. The data extraction and quality assessments for each review were conducted by one author and checked by a second. The six high quality reviews provide evidence on the effectiveness of behaviour changing interventions conducted in children <6 years (7 trials), 6-11 years (70 trials), adolescents 12-17 years (44 trials) and interventions that target only parents of children aged 5-11 years (20 trials); in addition to interventions examining surgery (1 trial) and drugs (21 trials). Most of the evidence was derived from high-income countries and published in the last two decades. Collectively, the evidence suggests that multi-component behaviour changing interventions may be beneficial in achieving small reductions in body weight status in children of all ages, with low adverse event occurrence were reported. More research is required to understand which specific intervention components are most effective and in whom, and how best to maintain intervention effects. Evidence from surgical and drug interventions was too limited to make inferences about use and safety, and adverse events were a serious consideration.
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Verjans-Janssen SRB, Van Kann DHH, Gerards SMPL, Vos SB, Jansen MWJ, Kremers SPJ. Study protocol of the quasi-experimental evaluation of "KEIGAAF": a context-based physical activity and nutrition intervention for primary school children. BMC Public Health 2018; 18:842. [PMID: 29980235 PMCID: PMC6035437 DOI: 10.1186/s12889-018-5764-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/26/2018] [Indexed: 11/10/2022] Open
Abstract
Background The environment affects children’s energy balance-related behaviors to a considerable extent. A context-based physical activity and nutrition school- and family-based intervention, named KEIGAAF, is being implemented in low socio-economic neighborhoods in Eindhoven, The Netherlands. The aim of this study was to investigate: 1) the effectiveness of the KEIGAAF intervention on BMI z-score, waist circumference, physical activity, sedentary behavior, nutrition behavior, and physical fitness of primary school children, and 2) the process related to the implementation of the intervention. Methods A quasi-experimental, controlled study with eight intervention schools and three control schools was conducted. The KEIGAAF intervention consists of a combined top-down and bottom-up school intervention: a steering committee developed the general KEIGAAF principles (top-down), and in accordance with these principles, KEIGAAF working groups subsequently develop and implement the intervention in their local context (bottom-up). Parents are also invited to participate in a family-based parenting program, i.e., Triple P Lifestyle. Children aged 7 to 10 years old (grades 4 to 6 in the Netherlands) are included in the study. Effect evaluation data is collected at baseline, after one year, and after two years by using a child questionnaire, accelerometers, anthropometry, a physical fitness test, and a parent questionnaire. A mixed methods approach is applied for the process evaluation: quantitative (checklists, questionnaires) and qualitative methods (observations, interviews) are used. To analyze intervention effectiveness, multilevel regression analyses will be conducted. Content analyses will be conducted on the qualitative process data. Discussion Two important environmental settings, the school environment and the family environment, are simultaneously targeted in the KEIGAAF intervention. The combined top-down and bottom-up approach is expected to make the intervention an effective and sustainable version of the Health Promoting Schools framework. An elaborate process evaluation will be conducted alongside an effect evaluation in which multiple data collection sources (both qualitative and quantitative) are used. Trial registration Dutch Trial Register NTR6716 (registration date 27/06/2017, retrospectively registered), METC163027, NL58554.068.16, Fonds NutsOhra project number 101.253. Electronic supplementary material The online version of this article (10.1186/s12889-018-5764-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S R B Verjans-Janssen
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, Maastricht, The Netherlands.
| | - Dave H H Van Kann
- School of Sport Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Sanne M P L Gerards
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, Maastricht, The Netherlands
| | - Steven B Vos
- School of Sport Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands.,Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Maria W J Jansen
- Academic Collaborative Center for Public Health, Public Health Service South-Limburg, Heerlen, The Netherlands.,Department of Health Services Research, Maastricht University, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Stef P J Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, Maastricht, The Netherlands
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Saez L, Legrand K, Alleyrat C, Ramisasoa S, Langlois J, Muller L, Omorou AY, De Lavenne R, Kivits J, Lecomte E, Briançon S. Using facilitator-receiver peer dyads matched according to socioeconomic status to promote behaviour change in overweight adolescents: a feasibility study. BMJ Open 2018; 8:e019731. [PMID: 29934380 PMCID: PMC6020946 DOI: 10.1136/bmjopen-2017-019731] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To evaluate the feasibility of an innovative peer intervention promoting healthy eating and physical activity, which purposefully selected peer facilitators according to socioeconomic status to target less-advantaged overweight receivers. SETTING Nine high schools, two middle schools. PARTICIPANTS One hundred and fifty-six adolescents were approached to become facilitators, of whom 18 were trained. Thirty-two of 56 potential receivers agreed to participate. INTERVENTION The peer intervention was carried out in 2013-2014 and embedded in a larger trial: PRALIMAP-INÈS (Promotion de l'ALIMentation et l'Activité Physique-INEgalité de Santé). Facilitanoators were selected and trained to organise weight-control activities with specific peer receivers participating in the programme. PRIMARY AND SECONDARY OUTCOME MEASURES Different types of data were collected to assess demand, acceptability, implementation and practicality of the intervention. For the facilitators, this included 6 training sessions, 11 mid-programme interviews, 4 end-of-programme sessions, telephone notes and text message exchanges. All six potential receivers in one school were also interviewed. Sociodemographic and health characteristics were also analysed. RESULTS Agreeing to participate was more likely when asked by a peer compared with a professional (51.2% discordant pairs; p<0.02). Twelve activities, mostly based on physical activity and implemented during weekends or holidays, were carried out. The mean age of active receivers was 16 and their body mass index was higher than other participants. For both facilitators and active receivers, there were more participating girls. Qualitative analysis reveals key implementation challenges for facilitators. Interviews with the receivers highlight social difficulties, with most feeling bad about their appearance and wanting to lose weight. Those who participated in peer activities were very positive about the experience especially social support. CONCLUSIONS The present study suggests the peer intervention is feasible provided organisational difficulties are addressed. Good practice recommendations are formulated, including a longer training session, organising a joint meeting with the facilitators and receivers, matching dyads on place of residence and multiplying modes of contact. TRIAL REGISTRATION NUMBER NCT01688453.
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Affiliation(s)
- Laura Saez
- University of Lorraine, APEMAC EA 4360, Nancy, France
| | - Karine Legrand
- University of Lorraine, APEMAC EA 4360, Nancy, France
- INSERM, CIC-1433, CHRU Nancy, F-54 000, Nancy, France
| | | | | | - Johanne Langlois
- University of Lorraine, APEMAC EA 4360, Nancy, France
- National Conservatory of Arts and Crafts (CNAM), Nancy, France
| | | | - Abdou Yacoubou Omorou
- University of Lorraine, APEMAC EA 4360, Nancy, France
- INSERM, CIC-1433, CHRU Nancy, F-54 000, Nancy, France
| | | | - Joëlle Kivits
- University of Lorraine, APEMAC EA 4360, Nancy, France
| | - Edith Lecomte
- National Conservatory of Arts and Crafts (CNAM), Nancy, France
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Amiri P, Jalali-Farahani S, Akbar HM, Cheraghi L, Khalili D, Momenan A, Mirmiran P, Ghanbarian A, Hedayati M, Hosseini-Esfahani F, Azizi F. The Effects of a Community-Based Lifestyle Intervention on Metabolic Syndrome and Its Components in Adolescents: Findings of a Decade Follow-Up. Metab Syndr Relat Disord 2018; 16:215-223. [PMID: 29648906 DOI: 10.1089/met.2017.0055] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The increasing prevalence of metabolic syndrome (MetS) in childhood makes lifestyle interventions imperative during adolescence. This study aimed to assess the effects of a community-based lifestyle intervention on MetS and its components in adolescents. METHODS Adolescents, based on their residential area were categorized into three groups: complete intervention (residing in the intervention area at baseline and during all follow-ups), incomplete intervention (residing in either the intervention or control areas and were in transition between these two areas), and control group (residing in the control area at baseline and throughout all follow-ups). All measurements were repeated every 3 years for up to 9 years. Lifestyle intervention aimed at achieving healthy dietary patterns and increasing physical activity. Generalized estimating equation models were used to analyze data. RESULTS In boys with incomplete intervention versus controls, the prevalence of MetS was significantly lower in the short term (14.0 vs. 22.9), but not in long term. In boys with complete intervention, the prevalence was significantly lower versus controls (9.0 vs. 23.4) in the long term. In girls, the short-term prevalence of MetS was significantly lower in the complete intervention group compared with controls (2.5 vs. 9.1) and then remained constantly low in all study groups after that. Among MetS components, in boys, triglycerides and fasting plasma glucose in the short term and high-density lipoprotein mid term, and in girls HDL in mid and long term were both significantly improved. The odds of MetS decreased significantly in the complete [odds ratio (OR): 0.516, confidence interval (95% CI): 0.273-0.973] and incomplete (OR: 0.591, 95% CI: 0.358-0.976) intervention groups only in boys. The short- and long-term interventions resulted improvement in some of the MetS components in both genders. CONCLUSIONS The healthy lifestyle intervention reduced the risk of MetS in both genders in short and long term, but with different patterns and improved some of the MetS components.
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Affiliation(s)
- Parisa Amiri
- 1 Research Center for Social Determinants of Health, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Sara Jalali-Farahani
- 1 Research Center for Social Determinants of Health, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Hasti Masihay Akbar
- 1 Research Center for Social Determinants of Health, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Leila Cheraghi
- 1 Research Center for Social Determinants of Health, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Davood Khalili
- 2 Prevention of Metabolic Disorders Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Amirabbas Momenan
- 2 Prevention of Metabolic Disorders Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Parvin Mirmiran
- 3 Nutrition and Endocrine Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Arash Ghanbarian
- 2 Prevention of Metabolic Disorders Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Mehdi Hedayati
- 4 Cellular and Molecular Endocrine Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Firoozeh Hosseini-Esfahani
- 3 Nutrition and Endocrine Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Fereidoun Azizi
- 5 Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran, Iran
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Bleich SN, Vercammen KA, Zatz LY, Frelier JM, Ebbeling CB, Peeters A. Interventions to prevent global childhood overweight and obesity: a systematic review. Lancet Diabetes Endocrinol 2018; 6:332-346. [PMID: 29066096 DOI: 10.1016/s2213-8587(17)30358-3] [Citation(s) in RCA: 233] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 09/20/2017] [Accepted: 09/26/2017] [Indexed: 12/31/2022]
Abstract
In view of the prevalence, health consequences, and costs of childhood obesity, there has been substantial interest in identifying effective interventions to prevent excess weight gain in young people. In this systematic review, we expand on previous reviews of obesity prevention interventions by including recent studies (until May 23, 2017) from all parts of the world. We searched MEDLINE, Embase, CINAHL Plus, Web of Science, CAB Abstracts, and PAIS Index and included randomised controlled trials, quasi-experimental studies, or natural experiments with: (1) a control group; (2) minimum follow-up of 12 months for community-based and home-based interventions or 6 months for school-based and preschool-based interventions; and (3) a primary outcome of BMI, BMI Z score, BMI percentile, body fat percentage, skinfold thickness, waist circumference, or prevalence of overweight or obesity. School-based interventions with combined diet and physical activity components and a home element (n=41) had greatest effectiveness; evidence in support of the effect of preschool-based (n=6), community-based (n=7), and home-based (n=2) interventions was limited by a paucity of studies and heterogeneity in study design. The effectiveness of school-based interventions that combined diet and physical activity components suggests that they hold promise for childhood obesity prevention worldwide. More research with rigorous evaluation and consistent reporting is needed in non-school settings and in combinations of settings.
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Affiliation(s)
- Sara N Bleich
- Department of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Kelsey A Vercammen
- Department of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Laura Y Zatz
- Department of Nutrition and Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Johannah M Frelier
- Department of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Cara B Ebbeling
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, USA
| | - Anna Peeters
- School of Health and Social Development, Deakin University, Burwood, VIC, Australia
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45
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Raber M, Patterson M, Jia W, Sun M, Baranowski T. Utility of eButton images for identifying food preparation behaviors and meal-related tasks in adolescents. Nutr J 2018; 17:32. [PMID: 29477143 PMCID: PMC6389239 DOI: 10.1186/s12937-018-0341-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 02/15/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Food preparation skills may encourage healthy eating. Traditional assessment of child food preparation employs self- or parent proxy-reporting methods, which are prone to error. The eButton is a wearable all-day camera that has promise as an objective, passive method for measuring child food preparation practices. PURPOSE This paper explores the feasibility of the eButton to reliably capture home food preparation behaviors and practices in a sample of pre- and early adolescents (ages 9 to 13). METHODS This is a secondary analysis of two eButton pilot projects evaluating the dietary intake of pre- and early adolescents in or around Houston, Texas. Food preparation behaviors were coded into seven major categories including: browsing, altering food/adding seasoning, food media, meal related tasks, prep work, cooking and observing. Inter-coder reliability was measured using Cohen's kappa and percent agreement. RESULTS Analysis was completed on data for 31 participants. The most common activity was browsing in the pantry or fridge. Few participants demonstrated any food preparation work beyond unwrapping of food packages and combining two or more ingredients; actual cutting or measuring of foods were rare. CONCLUSIONS Although previous research suggests children who "help" prepare meals may obtain some dietary benefit, accurate assessment tools of food preparation behavior are lacking. The eButton offers a feasible approach to food preparation behavior measurement among pre- and early adolescents. Follow up research exploring the validity of this method in a larger sample, and comparisons between cooking behavior and dietary intake are needed.
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Affiliation(s)
- Margaret Raber
- Department of Pediatrics Research, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Monika Patterson
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, USA
| | - Wenyan Jia
- Department of Neurological Surgery, University of Pittsburg, Pittsburg, USA
| | - Mingui Sun
- Department of Neurological Surgery, University of Pittsburg, Pittsburg, USA
| | - Tom Baranowski
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, USA
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46
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Glapa A, Grzesiak J, Laudanska-Krzeminska I, Chin MK, Edginton CR, Mok MMC, Bronikowski M. The Impact of Brain Breaks Classroom-Based Physical Activities on Attitudes toward Physical Activity in Polish School Children in Third to Fifth Grade. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E368. [PMID: 29466285 PMCID: PMC5858437 DOI: 10.3390/ijerph15020368] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 02/15/2018] [Accepted: 02/17/2018] [Indexed: 12/20/2022]
Abstract
The purpose of this study was to examine the effectiveness of the Brain Breaks® Physical Activity Solutions in changing attitudes toward physical activity of school children in a community in Poland. In 2015, a sample of 326 pupils aged 9-11 years old from 19 classes at three selected primary schools were randomly assigned to control and experimental groups within the study. During the classes, children in the experimental group performed physical activities two times per day in three to five minutes using Brain Breaks® videos for four months, while the control group did not use the videos during the test period. Students' attitudes toward physical activities were assessed before and after the intervention using the "Attitudes toward Physical Activity Scale". Repeated measures of ANOVA were used to examine the change from pre- to post-intervention. Overall, a repeated measures ANOVA indicated time-by-group interaction effects in 'Self-efficacy on learning with video exercises', F(1.32) = 75.28, p = 0.00, η2 = 0.19. Although the changes are minor, there were benefits of the intervention. It may be concluded that HOPSports Brain Breaks® Physical Activity Program contributes to better self-efficacy on learning while using video exercise of primary school children.
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Affiliation(s)
- Agata Glapa
- University School of Physical Education in Poznań, Królowej Jadwigi 27/39, 61-871 Poznań, Poland.
| | - Joanna Grzesiak
- University School of Physical Education in Poznań, Królowej Jadwigi 27/39, 61-871 Poznań, Poland.
| | - Ida Laudanska-Krzeminska
- University School of Physical Education in Poznań, Królowej Jadwigi 27/39, 61-871 Poznań, Poland.
| | - Ming-Kai Chin
- HOPSports, Inc., 4262 Blue Diamond Road #102-359, Las Vegas, NV 89139, USA.
| | | | - Magdalena Mo Ching Mok
- Assessment Research Centre, and Department of Psychology, The Education University of Hong Kong, 10 Lo Ping Rd, Taipo, Hong Kong.
| | - Michal Bronikowski
- University School of Physical Education in Poznań, Królowej Jadwigi 27/39, 61-871 Poznań, Poland.
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Budrewicz S, Banaszczak M, Piotrowski J, Czerwińska M, Stachowska E. Allergens and food additives, including potentially harmful ones, present in food products that are preferred by children and adolescents. DEVELOPMENTAL PERIOD MEDICINE 2017. [PMID: 28796984 PMCID: PMC8522964 DOI: 10.34763/devperiodmed.20172102.131138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The proper development of a child is linked with proper nutrition, including nutritional habits which are formed from childhood. THE AIM OF THE STUDY The aim of the study was to establish a list of the most popular food products among children and to develop a register of potentially dangerous substances on a Facebook website. MATERIALS AND METHODS A website was created on Facebook. The participants provided lists of favorite dishes or products. RESULTS The study involved 264 participants. An inverse correlation was observed with reference to the age of the subjects and the occurrence of sugar syrup in their diet (R=-0.20; p<0.001), glucose-fructose (R= -0.18; p< 0.004), and glucose (R=-0.13; p< 0.039) syrups. The most common potential food allergens are: gluten (R=0.28; p<0.001), eggs (R=0.28; p<0.001), and wheat (R=0.25; p<0.001). The main substances added to food that are present in a child's diet that increase proportionally with reference to the child's age are: salicylates (R=0.37; p<0.001), iron and ammonium sulfates (R=0.21; p<0.001). CONCLUSION The choices of favorite products are related to age and sex. Products containing gluten, the consumption of which increases with age, carry a risk of undiagnosed celiac disease and non-celiac gluten sensitivity in people with a genetic predisposition. Facebook has fulfilled its role as an effective tool for gathering information about the food preferences of children and adolescents.
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Affiliation(s)
- Sandra Budrewicz
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Marcin Banaszczak
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Jakub Piotrowski
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Maja Czerwińska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, Szczecin, Poland,Maja Czerwińska Department of Biochemistry and Human Nutrition Pomeranian Medical University in Szczecin ul. Broniewskiego 24, 71-460 Szczecin tel. 607-898-068, fax: (91) 441-48-07
| | - Ewa Stachowska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, Szczecin, Poland
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48
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Legrand K, Lecomte E, Langlois J, Muller L, Saez L, Quinet MH, Böhme P, Spitz E, Omorou AY, Briançon S. Reducing social inequalities in access to overweight and obesity care management for adolescents: The PRALIMAP-INÈS trial protocol and inclusion data analysis. Contemp Clin Trials Commun 2017; 7:141-157. [PMID: 29696179 PMCID: PMC5898577 DOI: 10.1016/j.conctc.2017.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 05/23/2017] [Accepted: 05/29/2017] [Indexed: 01/25/2023] Open
Abstract
Background Despite social inequalities in overweight/obesity prevalence, evidence-based public health interventions to reduce them are scarce. The PRALIMAP-INÈS trial aimed to investigate whether a strengthened-care management for adolescents with low socioeconomic status has an equivalent effect in preventing and reducing overweight as a standard-care management for high socioeconomic status adolescents. Methods PRALIMAP-INÈS was a mixed, prospective and multicenter trial including 35 state-run schools. It admitted overweight or obese adolescents, age 13–18 years old, for 3 consecutive academic years. One-year interventions were implemented. Data were collected before (T0), after (T1) and post (T2) intervention. Among 2113 eligible adolescents who completed questionnaires, 1639 were proposed for inclusion and 1419 were included (220 parental refusals). Two groups were constituted according to the Family Affluence Scale (FAS) score: the less advantaged (FAS≤5) were randomly assigned to 2 groups in a 2/1 ratio. The 3 intervention groups were: advantaged with standard-care management (A.S, n = 808), less advantaged with standard-care management (LA.S, n = 196), and less advantaged with standard and strengthened-care management (LA.S.S, n = 415). The standard-care management was based on the patient education principle and consisted of 5 collective sessions. The strengthened-care management was based on the proportionate universalism principle and consisted of activities adapted to needs. Inclusion results The written parental refusal was less frequent among less advantaged and more overweight adolescents. A dramatic linear social gradient in overweight was evidenced. Discussion The PRALIMAP-INÈS outcomes should inform how effectively a socially adapted public health program can avoid worsening social inequalities in overweight adolescents attending school. Trial registration ClinicalTrials.gov (NCT01688453).
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Affiliation(s)
- Karine Legrand
- Lorraine University, Paris Descartes University, EA 4360 APEMAC, Nancy, France.,Inserm, CIC-1433 Clinical Epidemiology, Nancy University Hospital, Nancy, France
| | - Edith Lecomte
- National Conservatory of Arts and Crafts, Nancy, France
| | - Johanne Langlois
- Lorraine University, Paris Descartes University, EA 4360 APEMAC, Nancy, France.,National Conservatory of Arts and Crafts, Nancy, France
| | - Laurent Muller
- Lorraine University, Paris Descartes University, EA 4360 APEMAC, Nancy, France
| | - Laura Saez
- Lorraine University, Paris Descartes University, EA 4360 APEMAC, Nancy, France
| | | | - Philip Böhme
- Lorraine University, Paris Descartes University, EA 4360 APEMAC, Nancy, France.,Department of Diabetology, Metabolic Diseases and Nutrition, Nancy University Hospital, Nancy, France
| | - Elisabeth Spitz
- Lorraine University, Paris Descartes University, EA 4360 APEMAC, Nancy, France
| | - Abdou Y Omorou
- Lorraine University, Paris Descartes University, EA 4360 APEMAC, Nancy, France.,Inserm, CIC-1433 Clinical Epidemiology, Nancy University Hospital, Nancy, France
| | - Serge Briançon
- Lorraine University, Paris Descartes University, EA 4360 APEMAC, Nancy, France.,Inserm, CIC-1433 Clinical Epidemiology, Nancy University Hospital, Nancy, France
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Chung KF, Chan MS, Lam YY, Lai CSY, Yeung WF. School-Based Sleep Education Programs for Short Sleep Duration in Adolescents: A Systematic Review and Meta-Analysis. THE JOURNAL OF SCHOOL HEALTH 2017; 87:401-408. [PMID: 28463450 DOI: 10.1111/josh.12509] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 08/12/2016] [Accepted: 01/26/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Insufficient sleep among students is a major school health problem. School-based sleep education programs tailored to reach large number of students may be one of the solutions. A systematic review and meta-analysis was conducted to summarize the programs' effectiveness and current status. METHODS Electronic databases were searched up until May 2015. Randomized controlled trials of school-based sleep intervention among 10- to 19-year-old students with outcome on total sleep duration were included. Methodological quality of the studies was assessed using the Cochrane's risk of bias assessment. RESULTS Seven studies were included, involving 1876 students receiving sleep education programs and 2483 attending classes-as-usual. Four weekly 50-minute sleep education classes were most commonly provided. Methodological quality was only moderate, with a high or an uncertain risk of bias in several domains. Compared to classes-as-usual, sleep education programs produced significantly longer weekday and weekend total sleep time and better mood among students at immediate post-treatment, but the improvements were not maintained at follow-up. CONCLUSIONS Limited by the small number of studies and methodological limitations, the preliminary data showed that school-based sleep education programs produced short-term benefits. Future studies should explore integrating sleep education with delayed school start time or other more effective approaches.
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Affiliation(s)
- Ka-Fai Chung
- Department of Psychiatry, University of Hong Kong, Pokfulam, Hong Kong
| | - Man-Sum Chan
- Department of Psychiatry, Queen Mary Hospital, Pokfulam, Hong Kong
| | | | - Cindy Sin-Yee Lai
- Department of Psychiatry, University of Hong Kong, Pokfulam, Hong Kong
| | - Wing-Fai Yeung
- School of Nursing, the Hong Kong Polytechnic University, Kowloon, Hong Kong
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50
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Llargués E, Recasens MA, Manresa JM, Jensen BB, Franco R, Nadal A, Vila M, Recasens I, Pérez MJ, Castell C. Four-year outcomes of an educational intervention in healthy habits in schoolchildren: the Avall 3 Trial. Eur J Public Health 2017; 27:42-47. [PMID: 28177448 DOI: 10.1093/eurpub/ckw199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
| | | | | | | | - Rosa Franco
- Public Health Department, Granollers City Council, Granollers, Spain
| | - Anna Nadal
- Public Health Department, Granollers City Council, Granollers, Spain
| | - Maria Vila
- Internal Medicine Department, Granollers General Hospital, Granollers, Spain
| | - Isabel Recasens
- Primary Health Subdivision (PHS) Granollers-Mollet, Catalan Institute of Health, Granollers, Spain
| | - M José Pérez
- Primary Health Subdivision (PHS) Granollers-Mollet, Catalan Institute of Health, Granollers, Spain
| | - Conxa Castell
- Public Health Agency, Department of Health, Generalitat de Catalunya, Barcelona, Spain
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