Implementing School-Based Policies to Prevent Obesity: Cluster Randomized Trial

被引:43
|
作者
Ickovics, Jeannette R. [1 ,2 ]
Duffany, Kathleen O'Connor [1 ]
Shebl, Fatma M. [1 ]
Peters, Sue M. [3 ]
Read, Margaret A. [4 ]
Gilstad-Hayden, Kathryn R. [5 ]
Schwartz, Marlene B. [4 ]
机构
[1] Yale Sch Publ Hlth, 60 Coll St,POB 208034, New Haven, CT 06520 USA
[2] Yale NUS Coll, Singapore, Singapore
[3] New Haven Publ Sch, New Haven, CT USA
[4] Univ Connecticut, Rudd Ctr Food Policy & Obes, Hartford, CT 06112 USA
[5] Yale Sch Med, Dept Psychiat, New Haven, CT USA
关键词
CHILDHOOD OBESITY; WELLNESS POLICIES; PHYSICAL-ACTIVITY; COMPETITIVE FOOD; WEIGHT-STATUS; NUTRITION; INTERVENTIONS; METAANALYSIS; COMMUNITY; EDUCATION;
D O I
10.1016/j.amepre.2018.08.026
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Introduction: Healthier school environments can benefit students, and school wellness policies may result in meaningful enhancements. Schools participating in federal child nutrition programs must implement wellness policies as mandated by law. The primary study objective is to assess effectiveness of implementing school-based nutrition and physical activity policies on student BMI trajectories. Study design: Cluster randomized trial using 2 x 2 factorial design. Setting/participants: Twelve randomly selected schools in an urban district. Students were followed for 3 years through middle school, fifth to eighth grades (2011-2015, n=595 students, 92.3% participation, 85.2% retention). Intervention: Specific to randomized condition, support was provided for implementation of nutrition policies (e.g., alternatives to food-based rewards/celebrations) and physical activity policies (e.g., opportunities for physical activity during/after school). Main outcome measures: Sex-/age-adjusted BMI percentile and BMI z-score; behavioral indicators. Data collected via standardized protocols. Results: Analyses followed intention-to-treat principles, with planned secondary analyses (conducted 2016-2018). Students at schools randomized to receive support for nutrition policy implementation had healthier BMI trajectories over time (F=3.20, p=0.02), with a greater magnitude over time and cumulatively significant effects 3 years post-intervention (beta=-2.40, p=0.04). Overall, students at schools randomized to receive the nutrition intervention had an increase in BMI percentile of <1%, compared with students in other conditions, whereas BMI percentile increased 3%-4%. There was no difference in student BMI between those in schools with and without physical activity policy implementation. Examining behavioral correlates in eighth grade, students at schools randomized to the nutrition condition consumed fewer unhealthy foods and sugar-sweetened beverages, and ate less frequently at fast-food restaurants (all p<0.03). Conclusions: This cluster randomized trial demonstrated effectiveness of providing support for implementation of school-based nutrition policies, but not physical activity policies, to limit BMI increases among middle school students. Results can guide future school interventions. (C) 2019 Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.
引用
收藏
页码:E1 / E11
页数:11
相关论文
共 50 条
  • [41] Detailed statistical analysis plan for a cluster randomised controlled trial of the Healthy Lifestyles Programme (HeLP), a novel school-based intervention to prevent obesity in school children
    Creanor, Siobhan
    Lloyd, Jenny
    Hillsdon, Melvyn
    Dean, Sarah
    Green, Colin
    Taylor, Rod S.
    Ryan, Emma
    Wyatt, Katrina
    TRIALS, 2016, 17
  • [42] Detailed statistical analysis plan for a cluster randomised controlled trial of the Healthy Lifestyles Programme (HeLP), a novel school-based intervention to prevent obesity in school children
    Siobhan Creanor
    Jenny Lloyd
    Melvyn Hillsdon
    Sarah Dean
    Colin Green
    Rod S. Taylor
    Emma Ryan
    Katrina Wyatt
    Trials, 17
  • [43] Tackling childhood obesity through a school-based physical activity programme: a cluster randomised trial
    Santina, Tania
    Beaulieu, Dominique
    Gagne, Camille
    Guillaumie, Laurence
    INTERNATIONAL JOURNAL OF SPORT AND EXERCISE PSYCHOLOGY, 2021, 19 (03) : 342 - 358
  • [44] Two-year controlled effectiveness trial of a school-based intervention to prevent obesity in Chilean children
    Kain, Juliana
    Leyton, Barbara
    Cerda, Ricardo
    Vio, Fernando
    Uauy, Ricardo
    PUBLIC HEALTH NUTRITION, 2009, 12 (09) : 1451 - 1461
  • [45] Implementing a Multicomponent School-Based Obesity Prevention Intervention: A Qualitative Study
    Greaney, Mary L.
    Hardwick, Cary K.
    Spadano-Gasbarro, Jennifer L.
    Mezgebu, Solomon
    Horan, Christine M.
    Schlotterbeck, Sara
    Austin, S. Bryn
    Peterson, Karen E.
    JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR, 2014, 46 (06) : 576 - 582
  • [46] School-based strategies for oral health education of adolescents- a cluster randomized controlled trial
    Abdul Haleem
    Muhammad Irfanullah Siddiqui
    Ayyaz Ali Khan
    BMC Oral Health, 12
  • [47] Protocol for a cluster-randomized trial of a school-based skin cancer preventive intervention for adolescents
    Wu, Yelena P.
    Stump, Tammy K.
    Hay, Jennifer L.
    Buller, David B.
    Jensen, Jakob D.
    Grossman, Douglas
    Shen, Jincheng
    Haaland, Benjamin A.
    Jones, Jacey
    Tercyak, Kenneth P.
    CONTEMPORARY CLINICAL TRIALS, 2024, 140
  • [48] Effect of a Scalable School-Based Intervention on Cardiorespiratory Fitness in Children A Cluster Randomized Clinical Trial
    Lonsdale, Chris
    Sanders, Taren
    Parker, Philip
    Noetel, Michael
    Hartwig, Timothy
    Vasconcellos, Diego
    Lee, Jane
    Antczak, Devan
    Kirwan, Morwenna
    Morgan, Philip
    Salmon, Jo
    Moodie, Marj
    McKay, Heather
    Bennie, Andrew
    Plotnikoff, Ronald C.
    Cinelli, Renata
    Greene, David
    Peralta, Louisa
    Cliff, Dylan
    Kolt, Gregory
    Gore, Jennifer
    Gao, Lan
    Boyer, James
    Morrison, Ross
    Hillman, Charles
    Shigeta, Tatsuya T.
    Tan, Elise
    Lubans, David R.
    JAMA PEDIATRICS, 2021, 175 (07) : 680 - 688
  • [49] School-based strategies for oral health education of adolescents- a cluster randomized controlled trial
    Haleem, Abdul
    Siddiqui, Muhammad Irfanullah
    Khan, Ayyaz Ali
    BMC ORAL HEALTH, 2012, 12
  • [50] PREVENTING HEAVY ALCOHOL USE IN ADOLESCENTS: CLUSTER RANDOMIZED TRIAL OF THREE SCHOOL-BASED INTERVENTIONS
    Koning, I. M.
    Vollebergh, W. A. M.
    Smit, F.
    Verdurmen, J. E. E.
    van den Eijnden, R. J. J. M.
    ter Bogt, T. F. M.
    Stattin, H.
    Engels, R. C. M. E.
    ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH, 2009, 33 (06) : 42A - 42A