Design of a multi-component controlled randomized community study for obesity prevention in school children: Research protocol

Authors

  • Laura González Céspedes Instituto Regional de Investigación en Salud, Universidad Nacional de Caaguazú. Coronel Oviedo, Paraguay. Departamento de Nutrición, Dirección de Investigación, Facultad de Ciencias Químicas, Universidad Nacional de Asunción. San Lorenzo, Paraguay.
  • Gabriela Fretes Instituto Regional de Investigación en Salud, Universidad Nacional de Caaguazú. Coronel Oviedo, Paraguay. Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Jaharis Family Center for Biomedical and Nutrition Sciences, Tufts University. Boston, Estados Unidos.
  • Patricia Ríos Instituto Regional de Investigación en Salud, Universidad Nacional de Caaguazú. Coronel Oviedo, Paraguay.
  • Gladys Estigarribia Instituto Regional de Investigación en Salud, Universidad Nacional de Caaguazú. Coronel Oviedo, Paraguay.
  • Guiomar Viveros Instituto Regional de Investigación en Salud, Universidad Nacional de Caaguazú. Coronel Oviedo, Paraguay.
  • Gloria Aguilar Instituto Regional de Investigación en Salud, Universidad Nacional de Caaguazú. Coronel Oviedo, Paraguay.
  • Laura Joy Instituto Regional de Investigación en Salud, Universidad Nacional de Caaguazú. Coronel Oviedo, Paraguay.
  • Fernando Pizarro Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile. Santiago, Chile.
  • Shrikant Bangdiwala Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University. Hamilton, Canadá.

DOI:

https://doi.org/10.14306/renhyd.24.4.1024

Keywords:

Child, Schools, Pediatric Obesity, Health Promotion, Physical Education and Training, Diet, Food, and Nutrition, Exercise

Abstract

Introduction: the aim was to design a multi-component randomized controlled community study and evaluate its effect in the prevention of obesity in schoolchildren from the department of Caaguazú, Paraguay.
Material and methods: Design: randomized controlled community trial. Setting: 16 public and private schools in the urban and rural area of the Department of Caaguazú, Paraguay. Participants and intervention: 16 schools will be randomly assigned to two groups. Intervention group, they will receive a nutritional education and physical activity program in the school environment for 6 months. Control group will receive 3 educational talks in the same period. Main outcome measure: primary (thickness of skin folds), secondary (z body mass index, nutritional knowledge, fruits and vegetables consumption, physical activity level) and demographic variables (sex, age and area). All variables will be measured at baseline and at the end of the study, using calibrated tools, validated questionnaires, and protocols. Analysis: descriptive statistics will be used, in addition to the Student t test and chi2 to establish differences. Crude and adjusted linear regression and logistic models will be run.
Ethics and dissemination: the study protocol has been evaluated and approved by the Research Ethics Committee of the National University of Caaguazú. Institutional (schools) and individual (parents) informed consent and children's assent will be used.

Author Biography

Laura González Céspedes, Instituto Regional de Investigación en Salud, Universidad Nacional de Caaguazú. Coronel Oviedo, Paraguay. Departamento de Nutrición, Dirección de Investigación, Facultad de Ciencias Químicas, Universidad Nacional de Asunción. San Lorenzo, Paraguay.

Departamento de Nutrición. Dirección de Investigación. Facultad de Ciencias Químicas. Universidad Nacional de Asunción.

Intituto Regional de Investigación en Salud (IRIS). Universidad Nacional de Caaguazú.

References

(1) Lobstein T, Jackson-leach R, Moodie ML, Hall KD, Gortmaker SL, Swinburn BA, et al. Obesity 4 Child and adolescent obesity: part of a bigger picture. Lancet. 2015;6736(14):1–11.

(2) Hruby A, Hu FB. HHS Public Access. Pharmacoeconomics. 2016;33(7):673–89.

(3) Kremers SPJ, Eves FF, Andersen RE. Environmental Changes to Promote Physical Activity and Healthy Dietary Behavior. J ofEnvironmental Public Heal. 2012;2012:10–3.

(4) Lowe C, Horne P, Tapper K, Bowdery M, Egerton C. Effects of a peer modelling and rewards-based intervention to increase fruit and vegetable consumption in children. Eur J Clin Nutr. 2004;58:510–22.

(5) Mihrshari S, Myton R, Partridge S, Esdaile E, Hardy L, Gale J. Sustained low consumption of fruit and vegetables in Australian children: Findings from the Australian National Health Surveys. Heal Promot J Austral. 2019;30:83–7.

(6) Sparrenberger K, Friedrich R, Schiffner M, Schuch I, Wagner M. Ultra-processed food consumption in children from a Basic Health Unit. J Pediatr (Rio J). 2015;91(6):535–42.

(7) Demetriou Y, Vondung C, Bucksch J, Schlund A, Schulze C, Knapp G, et al. Interventions on children’s and adolescent’s physical activity and sedentary behaviour: protocol for a systematic review from a sex / gender perspective. Syst Rev. 2019;8(65):1–7.

(8) Arundell L, Fletcher E, Salmon J, Veitch J, Hinkley T. A systematic review of the prevalence of sedentary behavior during the after-school period among children aged 5-18 years. Int J Behav Nutr Phys Act. 2016;13(93):1–9.

(9) Street SJ, Wells JCK, Hills AP. Windows of opportunity for physical activity in the. Obes Rev. 2015;16:857–70.

(10) Dietz H. Critical periods in childhood for the developmet of obesity. Am J Clin Nutr. 1994;59:955–9.

(11) UNSCN. Schools as a System to Improve Nutrition. A new statement for school-based food and nutrition interventions. Roma; 2017.

(12) Lakshman RR, Sharp SJ, Ong KK, Forouhi NG. A novel school-based intervention to improve nutrition knowledge in children: cluster randomised controlled trial. BMC Public Heal 2010,. 2010;10(123):1–9.

(13) Khambalia AZ, Dickinson S, Hardy LL, Gill T, Baur LA. A synthesis of existing systematic reviews and meta-analyses of school-based behavioural interventions for controlling and preventing obesity. Obes reviws. 2012;13:214–33.

(14) Kop JH Van De, Sc M, Kernebeek WG Van, Sc M, Otten RHJ, Sc M, et al. School-Based Physical Activity Interventions in Prevocational Adolescents: A Systematic Review and Meta-Analyses. J Adolesc Heal. 2019;65(2):185–94.

(15) Roberto C, Swinburn B, Hawkes C, Huang T, Costa S, Ashe M, et al. Patchy progress on obesity prevention: emerging examples , entrenched barriers, and new thinking. Lancet. 2015;6736(14):1–10.

(16) Kelley M, Yang S, Murray D, Stevens J. Childhood Obesity Prevention and Treatment Research (COPTR): Interventions Addressing Multiple Influences in Childhood and Adolescent Obesity. Contemp Clin Trials. 2013;36(2):406–13.

(17) Armendáriz-anguiano AJA. Intervenciones aleatorias controladas basadas en las escuelas para prevenir la obesidad infantil: revisión sistemática de 2006 a 2009. Arch Latinoam Nutr. 2009;59(10):253–9.

(18) Ramirez L, Gotz S, Riera J, Pastore B, Vera N, Sequera V. Nivel de actividad física y estado nutricional en una población pediátrica de un consultorio ambulatorio Asunción. Pediatr (Asunción). 2020;47(1):11–6.

(19) Núñez A, Collante C, López M, Galeano C. Impacto de la estrategia de entrega de frutas con educación nutricional sobre el estado nutricional y consumo frutas en escolares de la Escuela pública héroes luqueños de la comunidad de Jukyry Luque , Paraguay Impact. Mem Inst Investig Cienc Salud. 2019;17(3):55–62.

(20) Harrell S, Mcmurray R, Bangdiwala S, Frauman A, Gansky S, Bradley C. Effects of a school-based intervention to reduce cardiovascular disease risk factors in elementary-school children: The Cardiovascular Health in Children (CHIC) Study. J Pediatr. 1996;128(6):797–805.

(21) Concha F. Aptitud física y educación física: cimientos para una propuesta metodológica. 2011.

(22) MEC, MSPBS, FAO. Ministerio de Educación y Cultura. Ministerio de Salud Pública y Bienestar Social. Agencia de las Naciones Unidas para la Alimentación y la Agricultura. Alimentar la mente para crecer y vivir sanos. Cuadernillo de trabajos prácticos del segundo ciclo de l. 2010.

(23) NOO. National Obesity Observatory. Measuring diet and physical activity in weight management interventions. 2011. 1–28 p.

(24) Kowalski K, Crocker P, Donen R. The Physical Activity Questionnaire for Older Children (PAQ-C) and Adolescents (PAQ-A) Manual. Coll Kinesiol. 2004;

(25) WHO. WHO Anthro for personal computers, version 3.2.2, 2011: Software for assessing growth and development of the world’s children. Geneva World Health Organization. 2010.

(26) Slaughter M, Lohman T, Boileau R, Horswill C, Stillmen R, Van Loan M, et al. Skinfold equations for estimation of body fatness in children and youth. Hum Biol. 1988;60(5):709–23.

(27) StataCorp. Stata Statistical Software: Release 15. College Station, TX: StataCorp LLC. 2017.

(28) Glickman D, Parker L, Sim LJ, Del H, Cook V. Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation. 2012.

(29) Verjans-Janssen S, Van de Kolk I, Van Kann D, Kremers S, Gerards S. Effectiveness of school-based physical activity and nutrition interventions with direct parental involvement on children’s BMI and energy balance-related behaviors – A systematic review. PLoS One. 2018;13(9):e0204560.

(30) Safdie M, Jennings-Aburto N, Lévesque L, Janssen I, Campirano-Nuñez F, López-Olmedo N, et al. Impact of a school-based intervention program on obesity risk factors in Mexican children. Salud Publica Mex. 2013;55(3):s374–87.

(31) Pineda E, Swinburn B, Sassi F. Effective school food environment interventions for the prevention of childhood obesity: systematic review and. Lancet. 2019;394:S77.

(32) Micha R, Karageorgou D, Bakogianni I, Trichia E, Whitsel P, Story M, et al. Effectiveness of school food environment policies on children ’ s dietary behaviors: A systematic review and meta-analysis. PLoS One. 2018;16:1–27.

(33) MSPBS. Ministerio de Salud Pública y Bienestar Social. Estrategia Nacional para la prevención y el control de la obesidad 2015 - 2025. 2015.

Published

2020-12-25

How to Cite

González Céspedes, L., Fretes, G., Ríos, P., Estigarribia, G., Viveros, G., Aguilar, G., Joy, L., Pizarro, F., & Bangdiwala, S. (2020). Design of a multi-component controlled randomized community study for obesity prevention in school children: Research protocol. Spanish Journal of Human Nutrition and Dietetics, 24(4), 389–397. https://doi.org/10.14306/renhyd.24.4.1024