Environmental interventions for eating and physical activity

Sallis, James F.; McKenzie, Thomas L.; Conway, Terry L.; Elder, John P.; Prochaska, Judith J.; Brown, Marianne; Zive, Michelle; Marshall, Simon; Alcaraz, John E.

doi:10.1016/s0749-3797(02)00646-3

Cited by 434 publications

(392 citation statements)

References 27 publications

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“…8,18 We analyzed the results separately by gender because of previous findings of stronger effects either in girls 2,9 or Table 1 Demographic characteristics for pupils completing both years of data collection School PE and adiposity in adolescents J Wardle et al boys. 4,5 Our results resemble the M-Span study, 4 which examined the effects of increased opportunities for activity in school and found reduced adiposity in boys but not girls. One explanation for the sex difference could be that many adolescent girls try to avoid PE, so greater opportunities for activity, or even timetabled PE, are not necessarily reflected in higher levels of activity.…”

Section: Discussionsupporting

confidence: 80%

“…Effects on adiposity were seen only in the Planet Health program, 2 and then only among girls. Reviewing an additional eight trials, Wareham et al 3 also found heterogeneous results: two trials achieved effects for boys but not girls, 4,5 while the others, including the elaborate Pathways program that ran for 3 years, 6 were unsuccessful in modifying adiposity. The US Task Force on Community Preventive Services concluded that the evidence on school-based interventions was not adequate to recommend them for obesity prevention.…”

Section: Introductionmentioning

confidence: 99%

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School-based physical activity and changes in adiposity

2007

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Objective: School-based physical education (PE) is often proposed as a strategy for obesity prevention, but many trials have found non-significant effects on body mass index (BMI). We examined the impact of school PE on adiposity in adolescents, using an ecological analysis to relate the number of PE sessions to changes in BMI and waist circumference. Research methods and procedures: Five-year, longitudinal, school-based study involving 34 secondary schools in London, England. Students were aged 11-12 years at baseline. Twenty-five schools reported one weekly session of PE, seven schools reported two sessions and two boys' schools reported three sessions. Weights, heights and waist circumferences were measured annually, and complete data from the first and fifth years of the study were available on 2727 students. Analyses compared anthropometric changes between students in schools with higher or lower amounts of PE time. In boys, the comparisons were between those receiving 1, 2 or 3 weekly sessions. In girls, comparisons were between those receiving one and two sessions. Results: There were no differences in BMI changes or the percentage of students classified as obese between schools of higher and lower frequency of PE. However, using unadjusted data, there were lower gains in waist circumference in boys and girls from the higher PE schools. Controlling for baseline demographic and anthropometric characteristics, boys in schools providing 3 weekly PE sessions gained on average approximately 3 cm less than boys in schools providing one or two sessions (Po0.001). Differences in girls were in the same direction but not significant. Discussion: Higher levels of school PE were associated with lower gains in adiposity in boys. This strengthens the case for including recommendations on school PE time as part of population strategies to control adolescent obesity.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

School-based physical activity and changes in adiposity

2007

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“…Common strategies included: parent or family member participation; [37][38][39][40][41][42][43][44][45] changing the physical environment; 43,44,[46][47][48] [37][38][39] and student training in behavioral techniques such as self-monitoring. 38,39,52,53 Detailed descriptions of each study can be found in Table 1.…”

Section: Study Identificationmentioning

confidence: 99%

Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis

et al. 2008

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Objective: To determine the effectiveness of school-based strategies for obesity prevention and control using methods of systematic review and meta-analysis. Methods: Peer-reviewed studies published between 1966 and October 2004 were considered for review. Studies meeting eligibility criteria were published in English, targeted children aged 3-18 in a school setting, reported weight-related outcomes, included a control measurement and had at least a 6-month follow-up period. Studies employed interventions related to nutrition, physical activity, reduction in television viewing or combinations thereof. Weight related data were analyzed using RevMan software. Results: Sixty-four studies were considered for inclusion. Fourteen did not meet inclusion criteria; 29 were excluded due to poor methodological quality. Twenty-one papers describing 19 studies were included in the systematic review and 8 of these were included in the meta-analysis. Nutrition and physical activity interventions resulted in significant reductions in body weight compared with control ((standardized mean difference, SMD ¼ À0.29, 95% confidence interval (CI) ¼ À0.45 to À0.14), random effects model). Parental or family involvement of nutrition and physical activity interventions also induced weight reduction ((SMD ¼ À0.20, 95%CI ¼ À0.41 to 0.00), random effects model). Conclusion: Combination nutrition and physical activity interventions are effective at achieving weight reduction in school settings. Several promising strategies for addressing obesity in the school setting are suggested, and warrant replication and further testing.

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“…The barriers and facilitators documented during the HEALTHY study are similar to those reported in similar school-based intervention studies promoting physical activity and/or nutrition, including Lifestyle Education for Activity Program (LEAP), Middle-School Physical Activity and Nutrition (M-SPAN), Pathways, Peers Running Organized Play (PROPS), Physical Activity Across the Curriculum (PAAC), and Trial of Activity for Adolescent Girls (TAAG) [18][19][20][21][22][23][24][25]. Common facilitators reported include interest and support from various school members (i.e., school board member, school administrators, school office staff, teachers, students, and parents), schools that had made physical activity and nutrition a priority prior to study, schools already implementing practices and strategies similar to intervention components, teachers collaborating with one another during implementation, and teachers and food service staff who were motivated and actively engaged in intervention implementation [18][19][20][21][22].…”

Section: Discussionmentioning

confidence: 58%

“…These barriers include financial constraints in the school food service system, inadequate facility space to implement activities or store equipment, lack of school personnel to deliver intervention components, and faculty and staff turnover [18][19][20][22][23][24]. Other barriers related to logistical issues in terms of food and beverage ordering problems, school districts with highly centralized food service systems impeding individual school nutrition changes, school scheduling problems, and teacher time constraints [18][19][20][22][23][24][25]. Some teachers reported being unable to implement intervention components due to school prioritization of nonhealth-related curricula and standardized testing requirements.…”

Section: Discussionmentioning

confidence: 99%

School factors as barriers to and facilitators of a preventive intervention for pediatric type 2 diabetes

Hall

Schneider

Thompson

et al. 2013

Behav. Med. Pract. Policy Res.

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School-based interventions are essential to prevent pediatric obesity and type 2 diabetes. School environmental factors influence implementation of these interventions. This article examines how school factors acted as barriers to and facilitators of the HEALTHY intervention. The HEALTHY study was a cluster-randomized trial of a multicomponent intervention implemented in 21 schools. Interview data were analyzed to identify barriers and facilitators. Barriers included teacher frustration that intervention activities detracted from tested subjects, student resistance and misbehavior, classroom management problems, communication equipment problems, lack of teacher/staff engagement, high cost and limited availability of nutritious products, inadequate facility space, and large class sizes. Facilitators included teacher/staff engagement, effective classroom management, student engagement, schools with direct control over food service, support from school leaders, and adequate facilities and equipment. Contextual barriers and facilitators must be taken into account in the design and implementation of school-based health interventions. KEYWORDSSchool, Intervention, Prevention, Health behavior, Diabetes, Obesity Type 2 diabetes is a chronic and progressive disease with complications that can include heart disease, stroke, kidney failure, loss of vision, and limb amputation [1]. The alarming prevalence of overweight and obesity among American children and adolescents and the connection with type 2 diabetes represent a serious public health concern for the twenty-first century [2,3]. Researchers estimated that approximately one in three children born in the year 2000 in the United States will develop diabetes in their lifetime [4].Recent findings on activity and dietary patterns of children and adolescents in the United States demonstrate the presence of problematic health behaviors. Findings from the National Survey of Children's Health and the Youth Risk Behavior Survey showed that approximately 78 % of youth did not eat fruits or vegetables five or more times per day [5], 29 % of youth drank a nondiet soda at least once per day [5], 64 % of youth did not engage in 20 min of daily vigorous physical activity for most days of the week [6], and 50 % of youth engaged in sedentary behaviors, such as playing video games or watching television for multiple hours a day [6].In light of the prevalence of unhealthful dietary and activity patterns among youth and their connections with overweight, obesity, and type 2 diabetes, population-level approaches to improve environmental contexts by promoting physical activity and healthful diet are essential. Schools are ideal settings for basing public health interventions aimed at preventing the development of serious health conditions because of the existing resources and infrastructure, and aside from the home, Implications Practice: School-based obesity interventions should take into account student interests and involvement, classroom skills of teachers delivering the interv...

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Environmental interventions for eating and physical activity

Cited by 434 publications

References 27 publications

School-based physical activity and changes in adiposity

School-based physical activity and changes in adiposity

Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis

School factors as barriers to and facilitators of a preventive intervention for pediatric type 2 diabetes

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