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Effectiveness of a health promotion program on overweight in vulnerable children from primary schools (BeE-school): A
Juliana Martins1,2,3,4, Cláudia Augusto1,2,3, Maria José Silva1,3
1School of Nursing, University of Minho, Braga, Portugal.
Insights
A school-based health promotion program significantly reduced obesity indicators in vulnerable children. The intervention, involving teachers and families, showed lasting positive effects on body composition one year later.
Area of Science:
- Public Health
- Pediatrics
- Health Promotion
Background:
- Obesity is a growing global health concern, disproportionately affecting children from lower socioeconomic backgrounds.
- Targeting obesity prevention in vulnerable school-age populations is crucial due to its long-term health implications.
- Primary schools in disadvantaged areas are key settings for implementing effective health interventions.
Purpose of the Study:
- To evaluate the effectiveness of a school-based health promotion program on overweight and obesity in vulnerable primary school children.
- To assess the short-term and long-term impact of the intervention on body composition measures.
Main Methods:
- A cluster-randomized controlled trial involving 735 children from 10 primary schools in Portugal.
- Intervention group received 16 weeks of teacher training in health promotion, classroom implementation, and bi-weekly family challenges.
- Outcomes measured included Body Mass Index z-scores (BMIz), waist-to-height ratio, and waist-to-weight ratio at baseline, post-intervention, and one-year follow-up.
Main Results:
- Post-intervention, children in the intervention group showed significant reductions in BMIz, waist-to-height ratio, and waist-to-weight ratio.
- The reduction in BMIz remained statistically significant one year after the intervention concluded.
- The intervention demonstrated a positive impact on key adiposity measures in the target population.
Conclusions:
- A school-based health promotion program effectively improved body composition in socially vulnerable children.
- The involvement of teachers and families is a key component for successful intervention delivery and sustained results.
- This intervention model offers a promising strategy for combating childhood obesity in at-risk communities.
Background:
Obesity is a complex, multifactorial disease with rising global prevalence. Considering its significant association with lower socioeconomic status, implementing obesity prevention programs in vulnerable school-age children is particularly pertinent. This cluster-randomized controlled trial aims to evaluate the effectiveness of a health promotion program on overweight in vulnerable children from primary schools.
Methods:
The BeE-school study involved 735 children (51.7% boys, average age 7.7 (1.2) years old) from 10 primary schools in the Northern region of Portugal, identified as Educational Territories for Priority Intervention. After the initial assessment, the schools were randomized into two groups: one receiving the intervention (4 schools, n = 353) and the other not (6 schools, n = 382). The intervention included education and training teachers for 16 weeks, their implementation in the classroom, and giving families challenges every two weeks during this length of time. The program's effectiveness was assessed short-term, immediately post-intervention (for 95.5% of participants) and long-term, one year after (for 50.8%). We considered the difference in BMI z-scores (BMIz), waist-to-height ratio and waist-to-weight ratio, from baseline to post-intervention and follow-up assessment.
Results:
In post-intervention, intervened children presented a significant reduction in all the three measures of adiposity: BMIz (B = -0.098, 95% CI: -0.156 to -0.040, p = 0.001), waist-to-height ratio (B = -0.007, 95% CI: -0.010 to -0.003, p < 0.001) and waist-to-weight ratio (B = -0.121, 95% CI: -0.193 to -0.048, p = 0.001). One year after the intervention ended the decrease in BMIz remained significant (B = -0.114, 95% CI: -0.213 to -0.015, p = 0.023).
Conclusion:
Conclusion: The school-based intervention, focusing on teacher training in health promotion and involving families, proved to be effective in improving body composition in socially vulnerable children.
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