Effects of School-based Interventions Targeting Obesity-Related Behaviors and Body Weight Change: A Systematic Umbrella Review

Safron, Magdalena; Cislak, Aleksandra; Gaspar, Tânia; Luszczynska, Aleksandra

doi:10.1080/08964289.2010.543194

Cited by 60 publications

(71 citation statements)

References 30 publications

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“…A recent systematic review demonstrated that the role of psychological theories and behavioural or cognitive mediators was rarely investigated (21) .…”

mentioning

confidence: 99%

Comparison of two school-based programmes for health behaviour change: the Belo Horizonte Heart Study randomized trial

Ribeiro¹,

Alves

2013

Public Health Nutr.

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Objective: To assess the efficacy of two school-based programmes to promote students' willingness to engage in lifestyle changes related to eating habits and physical activity behaviours. Design: Elementary school-based health promotion intervention, designed as a multicomponent experimental study, based on a behavioural epidemiological model. Setting: Nine intervention and eight comparative public and private elementary schools. Subjects: The goal was to determine the impact on the longitudinally assessed outcomes of two programmes that addressed healthy nutrition and active living in a cohort of 2038 children. The evaluations used pre-intervention and follow-up student surveys that were based on the Transtheoretical Model of the stages of behaviour change. Results: In the intervention group, there were significant (P , 0?001) differences between the pre-and post-intervention times in the stages of change, with a reduction in the percentage of children at the pre-contemplation and contemplation stages and increased percentages at the preparation, action and maintenance stages, leading to healthier behaviours in fatty food consumption, fruit and vegetable consumption, physical activity and time spent in sedentary activities. The determinants of the behaviour stage were the intervention programme, the type of school and the presence of motivated teachers. The comparison group did not show significant differences between the pre-and post-intervention times for any of the stages of behaviour. Conclusions: The intervention programme encouraged the students to make healthy lifestyle choices related to eating habits and physical activity behaviours. Keywords Healthy lifestyleOverweight Obesity School Children PreventionOverweight and obesity (excess body weight) has increased dramatically in southern Latin America (1) . In south-eastern Brazil 40?3 % of boys and 38?0 % of girls are overweight or obese (2) . There has been a threefold increase in the incidence of excess body weight (8?9 % to 26?5 %) from 1974-75 to 2008-09 (2) . This increase in childhood overweight and obesity has been attributed to behavioural factors that cause a long-term imbalance between energy intake and energy expenditure. Behavioural problems require behavioural solutions (3,4) and therefore prevention of excess body weight through targeted behavioural change has become a public health priority (5,6) .In Brazil, consumption of energy-dense, high-fat foods has increased to above recommended levels, while physical activity (PA) and consumption of fruit and vegetables (F&V) have fallen well below the recommended levels (7) .These behaviours have resulted in an increase in obesityrelated co-morbidities such as IHD, stroke and diabetes, which account for a high percentage of total disabilityadjusted life years lost (8) . Sedentary lifestyles account for 69 % of the cardiovascular risk factor prevalence in Brazil (9) .Suggested behavioural solutions include increased moderate-to-vigorous PA among school-aged children and reduced sedentary t...

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“…A recent systematic review demonstrated that the role of psychological theories and behavioural or cognitive mediators was rarely investigated (21) .…”

mentioning

confidence: 99%

Comparison of two school-based programmes for health behaviour change: the Belo Horizonte Heart Study randomized trial

Ribeiro¹,

Alves

2013

Public Health Nutr.

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“…Implications for practice and research Although the study found only limited effects on the students' knowledge and behaviour, a combined educational and environmental intervention to promote healthy nutrition behaviour is regarded as the most promising (7)(8)(9)(10) .…”

Section: Discussionmentioning

confidence: 99%

“…To improve the food environment in schools and minimize the sale of extra products there, it has been proposed that the availability of highcalorie extra beverages and food products in school vending machines should be restricted (5,6) . While school environments that encourage healthy eating are thought to help combat the increase in overweight in young people, the most effective way of preventing overweight and obesity may be through interventions that target both the change in the obesogenic environment and children's motivation to change their dietary behaviour (7)(8)(9)(10) . According to the Theory of Planned Behaviour (11) an individual's healthy eating behaviour is predicted by personal behavioural beliefs.…”

mentioning

confidence: 99%

Students’ beliefs and behaviour regarding low-calorie beverages, sweets or snacks: are they affected by lessons on healthy food and by changes to school vending machines?

Kocken

Kesteren²,

Buijs³

et al. 2015

Public Health Nutr.

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Objective: To study the effects of school lessons about healthy food on adolescents' self-reported beliefs and behaviour regarding the purchase and consumption of soft drinks, water and extra foods, including sweets and snacks. The lessons were combined with the introduction of lower-calorie foods, food labelling and price reductions in school vending machines. Design: A cluster-randomized controlled design was used to allocate schools to an experimental group (i.e. lessons and changes to school vending machines) and a control group (i.e. 'care as usual'). Questionnaires were used pre-test and post-test to assess students' self-reported purchase of extra products and their knowledge and beliefs regarding the consumption of low-calorie products. Setting: Secondary schools in the Netherlands. Subjects: Twelve schools participated in the experimental group (303 students) and fourteen in the control group (311 students). The students' mean age was 13·6 years, 71·5 % were of native Dutch origin and mean BMI was 18·9 kg/m 2 . Results: At post-test, the experimental group knew significantly more about healthy food than the control group. Fewer students in the experimental group (43 %) than in the control group (56 %) reported bringing soft drinks from home. There was no significant effect on attitude, social norm, perceived behavioural control and intention regarding the consumption of low-calorie extra products. Conclusions: The intervention had limited effects on students' knowledge and selfreported behaviour, and no effect on their beliefs regarding low-calorie beverages, sweets or snacks. We recommend a combined educational and environmental intervention of longer duration and engaging parents. More research into the effects of such interventions is needed.

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“…While important advances have been made and successes realized [6,7], there are numerous examples of carefully designed and wellimplemented interventions that had small effects or were ineffective [8][9][10][11][12][13][14]. Effective interventions have shown diminished effectiveness when disseminated perhaps due to their complex nature and intensive components [15].…”

Section: Introductionmentioning

confidence: 99%

Deconstructing interventions: approaches to studying behavior change techniques across obesity interventions

Tate

Lytle

Sherwood

et al. 2016

Behav. Med. Pract. Policy Res.

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Deconstructing interventions into the specific techniques that are used to change behavior represents a new frontier in behavioral intervention research. This paper considers opportunities and challenges in employing the Behavior Change Techniques Taxonomy (BCTTv1) developed by Michie and colleagues, to code the behavior change techniques (BCTs) across multiple interventions addressing obesity and capture dose received at the technique level. Numerous advantages were recognized for using a shared framework for intervention description. Coding interventions at levels of the social ecological framework beyond the individual level, separate coding for behavior change initiation vs. maintenance, fidelity of BCT delivery, accounting for BCTs mode of delivery, and tailoring BCTs, present both challenges and opportunities. Deconstructing interventions and identifying the dose required to positively impact health-related outcomes could enable important gains in intervention science.

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Effects of School-based Interventions Targeting Obesity-Related Behaviors and Body Weight Change: A Systematic Umbrella Review

Cited by 60 publications

References 30 publications

Comparison of two school-based programmes for health behaviour change: the Belo Horizonte Heart Study randomized trial

Comparison of two school-based programmes for health behaviour change: the Belo Horizonte Heart Study randomized trial

Students’ beliefs and behaviour regarding low-calorie beverages, sweets or snacks: are they affected by lessons on healthy food and by changes to school vending machines?

Deconstructing interventions: approaches to studying behavior change techniques across obesity interventions

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