Systematic Review on Efficacy of School-based Intervention Programs in Reducing Obesity among School Children
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This systematic review aims to assess the effectiveness of school-based intervention programs in reducing obesity among school children. It will investigate existing school-based intervention programs, evaluate their efficacy, explore barriers and challenges in implementation, and suggest ways to improve effectiveness.
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7707MED Public Health Practice7417MED International Public Health Practice Assessment item 1:Workplan template WORKPLAN TEMPLATE Section A: General Details STUDENT’S NAME: STUDENT ID: EMAIL: SUPERVISOR’S NAME, ORGANISATIONAND EMAIL (please list all of your supervisors) PROJECT TITLE: A systematic review on efficacy intervention in reducing obesity among school children PROJECT TYPE: (Clearly indicate the type of project you are undertaking e.g. literature review, grant application, analysis of an existing data set, systematic review, primary researchor other.) Systematic review FINAL REPORT FORMAT: (Clearly indicate the format of your final output – Final report, e.g. manuscript for journal, evaluation report or other.) Report of MPH research project ETHICAL CLEARANCE: (If your project involves primary data collection and/or analysis, University’s ethical clearance may be required. Guidelines are available from the office of research.) Ethics application has been submitted/approved Ethics application to be submitted Not applicable 1
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7707MED Public Health Practice7417MED International Public Health Practice Assessment item 1:Workplan template Section B: Project Plan Background information: Schoolsprovideanexclusiveenvironmenttosupportchildrenandyoungpeoplein developing their mental health, supporting them for effective treatment of the existing issues and preventing the problems with mental health. The schools-based intervention programs help the children in managing different health concerns such as physical development and reducing the obesity issues (Bleich et al., 2013). The children and young people spend their most time at schools so school-based intervention programs play an essential role in health development (Amini, Djazayery, Majdzadeh, Taghdisi, & Jazayeri, 2015). The time spent in schools does not only impact to cognitive and academic progress but also impact on social integration, physical development and knowledge about the health nutrients to reduce obesity (Hung et al., 2015). Theefficacyofschools-basedprogramssuchasawarenessbuildingandbehaviour modification programsrefers to outcome of preventing the depression in the adolescences and health nutrition issues. In schools, the children remain in a unique environment, where they can understand the symptom of depression and ways to overcome depression from their life (Balle and Tortella, 2010).Depression is also considered as a major cause on obesity as the individuals use simular to manage depression.In this concern, the efficacy of schools- based programs can be determined as a way of preventing depression among the children and youth. The major barriers and challenges in school base intervention programs are time allotment, lackof disciplinepracticesandexistingresources. These barriersare influencingthe 2
7707MED Public Health Practice7417MED International Public Health Practice Assessment item 1:Workplan template effectiveness of school base intervention programs. It is analyzed that the time is allotted by the management of school for each activity but appropriate time is not allotted for the therapeutic groups, which is influencing the knowledge of the children about their health concerns. In addition, there is lack of discipline in the learning practices regarding the obesity and other healthcare issues, which is influencing the results of the school base intervention programs (Sobol‐Goldberg, Rabinowitz, & Gross, 2013). It is also analyzed that the existing resources are not enough in the schools in achieving the objectives of the school base intervention programs. Due to lack of appropriate resources the schools are getting several issues in improving the knowledge of the children in proper manner (Dobbins et al., 2013). Obesity and overweight in children is a major health problem across the world. Obesity in children is responsible for childhood mortality and morbidity. Obesity in childhood increases the risk of cardiovascular diseases, osteoarthritis, different types of cancers and obesity in adulthood. The studies indicated that 17% children aged between 2-19 years are facing the issue of overweight and 10-35% occurrence of obesity and overweight is found among the children of European nations (Verjans, van de Kolk, Van Kann, Kremers, & Gerards, 2018). The issue of overweight and obesity has adverse health outcomes that are insulin resistance, early progression of atherosclerosis and cardiovascular diseases that can lead to premature death (Guerra et al., 2013). Thus, preventing childhood from obesity and overweight has been believed to be an effective way of reducing premature deaths. From 1980s, the prevalence of obesity in children is increasingly rapidly (Verjans, van de Kolk, Van Kann, Kremers, & Gerards, 2018). Different national and international efforts have made to reduce this health concern among the children and adults. There were 23.8% boys and 22.6% girls with occurrence of obesity or overweight in the developed countries (Amold et al., 2016). The major causes of obesity in children are low level of physical activities, unhealthy eating behaviour and sedentary lifestyle (Verjans, van de Kolk, Van 3
7707MED Public Health Practice7417MED International Public Health Practice Assessment item 1:Workplan template Kann, Kremers, & Gerards, 2018). This health concern can be reduced by involvement of the parentsinschool-basedinterventions.Theparentalinvolvementintheschool-based intervention programs will be helpful in understanding the nutritional behaviour, sedentary behaviour, physical activity behaviour, health risk factors and weight status of the children. The schools are implementing an avenue for effective intervention directing childhood obesity. Some of the countries such as UK and USA have been approved legislation and guidelines to implement the school-based intervention for better development of the children both in mental and physical perspectives (Mahmood, Perveen, Dino, Ibrahim & Mehraj, 2014). Gaps and limitations of previous research studies The previous research studies are not discussion about the major barriers and challenges in implementation of school-based programs. As well as, the previous research studies are not providing information properly about the strategies to manage these barriers and challenges in proper manner. The objective of this research study is to assess the effectiveness of school-based intervention programs in reducing occurrence of obesity among the children. From 1980s, the prevalence of obesity in children is increasingly rapidly. Different national and international efforts have need made to reduce this health concern among the children and adults. There were 23.8% boys and 22.6% girls with occurrence of obesity or overweight in the developed countries. The major causes of obesity in children are low level of physical activities, unhealthy eating behaviour and sedentary lifestyle (Verjans, van de Kolk, Van Kann, Kremers, & Gerards, 2018). Due to these causes the issue of obesity is increasing rapidly among the children.This health concern can be reduced by involvement of the parentsinschool-basedinterventions.Theparentalinvolvementintheschool-based 4
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7707MED Public Health Practice7417MED International Public Health Practice Assessment item 1:Workplan template intervention programs will be helpful in understanding the nutritional behaviour, sedentary behaviour, physical activity behaviour, health risk factors and weight status of the children. Rationale: The major rationales of conducting this systematic review are inconsistent and varied effectiveness of school-based intervention programs in schools. The inconsistent and varied settings of school-based intervention are making barriers in physical and mental development of the children. In addition, the lack of studies about the barriers and challengesin implementing the school-based programs is also a big rational of this systematic review. In this systematic review, the inclusion criteria, exclusion criteria data extraction will be used to analyse the challenges and barriers in implementation of school-based programs and achieve solution for the same. In addition, the research study will also have significance for the schools to understand the importance of involvement of the parents in the school-based intervention programs to reduce the issue of obesity among the children (Sobol‐Goldberg, Rabinowitz, & Gross, 2013). Aim and research objectives: The aim of this research project is to examine the effectiveness of school-based intervention programs in reducing obesity among school based children. The aim will be attained by addressing the specific objectives as below: To investigate what are the existing school-based intervention programs and their roles in physical development to reduce obesity in children. To evaluate the efficacy of school-based intervention programs in reducing the obesity among children To explore the barriers and challenges in implementing school-based intervention programs. 5
7707MED Public Health Practice7417MED International Public Health Practice Assessment item 1:Workplan template To suggest the ways to improve effectiveness of the school-based intervention programs in reducing obesity among children. Research questions: Below research questions will be identified during the research project to attain the research objectives in most reliable manner: What are existing school-based interventions? What are the roles of school-based intervention is helpful physical and mental development of children, focusing on obesity reduction? How do parents involve in school-based intervention programs ? What is the efficacy of school-based intervention programs in reducing obesity among children? What are the possible barriers and challenges in establishing and conducting school- based intervention programs? Whatarestrategiestoimprovetheeffectivenessofschool-basedintervention programs in reducing obesity occurrence in children? Methods or implementation strategies: Literature research: Literature search plays an essential role in attaining appropriate data from different secondary sources like books, journals, articles and web links. In order to conduct the systematic review of research project, literature research method will be used effectively (Hart, 2018). Study selection: The relevant published studies from 2011 to 2019 will be used to collect data regarding the school-based intervention programs in reducing obesity among the children. Eligible criteria: In this research project, all English, meta-analysis, policy briefs, reports related to children and adolescents that are published between 2011 and 2019 will be reviewed in systematic 6
7707MED Public Health Practice7417MED International Public Health Practice Assessment item 1:Workplan template mannertoconcludeavalidresult.Theinterventionalstudiesrelatedtotreatmentor prevention of obesity will be included in this research project. In order to make the research outcomes more reliable, applicable and comparable both inclusion criteria and exclusion criteria will be added in the research study. These inclusion and exclusion criteria are described as below: Inclusion criteria: The studies of inclusion criteria will investigate effectiveness of school- based intervention programs targeting sedentary behaviour, physical activity behaviour and nutrition behaviour. In addition, the age of targeted children will be 4 to 12 years who are attending primary school. Under the inclusion criteria, the parents will be involved directly in the school-based intervention programs to promote the physical activities and reduce the sedentary behaviour of their children. The way of communication will be English language. Exclusion criteria: The study will be excluded if the intervention id conducted directly with parents through inviting the parents to attend health related information, sending news settlers to parents and giving specific homework that should be completed with help of parents. The interventionwillnottargettheenvironmentoftheschoolandtheinterventionwill exclusively aim a specific subpopulation such as overweight children of primary school. Searching strategy: The data will be collected from different authorized web links concerning to school-based programs in development of children. Screening papers: The abstract and conclusion part will be analysed in proper manner to attain the objectives of this research study in quick and reliable manner. Data extraction: The evaluated validity of 70 selected and reviewed journals and article will be analysed through Critical Appraisal Skill Programs with proper focus on the research methodology. The disagreements will be resolved through proper discussion until reaching final consensus. 7
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7707MED Public Health Practice7417MED International Public Health Practice Assessment item 1:Workplan template Data analysis: The research study is based on qualitative data so that the collected data will be analysed in qualitative manner through supporting the data with existing literature review. Resources required: In order to accomplish the research project in successful manner, there will be requirement of access to GU library databases, Health and School resources and information from the social organizations. Activities timeline: Activity timeline is a process of describing a timeframe for each of the activity of research project in which the project activities will be accomplished in proper manner. Activity timeline will be helpful in accomplishing each of the project activity timely. The weekly activity timeline for this research project is as below: Activity NameTotal Weeks 123 Selection of the topic Prepare research background Make research aims, objectives and questions Conduct literature review Research methods Arrange the data in systematic manner Analysis of research findings Formulate the research report 8
7707MED Public Health Practice7417MED International Public Health Practice Assessment item 1:Workplan template References: Amini, M., Djazayery, A., Majdzadeh, R., Taghdisi, M. H., & Jazayeri, S. (2015). Effect of school-based interventions to control childhood obesity: a review of reviews.International journal of preventive medicine,6. Arnold,M.,Leitzmann,M.,Freisling,H.,Bray,F.,Romieu,I.,Renehan,A.,& Soerjomataram, I. (2016). Obesity and cancer: an update of the global impact.Cancer epidemiology,41, 8-15. Balle, M., & Tortella, M. (2010). Efficacy of a brief school-based program for selective prevention of childhood anxiety.Anxiety, Stress & Coping,23(1), 71-85. Bleich, S. N., Segal, J., Wu, Y., Wilson, R., & Wang, Y. (2013). Systematic review of community-based childhood obesity prevention studies.Pediatrics,132(1), e201-e210. Dobbins, M., Husson, H., DeCorby, K., & LaRocca, R. L. (2013). School‐based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18.Cochrane database of systematic reviews, (2). Hart, C. (2018).Doing a literature review: Releasing the research imagination. USA: Sage. Hung, L. S., Tidwell, D. K., Hall, M. E., Lee, M. L., Briley, C. A., & Hunt, B. P. (2015). A meta-analysis of school-based obesity prevention programs demonstrates limited efficacy of decreasing childhood obesity.Nutrition Research,35(3), 229-240. Mahmood, S., Perveen, T., Dino, A., Ibrahim, F., & Mehraj, J. (2014). Effectiveness of school-based intervention programs in reducing prevalence of overweight.Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine,39(2), 87-91. Sobol‐Goldberg, S., Rabinowitz, J., & Gross, R. (2013). School‐based obesity prevention programs: A meta‐analysis of randomized controlled trials.Obesity,21(12), 2422-2428. 9
7707MED Public Health Practice7417MED International Public Health Practice Assessment item 1:Workplan template Verjans, S. R., van de Kolk, I., Van Kann, D. H., Kremers, S. P., & Gerards, S. M. (2018). Effectivenessofschool-basedphysicalactivityandnutritioninterventionswithdirect parental involvement on children’s BMI and energy balance-related behaviors–A systematic review.PloS one,13(9). 1
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7707MED Public Health Practice7417MED International Public Health Practice Assessment item 1:Workplan template Section C: Contract SUPERVISOR’S AGREEMENT: Name of principal supervisor: Organisation: I have read this workplan and Iagree to supervise this 20 CP Public Health Practice project. I will be available throughout the trimester to provide guidance to the student. I have received the marking criteria and description of assessment items and I am familiar with the requirements. Signature: ______________________Date:______________ CO-SUPERVISOR’SAGREEMENT (if applicable) Name of co-supervisor: Organisation: I have read this workplan and Iagree to supervise this 20 CP Public Health Practice project. I will be available throughout the trimester to provide guidance to the student. I have received the marking criteria and description of assessment items and I am familiar with the requirements. Signature: ______________________Date:______________ STUDENT’S DECLARATION: By signing below I confirm that: • I understand the requirements of the work to be undertaken for this course; • I agree with the supervision arrangements; • It is my responsibility to keep the course convenor up-to-date regarding my progress and inform about any issues should they arise; • I am aware that the report produced in this course must be my own original work. Signature: ______________________Date:______________ 1