A National School-based Health Lifestyles Interventions Among Chinese Children and Adolescents Against Obesity

A National School-based Health Lifestyles Interventions Among Chinese Children and Adolescents Against Obesity

Development and Application of Appropriate Technology for Obesity Prevention and Control in Seven Centers in China

Peking University, Central South University, Tianjin Medical University, Shanghai Municipal Center for Disease Control and Prevention, Chongqing Medical University, Ningxia Medical University

The study was designed as a national multi-centered cluster randomized controlled trial involving more than 70,000 children and adolescents aged 7-18 years from 7 provinces in China. In each center, about 12-16 primary and secondary schools, with totally at least 10000 participants were randomly selected (Primary: Secondary=1:1). All of the selected schools were randomly allocated to either intervention or control group (Intervention: Control=1:1).The multi-components school-based and family-involved scheme was conducted within the intervention group for 9 month, while students in the control group followed their usual health practice. The intervention consisted of four components: a) Create supportive school and family environment, b) Health lifestyles education and related compulsory physical activities, c) Instruct and promote school physical education, d) Self-monitor obesity related behaviors. Four types of outcomes including anthropometric, behavioral, blood chemical and physical fitness were measured to assess the effectiveness of the intervention program.

Creating a supportive school, family and community environment; Health lifestyles educational strategies; Instruct and promote school physical education; The monitoring and instruction of obesity related behaviors (focus group)

Creating supportive school and family environment, whole intervention periods; Health lifestyles educational strategies, 30min/week for education lessons and six times education activities; Instruct and promote school physical education, whole intervention periods; The monitoring and instruction of obesity related behaviors, once a week for physical activity and dietary behavioral log and once a month for parental monitor

Change in obesity related anthropometric measurements (waist circumference, hip circumference, blood pressure and skin fold thickness)

Change in physical activity and dietary behaviors (Dietary, sedentary or physical activity behaviors and their determents, as measured by validated questionnaires (parent, children and school version)

Change in serum lipids and fasting glucose (fasting plasma glucose, fasting triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol)

Change in physical fitness (standing-board jump, 50 meters speed run, 50 meters × 8 shuttle run (primary students) and run 800/1000 meters (secondary school students)

Inclusion Criteria: grade of 1 to 5 in primary schools and grade of 6 to 8 and 10 to 11 in secondary schools. Exclusion Criteria: Suffering or any history of disabilities, cardiovascular diseases, asthma, metabolic diseases, etc.

Shanghai Municipal Center for Disease Control and Prevention & Shanghai Institutes of Preventive Medicine

Neil-Sztramko SE, Caldwell H, Dobbins M. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev. 2021 Sep 23;9(9):CD007651. doi: 10.1002/14651858.CD007651.pub3.

Dong Y, Zou Z, Wang H, Dong B, Hu P, Ma Y, Song Y, Ma J. National School-Based Health Lifestyles Intervention in Chinese Children and Adolescents on Obesity and Hypertension. Front Pediatr. 2021 May 28;9:615283. doi: 10.3389/fped.2021.615283. eCollection 2021.

Diao H, Wang H, Yang L, Li T. The impacts of multiple obesity-related interventions on quality of life in children and adolescents: a randomized controlled trial. Health Qual Life Outcomes. 2020 Jul 6;18(1):213. doi: 10.1186/s12955-020-01459-0.

Zou Z, Yang Z, Yang Z, Wang X, Gao D, Dong Y, Ma J, Ma Y. Association of high birth weight with overweight and obesity in Chinese students aged 6-18 years: a national, cross-sectional study in China. BMJ Open. 2019 May 22;9(5):e024532. doi: 10.1136/bmjopen-2018-024532.