Child Obesity - School-Based Programs
Childhood Obesity & Primary School
Programs
Most obesity interventions have taken place in clinical settings, however
schools provide an excellent opportunity for preventing and treating obesity.
School-based approaches for childhood obesity
can be separated into either primary or secondary interventions. Primary
interventions focus on prevention of obesity and adopt the population
approach or target high-risk individuals at risk of developing obesity.
Secondary interventions target those with existing obesity.
Childhood Obesity & Secondary School
Programs
Secondary intervention school-based programs targeted at obese children
and adolescents have been attempted mainly in the US since the mid 1960s
and have met with some success. Programs reporting positive results included
particularly those aimed at younger children; those which combined both
diet and exercise and those with parental involvement. Although interventions
aimed at obese children consistently report positive effects, these studies
have methodological and ethical problems which limit their internal validity
and generalisability. Most participants are parentally volunteered, most
interventions multi-componented, not evaluated and there is limited follow-up
post intervention. It is also felt that isolating children on the basis
of their weight may further compound any psychosocial problems they may
already experience.
Childhood Obesity & Primary School
Intervention Program
An alternative strategy is to implement a primary intervention program
which is targeted at all pupils or at pupils who are at a high risk of
becoming overweight. These initiatives have also met with some success,
although outcome assessed in terms of change in weight or body fat is
generally not as robust when compared to the studies targeted solely at
obese pupils. Many of these studies have examined the entire pupil cohort
using anthropometric measurements with inherent error, rather than considering
the effect of the program on children within separate weight categories.
Childhood Obesity Risk of Adult Obesity
However, this population-based approach in the prevention of obesity is
desirable and likely to be more effective than approaches targeted at
fat children because the prediction for adult obesity from child measures
is poor. Therefore population-based approaches have the potential to reduce
children's risk of adult obesity.
APPLES Program Tackling Childhood Obesity
Two key components for obesity prevention are diet and physical activity.
Within schools both should be promoted as part of a co-ordinated, comprehensive
program for school health.
The APPLES Program was designed as a multi-agency,
multidisciplinary program using a population approach underpinned by the
Health Promoting Schools philosophy. The program was successfully implemented
and produced changes at school level, however it had little effect on
children's behaviour other than a modest increase in vegetable consumption.
It is suggested that this approach shows potential for school-based obesity
prevention programs.
Source: Dr Pinki Sahota, School of Health
Sciences, Leeds Metropolitan University, Leeds, UK. (2002)
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