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Moving more and sitting less in schools: What's the next step?
Strieter, L, Arena, R, Huizar, M
Progress in cardiovascular diseases. 2021;:22-26
Abstract
Schools serve as the ideal location for implementing interventions to increase physical activity (PA) as children spend most of their day in the school setting. As adolescents become more and more sedentary and obesity statistics become more dire, efforts to increase physical literacy and PA should be heightened. Physical literacy is the ability for a child to understand the movement of their body and how it can be manipulated to increase activity for recreation or sports movement. When physical literacy is paired with school-based multi-component programs, children are more likely to make a behavior change. As educators know, children are more likely to make a behavior change when mastery of content is achieved, and the lesson is tailored to their needs. Even small changes, like moving a little more or adding an additional serving of vegetables to the diet, can make a profound impact. In the current review we discuss: 1) the state of PA within school systems; 2) provide a rationale for why school systems fail to meet said guidelines; and 3) suggest how guidelines can eventually be achieved through the promotion of physical literacy and effective school-based multi component programs.
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School Health Program: Impacting Physical Activity Behaviors Among Disadvantaged Students.
Dai, CL
The Journal of school health. 2019;(6):468-475
Abstract
BACKGROUND Children from disadvantaged backgrounds are more apt to experience lower availability of nutritious foods, lack opportunities to exercise, and lack access to recreational facilities, and thus, are more likely to be obese and at greater risk for developing chronic diseases. We review school health education programs' impact on physical activity behaviors among disadvantaged students. METHODS The inclusion criteria of the study were articles: published in English with full text between 2011 and 2017; focused on school health education programs for disadvantaged school-aged students; assessed programs including a physical activity component; examined school-aged children and adolescents' physical activity behaviors; and assessed programs with comparison groups. RESULTS There were 13 studies matching inclusion criteria in this review. The results of this review indicated that school-based health education programs which included culturally appropriate physical activity, parent involvement, and enhanced student motivation and choice of activities appeared to increase physical activity levels among disadvantaged school-aged students. Health education programs should also emphasize behavioral change skills, such as goal setting and self-motivation, to positively impact on students' physical activity behaviors. CONCLUSIONS School-based health education programs may help increase access to physical activity among disadvantaged populations.
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Barriers to the Implementation of Pediatric Overweight and Obesity Guidelines in a School-Based Health Center.
Yeager, LJ, Karp, SM, Leming-Lee, T'
The Nursing clinics of North America. 2019;(1):159-168
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Abstract
This project applied a quality improvement design to assess perceived barriers to pediatric overweight and obesity guideline implementation in school-based health centers. An electronic survey was administered to nurse practitioners and licensed practical nurses working in school-based health centers in New York. The most commonly cited primary care-based barriers were lack of patient compliance, family lifestyle, and the poor dietary practices and sedentary behaviors common in America. The most commonly cited school-based barriers were that children have little control over the groceries purchased and foods cooked at home and the lack of parent presence during appointments.
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4.
Potential interventions targeting adolescent nutrition in Indonesia: a literature review.
Oddo, VM, Roshita, A, Rah, JH
Public health nutrition. 2019;(1):15-27
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OBJECTIVE The present study aimed to take stock of nutrition interventions that warrant consideration as a minimum package of interventions in Indonesia to improve four key nutrition indicators for adolescents: stunting, thinness, overweight and anaemia. DESIGN We conducted a review of the peer-reviewed literature published between 1995 and 2017 on nutrition-specific and nutrition-sensitive interventions that target adolescents in Indonesia. The search to identify studies was conducted in PubMed, Google Scholar and EMBASE, using key search terms. We also explored programmatic and policy documents from the grey literature as they related to adolescents and/or Indonesia. Our search yielded thirty-five peer-reviewed articles and programmatic documents. SETTING Indonesia. SUBJECTS Adolescent girls and boys. RESULTS There is very limited evidence on the impact of interventions specifically among adolescents in Indonesia. Nevertheless, findings from our review suggest the minimum package of interventions in Indonesia could include the following nutrition-specifc interventions: (i) iron-folic acid supplements, paired with antihelminths delivered at scale via school-based platforms and through health centres; and (ii) diet counselling and nutrition education provided through school-based platforms, adolescent youth centres/peer education and technology-based platforms. The minimum package could also include the following nutrition-sensitive interventions: (i) improving access to reproductive health services; and (ii) increasing the coverage of interventions designed to increase school attendance. CONCLUSIONS Programmes and policies targeting adolescent nutrition are relatively new and coverage is low. To improve the nutritional status of this vulnerable population, additional evaluations of adolescent programming and surveillance data on adolescents are needed.
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Supporting Obesity Prevention in Statewide Quality Rating and Improvement Systems: A Review of State Standards.
Geary, NA, Dooyema, CA, Reynolds, MA
Preventing chronic disease. 2017;:E129
Abstract
INTRODUCTION A quality rating and improvement system (QRIS) is a fundamental component of most states' early care and education infrastructures. States can use a QRIS to set standards that define high-quality care and award child care providers with a quality rating designation based on how well they meet these standards. The objective of this review was to describe the extent to which states' QRIS standards include obesity prevention content. METHODS We collected publicly available data on states' QRIS standards. We compared states' QRIS standards with 47 high-impact obesity prevention components in Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, 3rd Edition, and 6 additional topics based on the Centers for Disease Control and Prevention's Spectrum of Opportunities for Obesity Prevention in the Early Care and Education Setting. RESULTS Thirty-eight states operated a state-wide QRIS in early 2015. Of those, 27 states' QRIS included obesity prevention standards; 20 states had at least one QRIS standard that aligned with the high-impact obesity prevention components, and 21 states had at least one QRIS standard that aligned with at least one of the 6 additional topics. QRIS standards related to the physical activity high-impact obesity prevention components were the most common, followed by components for screen time, nutrition, and infant feeding. CONCLUSION The high proportion of states operating a QRIS that included obesity prevention standards, combined with the widespread use of QRISs among states, suggests that a QRIS is a viable way to embed obesity prevention standards into state early care and education systems.
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Nutrition Education and Body Mass Index in Grades K-12: A Systematic Review.
Price, C, Cohen, D, Pribis, P, Cerami, J
The Journal of school health. 2017;(9):715-720
Abstract
BACKGROUND Overweight and obese body mass index (BMI) status affects an increasing number of children in the United States. The school setting has been identified as a focus area to implement obesity prevention programs. METHODS A database search of PubMed, Education Search Complete, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted for peer-reviewed articles published between January 2005 and December 2015 pertaining to programs offered in the school setting to grades K-12 in the United States with a nutrition education component and measured BMI percentile or BMI z-score as an outcome. RESULTS Seven studies focused on elementary (K-5) populations and 2 studies focused on grades 6-8. Among the 9 identified studies, those with long-term (greater than 1 year) implementation showed more pronounced results with positive impact on reducing overweight/obese BMI measures. CONCLUSIONS This set of studies suggests that long-term nutrition education delivered in the school setting can provide children with tools to attain a healthy weight status. Additional studies examining participants' BMI status years after the initial study, and studies examining programs in grades 9-12 are needed to determine the most effective delivery time and methods.
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Improving School Experiences for Adolescents With Type 1 Diabetes.
Kise, SS, Hopkins, A, Burke, S
The Journal of school health. 2017;(5):363-375
Abstract
BACKGROUND Diabetes mellitus (diabetes) is one of the most common metabolic diseases in children worldwide and the incidence of type 1 diabetes (T1D) is growing. T1D is complicated to manage and adolescents with diabetes face unique, age-specific challenges. The purpose of this article is to discuss ways in which schools can create a positive environment and improve the experiences and outcomes for adolescents with T1D. METHODS The Cumulative Index of Nursing and Allied Health Literature (CINAHL) and PubMed databases were searched and yielded a total of 27 articles that were used in this integrative literature review. RESULTS Common concerns identified by students with T1D and their parents included a lack of full-time school nurses, lack of teacher knowledge of diabetes, lack of access to diabetes tools, lack of freedom to perform diabetes self-care, lack of nutritional information in cafeterias, and lack of communication between parents and school personnel. Students who are unable to attend school on a daily basis may not be able to achieve their academic potential. CONCLUSIONS Implications for school health including specifics for school nurses, teachers, students, and school environment were identified.
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Physical activity and nutrition education at the school environment aimed at preventing childhood obesity: evidence from systematic reviews.
Guerra, PH, da Silveira, JA, Salvador, EP
Jornal de pediatria. 2016;(1):15-23
Abstract
OBJECTIVE To organize the main findings and list the most frequent recommendations from systematic reviews of interventions developed at the school environment aimed at reducing overweight in children and adolescents. DATA SOURCE Searches for systematic reviews available until December 31, 2014 were conducted in five electronic databases: Cochrane, PubMed, SciELO, SPORTDiscus, and Web of Science. Manual search for cross-references were also performed. SUMMARY OF THE FINDINGS Of the initial 2139 references, 33 systematic reviews adequately met the inclusion criteria and were included in the descriptive summary. In this set, interventions with periods of time greater than six months in duration (nine reviews), and parental involvement in the content and/or planned actions (six reviews) were identified as the most frequent and effective recommendations. Additionally, it was observed that boys respond more effectively to structural interventions, whereas girls respond to behavioral interventions. None of the included reviews was able to make inferences about the theoretical basis used in interventions as, apparently, those in charge of the interventions disregarded this component in their preparation. CONCLUSIONS Although the summary identified evidence with important applications in terms of public health, there are still gaps to be filled in this field of knowledge, such as the effectiveness of different theoretical models, the identification of the best strategies in relation to gender and age of participants and, finally, the identification of moderating variables to maximize the benefits provided by the interventions.
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The effects of school-based lifestyle interventions on body mass index and blood pressure: a multivariate multilevel meta-analysis of randomized controlled trials.
Oosterhoff, M, Joore, M, Ferreira, I
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2016;(11):1131-1153
Abstract
Primary prevention of childhood obesity and related hypertension is warrant given that both risk factors are intertwined and track into adulthood. This systematic review and meta-analysis assess the impact of school-based lifestyle interventions on children's body mass index (BMI) and blood pressure. We searched databases and prior reviews. Eligibility criteria were the following: randomized controlled trial design, evaluation of a school-based intervention, targeting children aged 4-12 years, reporting on BMI and/or related cardiovascular risk factors, reporting data on at least one follow-up moment. The effects on BMI, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were evaluated by means of univariate and multivariate three-level random effects models. A total of 85 RCTs (91 papers) were included in the meta-analyses. In univariate models, the pooled effects were -0.072 (95%CI: -0.106; -0.038) for BMI, -0.183 (95%CI: -0.288; -0.078) for SBP and -0.071 (95%CI: -0.185; 0.044) for DBP. In multivariate analyses, the pooled effects of interventions were -0.054 (95%CI: -0.131; 0.022) for BMI, -0.182 (95%CI: -0.266; -0.098) for SBP and -0.144 (95%CI: -0.230; -0.057) for DBP. Parental involvement accentuated the beneficial effects of interventions. School-based lifestyle prevention interventions result in beneficial changes in children's BMI and blood pressure, and the effects on the latter may be stronger than and accrue independently from those in the former.
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Preventing childhood obesity in Asia: an overview of intervention programmes.
Uijtdewilligen, L, Waters, CN, Müller-Riemenschneider, F, Lim, YW
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2016;(11):1103-1115
Abstract
The rapid economic growth in Asia in the past few decades has contributed to the global increase in childhood obesity prevalence. Yet, little is known about obesity prevention efforts in this region. This systematic review provides an overview of child obesity prevention programmes in Asia. Searches were performed in six electronic databases. Out of 4,234 studies, 17 were included, among them 11 controlled trials (of which five were randomized). Only one study was published before 2007. Identified studies were predominantly conducted in China and Thailand and targeted primary school children in a school setting. Most studies implemented different programmes, frequently targeting behavioural modification through nutrition/health education lectures and/or physical activity sessions. Programme effects related to obesity outcome measures were mixed. Most substantial effects were found for outcomes such as improved health knowledge and/or favourable lifestyle practices. The relatively small number of relevant publications in Asia highlights the need for scientific evaluations of existing and future programmes. This will help ensure the implementation and dissemination of evidence-based approaches that have been proven to be effective in the Asian context. Targeting preschool settings and applying a comprehensive multisectoral approach may increase the effectiveness and sustainability of childhood obesity prevention programmes.