A school-based, multi-faceted health promotion programme to prevent obesity among children: protocol of a cluster-randomised controlled trial (the DECIDE-Children study)

Abstract

IntroductionObesity is a public health concern that is becoming increasingly more serious worldwide. Effective and sustainable childhood obesity prevention strategies may help to reduce the prevalence of obesity and may have an impact on lifelong health. However, few such strategies have been rigorously evaluated for Chinese children in different regions of China.Methods and analysisThe Diet, ExerCIse and CarDiovascular hEalth-Children is a cluster-randomised controlled trial that aims to assess the effectiveness and sustainability of a school-based, multi-faceted intervention to prevent obesity among Grade 4 primary school students (8–10 years old) in China. Twenty-four schools (approximately 1200 students) from above average, average and below average developed regions in China will be randomised to an intervention (12 schools) or usual practice (12 schools) group. The intervention will last for one school year (9 months) and consists of activities towards students, parents and school environment. A smartphone application will be used to assist in providing information on, monitoring and providing feedback on the behaviours and body weight of the students. Data will be collected at baseline, 4 months, 9 months and 21 months. The primary outcome will be the difference between groups in the change in students’ body mass index at 9 months after the baseline investigation. The secondary outcomes will include the differences between groups in the changes in anthropometric measures, diet, physical activity levels and other measures at the follow-up visits. A variety of process evaluation methods will be used to evaluate the implementation process of the complex intervention.Ethics and disseminationThis study was approved by the Peking University Institution Review Board (IRB00001052-18021). The results will be disseminated through publication in peer-reviewed journals, presentations at conferences and in lay summaries provided to school staff and participants.Trial registration number NCT03665857.

Time-specific effects of a multifaceted intervention on accelerometer-measured physical activity in primary school children: A cluster-randomized controlled trial

“…Trained project staff went to each intervention school weekly to observe and record the amounts and intensity of in-school physical activity sessions, according to ‘An Operation Manual for Project Staff Involved in the Intervention’ [12]. Based on these field observations, the intervention schools achieved the amounts of 60 minutes/day of physical activity for a median (range) of 83% (62 to 97%) of school days, and achieved the intensity of MVPA in 88%, 84%, and 58% of physical education classes, extracurricular activities, and class-break exercises [13].…”

“…To fill in the research gaps, we conducted a nested study in the DECIDE-Children study [12] and aimed to examine whether a multifaceted intervention focusing on both children and contexts (schools and families) could improve the intensity and amounts of physical activity within specific periods of a week (i.e., weekday/weekend day) or a day (i.e., in-school/out-of-school periods) by using the objective accelerometer measure. We also examine whether potential moderators were associated with the effect size of the intervention.…”

Dietary Interventions to Prevent Childhood Obesity: A Literature Review

“…The DECIDE-Children Study [23] is a cluster-randomized controlled trial conducted in 1200 Chinese students from four primary schools (8-10 years old). The intervention consisted of health education activities for the parents; supervision and encouragement of the children as a way of increasing their physical activity practice outside of school; school policies to prevent obesity and health education activities for the children.…”

“…There was also the development of an app called 'Eat Wisely, Move Happily' that aids in diffusing information, monitoring the children's behavior, managing their weight, and giving feedback for the teachers and parents. Since this study is ongoing, the results of this intervention are not yet available [23].…”

Harnessing SmartPhones to Personalize Nutrition in a Time of Global Pandemic

“…Nutrition apps have been widely used to promote dietary interventions, such as increasing fruit and vegetable consumption or decreasing saturated fat and sugar-sweetened beverage intake [ 16 , 17 , 18 , 19 ]. They have also served as a tool in the armamentarium to prevent or combat obesity in children [ 20 ], adolescents [ 21 ], and adults with specific medical conditions, such as pregnancy [ 22 ] and type 2 diabetes mellitus (T2DM) [ 23 ]. With regards to the latter, a simple intervention of sending text messages providing information, motivation, support and reminders related to diabetes management improved glycemic control in poorly controlled individuals with T2DM [ 24 ].…”