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A national school-based health lifestyles interventions among Chinese children and adolescents against obesity: rationale, design and methodology of a randomized controlled trial in China.

Chen Y, Ma L, Ma Y, Wang H, Luo J, Zhang X, Luo C, Wang H, Zhao H, Pan D, Zhu Y, Cai L, Zou Z, Yang W, Ma J, Jing J - BMC Public Health (2015)

Bottom Line: There is an urgent need to develop effective interventions to prevent childhood obesity.The results of and lesson learned from this study will help guide future school-based national childhood obesity prevention programs in Mainland China.January 22, 2015; NCT02343588.

View Article: PubMed Central - PubMed

Affiliation: Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China. chenyj68@mail.sysu.edu.cn.

ABSTRACT

Background: The prevalence of obesity among children and adolescents has been rapidly rising in Mainland China in recent decades, both in urban and rural areas. There is an urgent need to develop effective interventions to prevent childhood obesity. Limited rigid data regarding children and adolescent overweight prevention in China are available. A national random controlled school-based obesity intervention program was developed in the mainland of China.

Methods/design: The study was designed as a national multi-centered cluster randomized controlled trial involving more than 70,000 children and adolescents aged 7-18 years from 7 provinces in China. In each center, about 12-16 primary and secondary schools, with totally at least 10000 participants were randomly selected (Primary: Secondary = 1:1). All of the selected schools were randomly allocated to either intervention or control group (Intervention: Control = 1:1).The multi-components school-based and family-involved scheme was conducted within the intervention group for 9 month, while students in the control group followed their usual health practice. The intervention consisted of four components: a) Create supportive school and family environment, b) Health lifestyles education and related compulsory physical activities, c) Instruct and promote school physical education, d) Self-monitor obesity related behaviors. Four types of outcomes including anthropometric, behavioral, blood chemical and physical fitness were measured to assess the effectiveness of the intervention program.

Discussion: This is the first and largest multi-centered school-based obesity intervention program with the consideration of geographical and social-demographic characteristics of the rapidly increased obesity prevalence of Chinese children and adolescent. The intervention is based on Social Cognitive Theory and Social-Ecological Model of Health, and follows a stepwise approach guided by PRECEDE-PROCEED (P-P) Model and Intervention Map. The results of and lesson learned from this study will help guide future school-based national childhood obesity prevention programs in Mainland China.

Trial registration: January 22, 2015;

Registration number: NCT02343588.

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Related in: MedlinePlus

The Process of the intervention strategies design. Health Lifestyles Interventions is a multi-components school-based and family-involved scheme. It was developed through the process: a) Social and epidemiological assessment, b) Educational and ecological assessment, c) Administrative and policy assessment, d) Pilot study.
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Fig3: The Process of the intervention strategies design. Health Lifestyles Interventions is a multi-components school-based and family-involved scheme. It was developed through the process: a) Social and epidemiological assessment, b) Educational and ecological assessment, c) Administrative and policy assessment, d) Pilot study.

Mentions: Health Lifestyles Interventions is a multi-components school-based and family-involved scheme which takes place over nine month and aims to deliver a general healthy lifestyle message encouraging a healthy energy balance. Literature review, qualitative interview and piloting has demonstrated that it is useful to focus on changing specific behavior patterns related to energy intake and expenditure, such as a decrease in the consumption of sweetened fizzy drinks; increasing the consumption of vegetables; increasing the ratio of healthy to unhealthy snacks; a reduction in sedentary behavior activities; and at least one hour moderate to vigorous PA (Figure 3). Firstly, creating a supportive school and family environment, including learn about what is known about obstacles and success factors that influence the development and implementation of these programs for the target group, setting the foundation for successful delivery of subsequent components; Secondly, the intensive Health lifestyles educational strategies involving health education lessons and related compulsory activities towards children and parents; Thirdly, instruct and promote school physical education; Fourthly, set up the monitoring and instruction of obesity related behaviors based on the messages learned before (Table 1).Figure 3


A national school-based health lifestyles interventions among Chinese children and adolescents against obesity: rationale, design and methodology of a randomized controlled trial in China.

Chen Y, Ma L, Ma Y, Wang H, Luo J, Zhang X, Luo C, Wang H, Zhao H, Pan D, Zhu Y, Cai L, Zou Z, Yang W, Ma J, Jing J - BMC Public Health (2015)

The Process of the intervention strategies design. Health Lifestyles Interventions is a multi-components school-based and family-involved scheme. It was developed through the process: a) Social and epidemiological assessment, b) Educational and ecological assessment, c) Administrative and policy assessment, d) Pilot study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4355994&req=5

Fig3: The Process of the intervention strategies design. Health Lifestyles Interventions is a multi-components school-based and family-involved scheme. It was developed through the process: a) Social and epidemiological assessment, b) Educational and ecological assessment, c) Administrative and policy assessment, d) Pilot study.
Mentions: Health Lifestyles Interventions is a multi-components school-based and family-involved scheme which takes place over nine month and aims to deliver a general healthy lifestyle message encouraging a healthy energy balance. Literature review, qualitative interview and piloting has demonstrated that it is useful to focus on changing specific behavior patterns related to energy intake and expenditure, such as a decrease in the consumption of sweetened fizzy drinks; increasing the consumption of vegetables; increasing the ratio of healthy to unhealthy snacks; a reduction in sedentary behavior activities; and at least one hour moderate to vigorous PA (Figure 3). Firstly, creating a supportive school and family environment, including learn about what is known about obstacles and success factors that influence the development and implementation of these programs for the target group, setting the foundation for successful delivery of subsequent components; Secondly, the intensive Health lifestyles educational strategies involving health education lessons and related compulsory activities towards children and parents; Thirdly, instruct and promote school physical education; Fourthly, set up the monitoring and instruction of obesity related behaviors based on the messages learned before (Table 1).Figure 3

Bottom Line: There is an urgent need to develop effective interventions to prevent childhood obesity.The results of and lesson learned from this study will help guide future school-based national childhood obesity prevention programs in Mainland China.January 22, 2015; NCT02343588.

View Article: PubMed Central - PubMed

Affiliation: Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China. chenyj68@mail.sysu.edu.cn.

ABSTRACT

Background: The prevalence of obesity among children and adolescents has been rapidly rising in Mainland China in recent decades, both in urban and rural areas. There is an urgent need to develop effective interventions to prevent childhood obesity. Limited rigid data regarding children and adolescent overweight prevention in China are available. A national random controlled school-based obesity intervention program was developed in the mainland of China.

Methods/design: The study was designed as a national multi-centered cluster randomized controlled trial involving more than 70,000 children and adolescents aged 7-18 years from 7 provinces in China. In each center, about 12-16 primary and secondary schools, with totally at least 10000 participants were randomly selected (Primary: Secondary = 1:1). All of the selected schools were randomly allocated to either intervention or control group (Intervention: Control = 1:1).The multi-components school-based and family-involved scheme was conducted within the intervention group for 9 month, while students in the control group followed their usual health practice. The intervention consisted of four components: a) Create supportive school and family environment, b) Health lifestyles education and related compulsory physical activities, c) Instruct and promote school physical education, d) Self-monitor obesity related behaviors. Four types of outcomes including anthropometric, behavioral, blood chemical and physical fitness were measured to assess the effectiveness of the intervention program.

Discussion: This is the first and largest multi-centered school-based obesity intervention program with the consideration of geographical and social-demographic characteristics of the rapidly increased obesity prevalence of Chinese children and adolescent. The intervention is based on Social Cognitive Theory and Social-Ecological Model of Health, and follows a stepwise approach guided by PRECEDE-PROCEED (P-P) Model and Intervention Map. The results of and lesson learned from this study will help guide future school-based national childhood obesity prevention programs in Mainland China.

Trial registration: January 22, 2015;

Registration number: NCT02343588.

Show MeSH
Related in: MedlinePlus