Childhood obesity prevention through a community-based cluster randomized controlled physical activity intervention among schools in china: the health legacy project of the 2nd world summer youth olympic Games (YOG-Obesity study)

Abstract

Background:Childhood obesity has been becoming a worldwide public health problem. We conducted a community-based physical activity (PA) intervention program aiming at childhood obesity prevention in general student population in Nanjing of China, the host city of the 2nd World Summer Youth Olympic Games (YOG-Obesity study).Methods:This was a cluster randomized controlled intervention study. Participants were the 4th (mean age±s.e.: 9.0±0.01) and 7th (mean age±s.e.: 12.0±0.01) grade students (mean age±s.e.: 10.5±0.02) from 48 schools and randomly allocated (1:1) to intervention or control groups at school level. Routine health education was provided to all schools, whereas the intervention schools additionally received an 1-year tailored multi-component PA intervention program, including classroom curricula, school environment support, family involvement and fun programs/events. The primary outcome measures were changes in body mass index, obesity occurrence and PA.Results:Overall, 9858 (97.7%) of the 10091 enrolled students completed the follow-up survey. Compared with the baseline, PA level increased by 33.13 min per week (s.e. 10.86) in the intervention group but decreased by 1.76 min per week (s.e. 11.53) in the control group (P=0.028). After adjustment for potential confounders, compared with the control group, the intervention group were more likely to have increased time of PA (adj. Odds ratio=1.15, 95% confidence interval=1.06–1.25), but had a smaller increase in mean body mass index (BMI) (0.22 (s.e. 0.02) vs 0.46 (0.02), P=0.01) and BMI z-score (0.07 (0.01) vs 0.16 (0.01), P=0.01), and were less likely to be obese (adj. Odds ratio=0.7, 95% confidence interval=0.6, 0.9) at study end. The intervention group had fewer new events of obesity/overweight but a larger proportion of formerly overweight/obese students having normal weight by study end.Conclusions:This large community-based PA intervention was feasible and effective in promoting PA and preventing obesity among the general student population in a large city in China. Experiences from this study are the lessons for China to control the childhood obesity epidemic.

Scaling‐up evidence‐based obesity interventions: A systematic review assessing intervention adaptations and effectiveness and quantifying the scale‐up penalty

“…From these searches, initially 21 studies were identified as eligible; however, 11 studies were subsequently excluded at the data‐extraction phase for various reasons: The efficacy trials for the PEACH QLD study and the Active‐For‐Life study reported within‐group improvement—but no between‐group difference—on measures of weight status between the trial arms postintervention; Action Schools! BC, TXT2BFiT, and the YOG‐Obesity studies found no significant difference on a measure of weight status in the pre–scale‐up RCT; Camp NERF had no available data for the pre–scale‐up RCT; CHAT and PASOS had no follow‐up outcome data (authors of these studies were contacted; however, no follow‐up data were able to be supplied); the original pre–scale‐up trial of EPODE was a non‐RCT design; Healthy and Vital did not include a measure of weight status, physical activity, or nutrition as its primary outcome measure; and finally, SHED‐IT tested an additional component in the larger trial where both control and intervention arms received SHED‐IT while the intervention arm also received a weight loss maintenance programme.…”

A sex/gender perspective on interventions to promote children’s and adolescents’ overall physical activity: Results from genEffects systematic review

“…In 58 studies PA was objectively assessed (e.g., accelerometer, pedometer), in 31 subjectively (e.g., diary, questionnaire) and eight studies used both, objective and subjective measurements. Average sample size was 829 participants, ranging from ve (28) to 9,859 (29). Most included studies (84 studies) used behavioral and social approaches, 55 studies were delivered with campaign and informational approaches and 18 studies used policy and environmental approaches.…”

A sex/gender perspective on interventions to promote children’s and adolescents’ overall physical activity: Results from genEffects systematic review

“…In 58 studies PA was objectively assessed (e.g., accelerometer, pedometer), in 31 subjectively (e.g., diary, questionnaire) and eight studies used both, objective and subjective measurements. Average sample size was 829 participants, ranging from ve (31) to 9,859 (32). Control groups of 87 studies received no intervention and continued usual practice.…”