School-based interventions for the treatment of childhood obesity: a systematic review, meta-analysis and meta-regression of cluster randomised controlled trials

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).

The Effect of School-Based Physical Activity Interventions on Body Mass Index Among ‎Adolescents: A Systematic Review of Randomised Trials

“…4 Adolescents also spend a significant amount of time in school, and previous systematic reviews have suggested that the school setting can be opportune for effective and constant delivery of weight-related interventions, such as physical activity, for students from a wide range of socioeconomic and sociodemographic backgrounds. 5,6 However, the effect of different types of schoolbased physical activity (SBPA) interventions on changing adolescent body mass index (BMI) is unclear. BMI, a measure derived from weight (per kg) divided by height (per meter) squared, has commonly served as a criterion for assessing body composition.…”

MaestraNatura Reveals Its Effectiveness in Acquiring Nutritional Knowledge and Skills: Bridging the Gap between Girls and Boys from Primary School

“…Due to the reciprocal relationship between health and education, schools are among the most effective settings for health promotion in terms of influencing the adolescents’ dietary habits [ 12 , 13 ]. Ideally, a school-based intervention should be carried out during school curriculum hours or an after-school program in order to reduce the attrition of participants [ 14 ]. In addition, in the school context, a holistic approach to health promotion could be established, allowing the involvement of families and communities to reinforce health messages outside the school environment [ 15 ].…”

“…In addition, in the school context, a holistic approach to health promotion could be established, allowing the involvement of families and communities to reinforce health messages outside the school environment [ 15 ]. Various interventions have been carried out so far in the school setting; however, only few of them have evaluated the real effectiveness in improving nutrition knowledge and dietary habits among children [ 14 , 16 ]. Furthermore, most of the interventions consisted of few and short lessons which were not organised in a structured education program and generally without planning practical activities or the involvement of parents [ 17 , 18 ].…”

Physical Activity and Nutrition Intervention for Middle Schoolers (Move More, Get More): Protocol for a Quasi-Experimental Study

“…There is convincing evidence that suggests school-based interventions to reduce obesity are effective; however, evaluations of the factors contributing to effectiveness are inconclusive [ 23 , 24 ]. Therefore, the purpose of this study is to describe the study protocol used to evaluate the effectiveness of an after-school intervention on increasing physical activity and fruit and vegetable consumption among middle schoolers in an urban Midwestern US school district.…”