A Policy-Based School Intervention to Prevent Overweight and Obesity

Center for Obesity Research and Education, Temple University, 3223 N Broad St, Suite 175, Philadelphia, PA 19140, USA.
PEDIATRICS (Impact Factor: 5.47). 05/2008; 121(4):e794-802. DOI: 10.1542/peds.2007-1365
Source: PubMed


The prevalence and seriousness of childhood obesity has prompted calls for broad public health solutions that reach beyond clinic settings. Schools are ideal settings for population-based interventions to address obesity.
The purpose of this work was to examine the effects of a multicomponent, School Nutrition Policy Initiative on the prevention of overweight (85.0th to 94.9th percentile) and obesity (> 95.0th percentile) among children in grades 4 through 6 over a 2-year period.
Participants were 1349 students in grades 4 through 6 from 10 schools in a US city in the Mid-Atlantic region with > or = 50% of students eligible for free or reduced-price meals. Schools were matched on school size and type of food service and randomly assigned to intervention or control. Students were assessed at baseline and again after 2 years. The School Nutrition Policy Initiative included the following components: school self-assessment, nutrition education, nutrition policy, social marketing, and parent outreach.
The incidences of overweight and obesity after 2 years were primary outcomes. The prevalence and remission of overweight and obesity, BMI z score, total energy and fat intake, fruit and vegetable consumption, body dissatisfaction, and hours of activity and inactivity were secondary outcomes. The intervention resulted in a 50% reduction in the incidence of overweight. Significantly fewer children in the intervention schools (7.5%) than in the control schools (14.9%) became overweight after 2 years. The prevalence of overweight was lower in the intervention schools. No differences were observed in the incidence or prevalence of obesity or in the remission of overweight or obesity at 2 years.
A multicomponent school-based intervention can be effective in preventing the development of overweight among children in grades 4 through 6 in urban public schools with a high proportion of children eligible for free and reduced-priced school meals.

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    • "One area in which a significant amount of research has been collated supporting the effects of social marketing interventions is the area of health and related behaviours. Studies have reported successful promotion and uptake of insecticide-treated nets for malaria prevention (Agha, Van Rossem, Stallworthy, & Kusanthan, 2007), early diagnosis of lung cancer (Athey, Suckling, Tod, Walters, & Rogers, 2012), increased use of condoms and safe sex (Cohen et al., 1999; Kegeles, Hays, & Coates, 1996) and prevention of obesity in school children (Foster et al., 2008), among other behaviours. The reviews of Gordon, McDermott, Stead, and Angus (2006) and Stead, Gordon, Angus, and McDermott (2007) found that for alcohol, tobacco, illicit drugs and physical activity interventions, social marketing techniques were effective. "
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    Journal of Marketing Management 02/2015; 31(3). DOI:10.1080/0267257X.2014.971045
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    • "At 6 months differences were observed in BMI and after 24 months, BMI z-score and WC enhanced and abdominal obesity declined Foster et al., 2008, USA [47] Randomized controlled cluster trial 4-6 th grade school children 2 years Meal supply, nutrition education, nutrition policy, social marketing, parent outreach Weight, BMI z scores, dietary intake, PA 50% decline in overweight incidence but not obesity Plachta-Danielzik et al., 2007, Germany [32] Randomized, controlled trial 6 years old children 1 year Nutrition education, increase in PA and decrease in TV consumption BMI percentiles, healthy eating index Cumulative incidence of overweight after 4 years was less only in children's of high socioeconomic status families Johnston, 2010 et al., Texas [48] Participants were randomized to either the ILI or SH 10-14 years old adolescents 1 year Increasing healthy eating and PA using behavioral strategies to individualize the plans which was parent-guided in SH and trainer guide in ILI group Weight, TSF, zBMI zBMI and TSF declined more in ILI children after 1 and 2 years Jiang et al., 2007, China [49] "
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    Journal of research in medical sciences 12/2014; 19(10):993-1008. · 0.65 Impact Factor
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    • "www.jahonline.org multidisciplinary [9]. Schools are commonplace in promoting healthy eating and physical activity policies [1] but are also ideal environments for such interventions [10]. "
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