A cross-sectional examination of school characteristics associated with overweight and obesity among grade 1 to 4 students

Abstract

BackgroundExcessive weight gain among youth is an ongoing public health concern. Despite evidence linking both policies and the built environment to adolescent and adult overweight, the association between health policies or the built environment and overweight are often overlooked in research with children. The purpose of this study was to examine if school-based physical activity policies and the built environment surrounding a school are associated with weight status among children.MethodsObjectively measured height and weight data were available for 2,331 grade 1 to 4 students (aged 6 to 9 years) attending 30 elementary schools in Ontario, Canada. Student-level data were collected using parent reports and the PLAY-On questionnaire administered to students by study nurses. School-level policy data were collected from school administrators using the Physical Activity Module of the Healthy School Planner tool, and built environment data were provided by the Enhanced Points of Interest data resource. Multi-level logistic regression models were used to examine the school- and student-level characteristics associated with the odds of a student being overweight or obese.ResultsThere was significant between-school random variation in the odds of a student being overweight [σ2μ0 = 0.274(0.106), p < 0.001], but not for being obese [σ2μ0 = 0.115(0.089)]. If a student attended a school that provided student access to a variety of facilities on and off school grounds during school hours or supported active transportation to and from school, he/she was less likely to overweight than a similar student attending a school without these policies. Characteristics of the built environment were not associated with overweight or obesity among this large cross-sectional sample of children.ConclusionsThis new evidence suggests that it may be wise to target obesity prevention efforts to schools that do not provide student access to recreation facilities during school hours or schools that do not support active transportation for students. Future research should evaluate if school-based overweight and obesity prevention programming might be improved if interventions selectively targeted the school characteristics that are putting students at the greatest risk.

Association between the school environment and children’s body mass index in Terengganu: A cross sectional study

“…Prior research indicated that the availability of healthy and nutritious food at school is significantly associated with consumption levels among school children [39]. Consistent with existing research, children attending schools that provided healthy foods and drinks at the tuck shop tended to have lower BMIs than their counterparts who were attending schools that sold less healthful foods [40]. In the aforementioned study conducted among children, the presence of fruit tuck shops due to school policy had a positive impact as more school children ate fruit as a snack at school [39].…”

A multiple case history and systematic review of adoption, diffusion, implementation and impact of provincial daily physical activity policies in Canadian schools

“…Those who accumulated ≥ 1 bout of MVPA were more active and fewer were overweight and obese. 1) Leatherdale et al, 2013 [ 145 ] ; 2) Leatherdale et al, 2014 [ 147 ] Impact Cross-sectional 2007-08 Convenience sample of 2326 grade 1–4 students/parents from 30 elementary schools in ON. Schools were purposively selected within public and separate school boards located in major geographic regions.…”

“…These results differ from a subsequent paper from the same study which showed that students in schools where administrators reported being in the ‘action’ phase of DPA implementation did not spend more time in light-to-vigorous PA compared to students from schools in the ‘initiation’ phase [ 133 ]. Similarly, implementation of DPA in ON was not associated with student self-reported PA or BMI in 30 elementary schools [ 134 , 145 - 147 ]. Differences across studies likely relate to the various exposure and outcome variables considered, and the small number of schools examined.…”

A systematic review of how researchers characterize the school environment in determining its effect on student obesity

“…Ethnicity of students in school . Leatherdale, 2013 [ 17 ]/Canada Cross-sectional/2,331 Yr 1–4 students from 30 schools BMI ( over-weight only) A written survey was completed by the ‘senior administrator most knowledgeable about school policies and practices’. Not reported Physical (15–16) 15.…”

“…To assist our analysis and abridge transparency, we used the ANGELO framework to categorize the school-level evidence. In the end, a total of five articles were included in our narrative synthesis [ 13 - 17 ]. These studies were included because the authors investigated the impact of school-level factors on objectively-measured student weight status.…”