Meta-Analysis of School-Based Childhood Obesity Interventions in the U.K. and U.S.

2009 ◽  
Vol 29 (3) ◽  
pp. 241-256 ◽  
Author(s):  
Amar Kanekar ◽  
Manoj Sharma
2021 ◽  
pp. 1-28
Author(s):  
Tarcisus Ho ◽  
Ling Jie Cheng ◽  
Ying Lau

Abstract Objective Schools offer an ideal setting for childhood obesity interventions due to their access to children and adolescents. This review aimed to systematically review the impact of school-based intervention for the treatment of childhood obesity. Design Eight databases were searched from inception till May 30, 2020. A revised Cochrane risk-of-bias tool and the Grading of Recommendations, Assessment, Development and Evaluations criteria were used to evaluate the risk of bias and overall evidence. Meta-analysis and meta-regression were performed on Stata software using the random-effects model. Overall effect was evaluated using Hedges’ g, and heterogeneity was assessed using Cochran’s Q and I2. Setting Cluster randomised trials (cluster-RCTs) delivered in school. Participants Children and adolescents (6-18 years of age) with overweight and obesity. Results Twelve cluster-RCTs from seven countries with 1,755 participants were included in the meta-analysis. School-based interventions for the treatment of childhood obesity reduced body mass index (BMI) and BMI z-scores with a medium effect (g=0·52). Subgroup analyses showed the greater effectiveness of brief school-based interventions and the interventions conducted in lower-middle to upper-middle economies. Meta-regression assessed the heterogeneity and the final model, with covariates of the type of economies and trial duration, accounted for 41.2% of the variability. The overall quality of evidence was rated low because of the high risk of bias and inconsistency. Conclusions School-based interventions is a possible approach to provide universal healthcare for the treatment of childhood obesity, and further well-designed cluster-RCTs with longer follow-up are needed. This study is registered with PROSPERO (CRD42020160735).


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Jiyoon J Park ◽  
Randa Bakhet ◽  
Danica Karl ◽  
Fei Yuan ◽  
Eva Lonn

Background: Childhood obesity is a major public health threat. Various school-based interventions (SBIs) to prevent obesity through physical activity and/or dietary modifications were implemented. However, the effectiveness of such SBIs remains unproven. Therefore, we conducted a meta-analysis of randomized controlled trials (RCTs) of SBIs. Methods: We searched for RCTs of SBIs published since 1990. To be eligible studies had to have an RCT design, to include children aged 6-18 years and SBIs were defined as non-pharmacological and non-surgical interventions carried out in a school setting with a minimum duration of 12 weeks. The primary outcome was change in body mass index (BMI. For each study the difference in the mean change in BMI between the intervention and the control groups was computed. The summary estimate for the difference in mean change in BMI and the 95% confidence interval (CI) was computed using a weighted inverse variance approach and a random- effects model. The I 2 statistic was used to test for heterogeneity. Results: Of 504 studies identified, 41 involving 42 430 participants met the inclusion criteria. SBIs varied greatly between studies by type, duration and delivery. In 10 RCTs the SBI focused on physical activity, in 6 on dietary modifications and in 25 on both physical activity and dietary modifications. SBIs duration ranged from 12 weeks to 4 years. There was no significant difference in mean BMI change between the intervention and the control groups (mean difference = -0.281kg/m 2 ; 95% CI -0.584 to 0.022), although there was significant heterogeneity between the RCTs’ findings (Figure). We found also no consistent impact on other measures of adiposity, physical activity patterns, dietary intakes and psychosocial health and wellbeing. Conclusions: SBIs had no substantial impact on BMI in children aged 6-18 years. Further research is needed to identify effective interventions to prevent childhood obesity.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Haiquan Xu ◽  
Yanping Li ◽  
Songming Du ◽  
Qian Zhang ◽  
Ailing Liu ◽  
...  

Abstract Background Economic evaluation of school-based obesity interventions could provide support for public health decision of obesity prevention. This study is to perform cost–utility and cost–benefit assessment of three school-based childhood obesity interventions including nutrition education intervention (NE), physical activity intervention (PA) and comprehensive intervention (both NE and PA, CNP) with secondary data analysis of one randomized controlled trial. Methods The standard cost-effectiveness analysis methods were employed from a societal perspective to the health outcome and costs that are attributable to the intervention. NE, PA and CNP were carried out separately for 2 semesters for childhood obesity interventions in primary schools. The additional quality-adjusted life years (QALYs) resulting from the interventions were measured as the health outcome. A cost–utility ratio (CUR) and A cost–benefit ratio (CBR) was calculated as the ratio of implementation costs to the total medical and productivity loss costs averted by the interventions. Results The CUR and CBR were ¥11,505.9 ($1646.0) per QALY and ¥1.2 benefit per ¥1 cost respectively, and the net saving was ¥73,659.6 ($10,537.9). The CUR and CBR for nutrition education and physical activity interventions were ¥21,316.4 ($3049.6) per QALY and ¥0.7 benefit per ¥1 cost, ¥28,417.1 ($4065.4) per QALY and ¥0.4 benefit per ¥1 cost, respectively (in 2019 RMB). Compared with PA intervention, the ICERs were ¥10,335.2 ($1478.6) and 4626.3 ($661.8) for CNP and NE respectively. The CBR was ¥1.2, 0.7, and 0.4 benefits per ¥1 cost for CNP, NE, and PA interventions, respectively. Net estimated savings were achieved only through CNP intervention, amounting to ¥73,659.6 ($10,537.9). Conclusions Comprehensive school-based obesity intervention is a beneficial investment that is both cost-effective and cost saving. Compared with PA intervention, both CNP and NE intervention were more cost-effective.


2011 ◽  
Vol 111 (9) ◽  
pp. A67
Author(s):  
L. Hung ◽  
D.K. Tidwell ◽  
M. Hall ◽  
M.L. Lee ◽  
C.A. Briley ◽  
...  

2014 ◽  
Vol 11 (9) ◽  
pp. 8940-8961 ◽  
Author(s):  
Melinda Ickes ◽  
Jennifer McMullen ◽  
Taj Haider ◽  
Manoj Sharma

Author(s):  
Riftiani Nikmatul Nurlaili ◽  
◽  
Yulia Lanti Retno Dewi ◽  
Rita Benya Adriani ◽  
◽  
...  

ABSTRACT Background: Childhood obesity remains a serious nutritional problem in both developed and developing countries. The prevalence of school-age children with obesity has increased more than ten times, from 11 million in 1975 to 124 million in 2016. One of the efforts to overcome the increase in childhood obesity is providing school-based intervention. This study aimed to estimate the effect of a school-based intervention to reduce the risk of obesity in children according to data from primary studies. Subjects and Method: This was a meta analysis and systematic review. Studies published from 2007 to 2018 were collected from Google Scholar, PubMed, BMJ, ScienceDirect, BMC, and Sage databases. Keywords used (preschool OR school) AND (intervention OR program OR prevention) AND (“children obesity” OR “children overweight”) AND “randomized control trials”. The inclusion criteria were full text, in English language, using randomized controlled trial study design, and reporting risk ratio. The selected articles were analyzed by PRISMA guideline and Revman 5.3. Results: 8 studies from China (3), Meksiko, United States (2), Portugal, and German showed that school-based intervention reduced the risk of obesity in children (RR= 0.91; CI 95%= 0.84 to 0.99; p=0.040) with (I2=35%; p=0.150). Conclusion: School-based intervention can reduce the risk of obesity in children. Keywords: school-based intervention, obesity, children Correspondence: Riftiani Nikmatul Nurlaili. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085746737137. DOI: https://doi.org/10.26911/the7thicph.03.126


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