Overweight
Conditions
Keywords
children, primary prevention, environmental change, behavioural change, school setting, changing of drinking habits, promotion of drinking tap water
Brief summary
A major goal in public health is to find effective, feasible and simple programs for overweight prevention among children. This controlled intervention study evaluates a simple environmental and behavioral modification for its efficacy in preventing overweight of children in the school setting. The intervention strategy focuses solely on the promotion of drinking tap water. The study was conducted in 32 elementary schools including about 3000 children in two German cities over 1 school year.
Detailed description
Soft drinks and other caloric beverages are supposed to be involved in the development of overweight and obesity in children. The intervention strategy of our study was to promote water consumption by facilitating access to tap water in schools assuming a concomitant decrease in caloric soft drinks at least at school. The environmental modification of installing a water dispenser at school and delivering a special bottle to each child in the intervention schools was supported by a few educational lessons. These lessons were held by the class teachers who received a prepared 6-hour curriculum dealing with the importance of water for the body and of water intake. For the study 17 randomly selected schools were assigned to the intervention group, 15 schools to the control group that did not receive any intervention. Body weight and height to calculate BMI as primary outcome were assessed at baseline and after the intervention period of 1 school year. As secondary outcome drinking and physical activity habits were evaluated at baseline and after the intervention. The water flow of the dispenser was measured at regular intervals. In addition, data of process evaluation was collected to measure acceptance and feasibility of the intervention in the school setting. To analyze the efficacy of this primarily environmental and behavioral intervention, incidence and prevalence was compared between intervention and control group.
Interventions
BEHAVIORALenvironmental and behavioral change
In intervention schools a water dispenser was installed and children received water bottles as environmental intervention. Children also received a 6-hour-curriculum about the importance of water for the body that were held by the teachers.
Sponsors
Research Institute of Child Nutrition, Dortmund
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
7 Years to 9 Years
Healthy volunteers
Yes
Inclusion criteria
* All children in 2nd and 3rd grade of selected elementary schools
Exclusion criteria
* parental consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overweight | one school year | Prevalence of overweight defined acording to the criteria of the International Obesity Task Force (IOTF) |
Secondary
| Measure | Time frame |
|---|---|
| Parameters of Process Evaluation (Acceptance, Feasibility) | 1,5 years |
| Water Flow of the Water Dispensers | one school year |
| Intake of Drinks | one school year |
| Physical Activity and Inactivity | one school year |
Participant flow
Recruitment details
second and third graders of participating schools
Participants by arm
| Arm | Count |
|---|---|
| Control Group Schools did not receive any intervention. | 1,469 |
| Intervention Group Schools received water fountains, drinking bottles and lessons as intervention. | 1,721 |
| Total | 3,190 |
Baseline characteristics
| Characteristic | Control Group | Intervention Group | Total |
|---|---|---|---|
| Age Continuous | 8.3 years STANDARD_DEVIATION 0.7 | 8.3 years STANDARD_DEVIATION 0.7 | 8.3 years STANDARD_DEVIATION 0.7 |
| Prevalence of overweight non-overweight | 1091 participants | 1317 participants | 2408 participants |
| Prevalence of overweight overweight | 378 participants | 404 participants | 782 participants |
| Sex: Female, Male Female | 734 Participants | 853 Participants | 1587 Participants |
| Sex: Female, Male Male | 735 Participants | 868 Participants | 1603 Participants |
Outcome results
Primary
Overweight
Prevalence of overweight defined acording to the criteria of the International Obesity Task Force (IOTF)
Time frame: one school year
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Control Group | Overweight | 683 participants |
| Intervention Group | Overweight | 385 participants |
Comparison: adjusted for overweight at baseline, age at baseline,sex and clustering by schoolp-value: <0.0595% CI: [0.48, 0.98]Regression, Logistic
Secondary
Intake of Drinks
Time frame: one school year
Secondary
Parameters of Process Evaluation (Acceptance, Feasibility)
Time frame: 1,5 years
Secondary
Physical Activity and Inactivity
Time frame: one school year
Secondary
Water Flow of the Water Dispensers
Time frame: one school year