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Updated: Feb 17, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Cluster-randomised controlled trial to assess the effectiveness and cost-effectiveness of an obesity prevention
Bai Li1, Wei Jia Liu2, Peymane Adab1
1Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Insights
This study evaluated a multicomponent childhood obesity intervention in China. The intervention, developed using the UK Medical Research Council (MRC) framework, targeted diet and physical activity in primary school children.
Area of Science:
- Public Health
- Pediatrics
- Health Intervention Research
Background:
- Childhood obesity rates in China are rising rapidly.
- There is a significant need for effective prevention interventions.
- Existing interventions often lack rigorous development and evaluation.
Purpose of the Study:
- To evaluate the clinical and cost-effectiveness of a complex multicomponent intervention for childhood obesity prevention in China.
- To assess the implementation process of the intervention using the UK Medical Research Council (MRC) framework.
- To provide a model for developing and evaluating obesity prevention programs in non-western populations.
Main Methods:
- A cluster-randomised controlled trial involving 40 primary schools in Guangzhou, China.
- The 12-month intervention targeted diet and physical activity behaviors, including family involvement.
- Primary outcome: difference in mean body mass index (BMI) z-score between intervention and control arms.
- Statistical analysis using mixed linear models, adjusted for baseline BMI z-score and school clustering (intention-to-treat).
Main Results:
- Pre-results indicate the trial is registered (ISRCTN11867516) and ongoing.
- The study is designed to detect a difference of 0.17 units in mean BMI z-score.
- Economic evaluation includes cost per quality-adjusted life year (QALY) and cost per change in BMI z-score.
Conclusions:
- This study represents a rigorous evaluation of a childhood obesity prevention program in a Chinese context.
- Findings will inform the development and implementation of similar interventions globally.
- Dissemination of results planned through international peer-reviewed journals and conferences.
Introduction:
Childhood obesity in China has increased more rapidly and over a shorter time period than in other countries. However, there is a paucity of rigorously developed and evaluated prevention interventions. We aim to evaluate the clinical and cost-effectiveness as well as the implementation process of a complex multicomponent intervention developed using the UK Medical Research Council (MRC) framework. This study provides one of the first examples of rigorous development and evaluation of a childhood obesity prevention programme in a non-western population using the MRC methods.
Methods And Analysis:
A cluster-randomised controlled trial in 40 primary schools in Guangzhou, China, including children aged 6-7 years at baseline. Schools will be randomly allocated to either the usual practice (n=20) or intervention arm (n=20). The 12-month intervention consists of four components targeting diet and physical activity behaviours in and outside school, with family involvement. The primary objective is to compare the difference in mean body mass index (BMI) z-score between the intervention and control arms at the end of the intervention (starting March/April 2017). A sample size of 1640 pupils recruited from 40 schools is sufficient to detect a difference of 0.17 units in the mean BMI z-score with a power of 80% (ICC=0.01. ICC, intraclass correlation coefficient) and a significance level of 5%. Treatment effects will be tested using a mixed linear model in STATA adjusting for the child baseline BMI z-score and clustering by school. All analyses will be by intention to treat. Secondary analyses will additionally adjust for prespecified school-level and child-level covariates. The incremental cost-effectiveness ratio for the intervention versus usual practice will be 'cost per quality-adjusted life year (QALY)'. Cost per change in BMI z-score will also be assessed. A range of methods will be used to evaluate intervention implementation, mechanisms of impact and contextual factors.
Ethics And Dissemination:
Ethical approval was obtained from the Life and Health Sciences Ethical Review Committee at the University of Birmingham and the Ethical Committee of Guangzhou Centre for Disease Control and Prevention. The primary, secondary, process evaluation and economic evaluation results of the trial will be disseminated through relevant international peer-reviewed journals and conferences.
Trial Registration Number:
ISRCTN11867516; Pre-results.
