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

Abstract

BackgroundThe 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/DesignThe 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.DiscussionThis 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 registrationJanuary 22, 2015; Registration number: NCT02343588

Waist Circumference is Better Than Other Anthropometric Indices for Predicting Cardiovascular Disease Risk Factors in Chinese Children—a Cross-Sectional Study in Guangzhou

“…Biochemical indicators, including GL, TG, TC, HDL-C, and LDL-C, were tested at a biomedical analyses company, which is accredited by Peking University. GL was measured by glucose oxidase method; TG and TC were measured by enzymatic methods; and HDL-C and LDL-C were measured by clearance method 15) .…”

“…This study was conducted as part of the baseline survey of a multi-center interventional project titled "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" 15) . The present paper described a sub-sample of primary school students which was obtained in Guangzhou, Guangdong prov-which was the best anthropometric index, two statistical methods was used.…”

“…Through a multistage cluster sampling, we first randomly selected five primary schools from the 10 urban districts from September to October 2013, and in a second stage, all of the students in grade 2 -5 and aged 8 -12 years in these schools were invited to participate in this survey (n 2563; boys: 1283, girls: 1280). The detailed sampling method was described in the previous study 15) . All of the included students took weight, height, WC, hip circumference, and blood pressure (BP) measurements, and 62.8% of them agreed to participate in blood sample collection and measurement of biochemical variables, including fasting glucose (GL), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) (n 1609; boys: 810, girls: 799).…”

National Blood Pressure Reference for Chinese Han Children and Adolescents Aged 7 to 17 Years

“…The procedures of two projects followed were in accordance with the guidelines, details of which have been published previously. 18, 19 In brief, data were anonymized and de-identified prior to analysis to protect their privacy. For both projects, the students underwent a complete medical examination before data collection and were excluded if they had one or more of the following conditions: (1) serious organ disease (e.g., heart, lung, liver, kidney); (2) abnormal physical development (e.g., dwarfism, gigantism); (3) physical impairment or deformity (e.g., severe scoliosis, pectus carinatum, limp, obvious O leg, X leg); or (4) acute disease symptoms (e.g., diarrhea, high fever) during the past month and not yet recovered.…”

“…The survey was conducted in September 2013 and adopted a standardized and uniform research protocol, described in detail previously. 19 In short, a multistage cluster random sampling was used to obtain a representative sample of children and adolescents aged 7–18 years. Several districts from each province were randomly selected in the first stage.…”