Overweight Prevention Implemented by Primary School Teachers: A Randomised Controlled Trial

Abstract

Objective: To describe the effects of URMEL-ICE, a German school-based intervention for overweight prevention, on children’s BMI and other measures of fat mass. Methods: A cluster-randomised controlled design was used. The intervention which focused on physical activity, TV time and soft drink consumption was integrated into a second-grade curriculum and was implemented by classroom teachers themselves. It comprised 29 teaching lessons, 2 short exercise blocks per day and 6 family homework lessons. BMI was assessed as primary outcome measure, waist circumference and skinfold thickness as secondary outcomes. Data of 945 children were analysed. Results: Multivariate analyses adjusted for baseline values showed no statistically significant effect of the intervention on BMI, but on waist circumference (–0.85; 95% confidence interval (95% CI) –1.59 to –0.12) and subscapular skinfold thickness (–0.64; 95% CI –1.25 to –0.02). After additional adjustment for individual time lag between baseline and follow-up, these effects were reduced to –0.60 (95% CI –1.25 to 0.05) and –0.61 (95% CI –1.26 to 0.04) and lost their statistical significance. Conclusion: This study contributes to the field of randomised school-based studies on overweight prevention and shows that within a 1-year, integrated intervention no effect on BMI, but a tendency towards effects on fat mass can be achieved.

A Systematic Review to Assess Sugar-Sweetened Beverage Interventions for Children and Adolescents across the Socioecological Model

“…Of these studies, 21 (38%) used intrapersonal and/or interpersonal strategies (Level 1) 46–80 , 18 (33%) utilized environmental or policy strategies (Level 2) 81–107 , and 16 (29%) used a combination of intrapersonal and/or interpersonal and environmental and/or policy strategies (Combined Level) 108–132 . Across all levels, the total proportion of RE-AIM reporting was 29%.…”

“…About half of the 55 studies were randomized controlled trials 46,49–55,57–63,65–71,73–75,77–80, 83–85, 96–98, 109–110, 112–118, 121–124, 127–129, 133 (29; 53%). The remaining studies utilized quasi-experimental designs, with either a two-group 64,76,86–90,104,106,111,119–120,125,130–132 (11; 20%), or one-group pretest-posttest 47–48,56,72,81–82,91–95,99–103,105,107–108,126 (15; 27%) design.…”

“…In seven of the one-group designs, the pre- and post-tests were administered to different samples 93–95,99–100,105, 107,126 . Nearly three-quarters of the interventions and policies (39; 71%) were implemented in schools or multiple settings including schools 46, 49–55, 57–64, 70–72, 76, 80, 86–102, 104–108, 110–111, 114–133 . Additional settings included home 66–67,109,112–113 (4; 7%), clinic 47–48,56,65,68–69,73–75,77–79 (7; 13%), and community-based organizations 81–85,103 (5; 9%).…”

“…Twenty of 55 (36%) studies identified SSB as their sole focus 56, 62–64, 70–72, 84–85, 90, 96, 98–99, 105–106, 109, 112–113, 120–125, 133 . Of the 55 studies, a third (19; 35%) were conducted internationally 46, 49–54, 57–60, 62–64, 77–80, 100, 106, 109–110, 115–124, 127–129, 133 . Of these, 15 (79%) were conducted in countries similar in economic development to the U.S. 46,49–54, 57–60,62–64,77–79,106,115–124,127–129,133 .…”

“…Of the 55 studies, a third (19; 35%) were conducted internationally 46, 49–54, 57–60, 62–64, 77–80, 100, 106, 109–110, 115–124, 127–129, 133 . Of these, 15 (79%) were conducted in countries similar in economic development to the U.S. 46,49–54, 57–60,62–64,77–79,106,115–124,127–129,133 . Twenty-two reported using a behavioral theory during development (40%) 46–54, 57–61, 64–68, 77–79, 82–83, 96–98, 110, 114–118, 121–124, 127–129, 133 .…”