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Background and evaluation design of a community-based health-promoting school intervention: Fit Lifestyle at School and at Home (FLASH).
van Dongen, BM, Ridder, MAM, Steenhuis, IHM, Renders, CM
BMC public health. 2019;(1):784
Abstract
BACKGROUND A community-based approach can be a promising strategy for implementing school-based health promotion aimed at stimulating healthy physical activity and dietary behaviour. Such an approach builds on the community capacity of multiple stakeholders, empowering them to design and implement tailored activities, supported by the whole school community. This paper describes the background and evaluation design of the community-based school intervention 'Fit Lifestyle at School and at Home' (FLASH) in four prevocational schools. FLASH includes four strategies for building the community capacity of students, school personnel and parents: 1) identifying leaders in each stakeholder group, 2) stimulating a school culture of participation, 3) having stakeholders design and implement tailored activities and 4) creating a network of local partners for structural embedding. The objective is to monitor the capacity-building processes of the FLASH intervention and to explore if these processes contribute to changes in community capacity. In addition, we will explore if the FLASH intervention is related to changes in PA, dietary behaviours and BMI of students. METHODS This study has a mixed methods design and uses a participatory action-oriented approach to monitor and evaluate changes in community capacity, tailored health-promotion activities and implementation processes. Methods include semi-structured interviews, focus groups, journals, document analysis and observational scans of the physical environment. In addition, changes in BMI, physical activity and dietary behaviours of prevocational students will be explored by comparing the four intervention schools to four control schools. Data are collected by questionnaires and anthropometric measurements. DISCUSSION The main strength of this study is its use of mixed methods to evaluate real-life processes of creating a healthy-school community. This will provide valuable information on capacity-building strategies for the structural embedding of health-promotion activities within school settings. The results could help schools become more empowered to adapt and adopt integral health-promotion interventions in daily practice that suit the needs of their communities, that are expected to be sustainable and that could lead to favourable changes in the PA and dietary behaviour of students. TRIAL REGISTRATION ISRCTN67201841 ; date registered: 09-05-2019, retrospectively registered.
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Effectiveness of a 16-month multi-component and environmental school-based intervention for recovery of poor income overweight/obese children and adolescents: study protocol of the health multipliers program.
Patriota, PF, Filgueiras, AR, de Almeida, VBP, Alexmovitz, GAC, da Silva, CE, de Carvalho, VFF, Carvalho, N, de Albuquerque, MP, Domene, SMA, do Prado, WL, et al
BMC public health. 2017;(1):708
Abstract
BACKGROUND Excess of weight is a serious public health concern in almost all countries, afflicting people of different ages and socioeconomic backgrounds. Studies have indicated the need for developing treatment strategies that intervene directly in the obesogenic environment. This study aims to evaluate the effectiveness of a multi-component and environmental school-based intervention, lasting 16 months, on the recovery of the nutritional status of low-income children and adolescents with overweight/ obesity. METHODS/STUDY DESIGN The study was conducted by the Center for Recovery and Nutritional Education (CREN) in São Paulo, Brazil. Two schools located in poor neighborhoods were selected for the intervention, between March 2016 and June 2017. The participants were all students aged 8 to 12 years from the two participating schools. At the beginning of the intervention, anthropometric measurements were carried out to assess the nutritional status of the students. For convenience, students from one of the schools were considered as the control group, while those from the other school formed the experimental group. The intervention in the experimental group (n = 438) consists of the following weekly activities at school: psychological counseling in groups, theoretical/practical nutrition workshops, and supervised physical education classes. In addition, theoretical and practical educational activities are held regularly for parents, teachers, and cooks. Students with excess of weight (≥1 body mass index [BMI] -for-age Z score, n = 138) received clinical and nutritional care periodically at the outpatient care at CREN. Students enrolled in the control group (n = 353) participated in psychological counseling groups and theoretical/practical nutrition workshops for 6 months held in the school environment to provide motivation to entire classrooms. In the following 10 months, students with excess of weight from the control group (n = 125) were invited to attend the routine outpatient care at CREN. DISCUSSION This study is the first to assess the effectiveness of a multi-component and environmental school-based intervention for the recovery of low-income, overweight/obese children and adolescents. If positive, the results demonstrate the feasibility for the recovery of excess of weight in populations of similar conditions and age. TRIAL REGISTRATION Brazilian Registry of Clinical Trials - ReBEC Primary Id Number RBR-9t2jr8 . Registration Date: Nov. 30, 2016. Retrospectively registered. Protocol version: 3.
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Effectiveness of a 5-year school-based intervention programme to reduce adiposity and improve fitness and lifestyle in Indian children; the SYM-KEM study.
Bhave, S, Pandit, A, Yeravdekar, R, Madkaikar, V, Chinchwade, T, Shaikh, N, Shaikh, T, Naik, S, Marley-Zagar, E, Fall, CH
Archives of disease in childhood. 2016;(1):33-41
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Abstract
DESIGN Non-randomised non-blinded school-based intervention study. SETTING Two schools in the cities of Pune and Nasik, India. PARTICIPANTS The intervention group comprised children attending a Pune school from 7-10 years until 12-15 years of age. Two control groups comprised children of the same age attending a similar school in Nasik, and children in the Pune intervention school but aged 12-15 years at the start of the study. INTERVENTION A 5-year multi-intervention programme, covering three domains: physical activity, diet and general health, and including increased extracurricular and intracurricular physical activity sessions; daily yoga-based breathing exercises; making physical activity a 'scoring' subject; nutrition education; healthier school meals; removal of fast-food hawkers from the school environs; and health and nutrition education for teachers, pupils and families. MAIN OUTCOME MEASURES Body mass index (BMI), waist circumference, physical fitness according to simple tests of strength, flexibility and endurance; diet; and lifestyle indicators (time watching TV, studying and actively playing). RESULTS After 5 years the intervention children were fitter than controls in running, long jump, sit-up and push-up tests (p<0.05 for all). They reported spending less time sedentary (watching TV and studying), more time actively playing and eating fruit more often (p<0.05). The intervention did not reduce BMI or the prevalence of overweight/obesity, but waist circumference was lower than in the Pune controls (p=0.004). CONCLUSIONS It was possible to achieve multiple health-promoting changes in an academically competitive Indian school. These changes resulted in improved physical fitness, but had no impact on the children's BMI or on the prevalence of overweight/obesity.
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The effect of a healthy lifestyle programme on 8-9 year olds from social disadvantage.
Breslin, G, Brennan, D, Rafferty, R, Gallagher, AM, Hanna, D
Archives of disease in childhood. 2012;(7):618-24
Abstract
AIMS: This study assessed the efficacy of a school-based healthy lifestyle intervention (Sport for LIFE) for increasing physical activity, decreasing sedentary behaviour, reducing screen time behaviour, encouraging healthy attitudes and behaviour to nutrition, and reducing body mass index (BMI) in 8-9-year-old primary school children from lower socioeconomic backgrounds in Northern Ireland. METHODS A non-randomised controlled trial of 416 children from 24 schools took part. Schools were randomly assigned to one of two groups, an intervention or control group with 12 schools in each group. The intervention group received a 12-week school-based programme based on social cognitive theory. At baseline and follow-up, groups completed questionnaires assessing physical activity, screen time behaviour and dietary patterns. On each occasion anthropometric assessments of height and weight were taken. Physical activity and sedentary behaviour were measured by accelerometry. RESULTS Significant effects were observed for vigorous, moderate and light activity for the intervention group at follow-up. Sedentary behaviour was significantly reduced for the intervention group but not for the control group. No significant effects of the intervention on BMI, screen time behaviour or attitudes to nutrition, with the exception of non-core foods, were shown. CONCLUSIONS The programme was effective in increasing physical activity and reducing sedentary behaviour, however no significant changes in screen time behaviour and attitude to nutrition, with the exception of non-core foods, were observed. Future research ideas are offered for tackling low levels of physical activity in children.
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A motivational school-based intervention for adolescent sleep problems.
Cain, N, Gradisar, M, Moseley, L
Sleep medicine. 2011;(3):246-51
Abstract
OBJECTIVE The current study aimed to develop and evaluate a motivational school-based intervention for adolescent sleep problems. METHODS The intervention was implemented in three co-educational secondary schools in Adelaide, South Australia. Two year-11 Psychology classes from each school participated, with one as the intervention class (N=53) and one as the control class (N=51). Students in the intervention classes attended four 50-min sleep education classes, held once per week. The lessons were modified from those of Moseley and Gradisar [23] to incorporate a motivational interviewing framework. Students completed an online questionnaire battery measuring school day and weekend sleep parameters, daytime sleepiness, and depression at pre- and post-program and follow-up, and completed motivation to change questionnaires during the program. RESULTS Students in the intervention group significantly increased their knowledge about sleep relative to the control group (p=0.001). During the intervention, students' motivation to regularize their out-of-bed times improved (p=0.03), and there was a trend towards improved motivation to increase average total sleep time (p=0.11). But despite improvements in sleep and daytime functioning for adolescents in the program group (p<0.05), these changes were not significantly different from the control group (all p>0.05). CONCLUSIONS School-based interventions are promising for educating adolescents about sleep. Future programs should translate increased motivation into long-term behavioral change. The identification of barriers and support to assist this change is recommended.
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Evaluating the effectiveness of the Kids Living Fit program: a comparative study.
Speroni, KG, Earley, C, Atherton, M
The Journal of school nursing : the official publication of the National Association of School Nurses. 2007;(6):329-36
Abstract
After-school programs can be implemented by school nurses to facilitate healthy lifestyle choices in children with the goal of decreasing obesity. Kids Living Fit (KLF), an after-school program designed by community hospital nurses, was implemented in elementary schools and focused on best lifestyle choices regarding foods consumed and activities chosen for children in grades 2 through 5. Study measures included comparison of body mass index (BMI) percentiles for age and gender and waist circumference between two self-selected groups composing a total sample size of 185 participants: the KLF intervention group (n = 80) and the no-intervention/ contrast group (n = 105). The 12-week intervention included a weekly fitness program and monthly dietitian presentations. Participants completed food and activity diaries and wore pedometers. In pairwise comparisons, the KLF group had a significant decrease in BMI percentile between baseline and follow-up (-2.3%) compared with the contrast group. The KLF group also demonstrated a smaller increase in waist circumference than the contrast group.
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[Nutritional information for children to modify the food habits of the whole family].
Borys, JM, Lafay, L
Revue medicale de la Suisse romande. 2000;(3):207-9
Abstract
The prevention of weight gain and cardiovascular diseases is probably easier, less expensive and more effective than treating these diseases after they have fully developed. The hypothesis of a prospective intervention study in northern France, the "Fleurbaix Laventie Ville Santé Study" is that nutritional education of children aged 6-12 years at school may not only improve their nutritional knowledge but also influence the dietary habits of the family. We have conducted an information program in school for these children and made an evaluation of the educational program used in this study and the modification of the dietary habits. The first results indicate a better nutritional knowledge in children of Fleurbaix and Laventie versus control children. The families have better dietary habits consuming less fat, more carbohydrates. In women the BMI is less important in Fleurbaix and Laventie compared with the control subjects. This study is on going with a 10 year-follow up taking into account the spontaneous evolution in a control town.