School-Based Interventions: Preventing Childhood Obesity in the UK

This report, prepared for the University of Sunderland in London, critically analyzes the effectiveness of school-based interventions in preventing childhood obesity in the UK. It begins by defining childhood obesity, outlining its prevalence, and highlighting the need for immediate preventive actions. The report investigates the determinants of childhood obesity, including genetic, social, and behavioral factors, and reviews the literature on school-based interventions. The methodology involves a comprehensive literature review, including an analysis of existing research and studies, the selection of relevant data sources, and the application of inclusion and exclusion criteria to ensure the validity of the findings. The report examines the effectiveness of various interventions and presents the results, discussing the implications of the findings and offering recommendations for future research and policy. It also summarizes the key findings, conclusions, and limitations of the research, providing a comprehensive overview of the topic.

Running head: EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO
PREVENT OVERWEIGHT AMONG CHILDREN IN THE UK
SUNIVERSITY OF SUNDERLAND IN LONDON
RESEARCH TOPIC: EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO
PREVENT OVERWEIGHT AMONG CHILDREN IN THE UK
STUDENT NAME: DANA DRUGHI
ID: BH48JP

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Table of Contents
CHAPTER 1: INTRODUCTION TO THE RESEARCH.....................................................2
1.0 Introduction:.............................................................................................................2
1.1 Operational Definition:.............................................................................................2
1.2 Background:.............................................................................................................3
1.3. Problem Statement:................................................................................................4
1.5. Justification of Research:........................................................................................5
1.6. Significance of the Research:.................................................................................5
1.7 Summary:.................................................................................................................6
CHAPTER 2: LITERATURE REVIEW...............................................................................7
2.0 Introduction:.............................................................................................................7
2.1. Determinants of childhood obesity in the UK:.........................................................7
2.1.2 School-based Interventions:.................................................................................9
2.1.3 Effectiveness of School-based Interventions:.......................................................9
2.2 Theoretical Framework:.........................................................................................10
2.3 Conceptual Framework:.........................................................................................12
2.4 Gaps in the Literature:...........................................................................................13
2.5 Summary:...............................................................................................................14
CHAPTER 3: RESEARCH METHODOLOGY.................................................................16
3.0 INTRODUCTION TO THE CHAPTER...................................................................16

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3.1 PHILOSOPHICAL ASPECTS OF THE RESEARCH.............................................16
3.2 DATA COLLECTION.............................................................................................17
3.3 DATA SOURCES...................................................................................................19
3.5 INCLUSION AND EXCLUSION CRITERIA...........................................................19
3.6 DATA ANALYSIS...................................................................................................20
3.6.1 Quantitative analysis.......................................................................................20
3.7 DATA SUMMARY TABLE OF JOURNAL ARTICLES...........................................21
3.8 RESEARCH ETHICS.............................................................................................25
3.9 LIMITATIONS OF THE RESEARCH.....................................................................25
3.10 SUMMARY OF THE CHAPTER..........................................................................26
Chapter 4: Results...........................................................................................................27
4.0 Introduction:...........................................................................................................27
4.1 Summary Table:.....................................................................................................27
4.2 Discussion of results:.............................................................................................30
4.6 Summary:...............................................................................................................33
Chapter 5: Conclusions and Recommendations.............................................................35
5.0 Introduction:...........................................................................................................35
5.1 Conclusions:...........................................................................................................35
5.2 Recommendation:..................................................................................................37
5.3. Summary:..............................................................................................................42

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References:......................................................................................................................43

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CHAPTER 1: INTRODUCTION TO THE RESEARCH
1.0 Introduction:
Obesity among children is a global problem; it is actually affecting 41 million children
aged under 5 years around the world (WHO, 2016). Childhood obesity with additional
economic and health effects is a very important predictor that causes obesity in
adulthood. The UK is no difference when it comes to excess weight among children.
Reportedly a quarter of 4- or 5-years old children have obesity in the UK (NHS, 2015a).
Furthermore, this proportion of obesity among children increases during the subsequent
six years; this increase is approximately from 9% to 19% (NHS, 2015b). As a result, this
is a critical issue that requires immediate preventive actions. This research paper aims
to critically analyse the effectiveness of school-based interventions in preventing obesity
among children. In order to achieve this aim, several literatures and frameworks will be
reviewed in this paper, based on this review, a research methodology will be decided for
further advancement in this topic.
1.1 Operational Definition:
Multiple systematic reviews have suggested that school-based interventions can
actually be effective in terms of reduction of the children proportions with obesity or
excess weight. Several school-based interventions were actually very effective in Body
Mass Index or BMI reduction among overweight children (McConnell-Nzunga et al.,
2018). Study designs and interventions based on heterogeneity actually precludes
conclusions about the combination of components that are likely to be effective.
Childhood obesity is also associated with several adverse health issues such as

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diabetes, asthma, hypertension, and negative self-image during childhood, sleep
disorders, and so on (Nishtar et al., 2016). Overall, multicomponent interventions, food
and physical activities, support from teachers and extended home and community
activities are most likely to be associated with the concrete and positive results. Few
key terms used in this research are defined below:
Childhood obesity: Childhood obesity can be referred as the condition where the child
is overweight in relation to his or her age (Turner et al., 2015). This can cause some
serious impacts on the children such as diabetes, excessive cholesterol, high blood
pressure and many more.
BMI: BMI can be defined by a value which is the derivation from the height and mass of
the person (McConnell-Nzunga et al., 2018). It is basically calculated by considering the
total square of the body height and generally expressed in kg/m²
School based intervention: School based intervention is the program to reduce the
issues in the children related to the body image, eating habit and many more to provide
the healthy lifestyle (Micha et al., 2018).
1.2 Background:
Prevalence of obesity and overweight is alarmingly increasing worldwide. Based on the
collected data, obesity and overweight tendencies among the children is very common.
Around a quarter of children aged within the five years old bracket has obesity tendency
(Fitzsimons and Pongiglione, 2019). There are several causal factors that are
associated with this problem among children. The most common and also modifiable
ones are related to their regular diets, as well as physical activity behaviours. Unhealthy

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diets and decreasing physical activities among the kids are actually increasing their BMI
(Nuttall, 2015). As the prior discussed statistics were constructed by several respective
authorities, this obesity tendencies and obesity-associated problems are indeed critical
for these children. (Hughes, 2018).
1.3. Problem Statement:
Childhood obesity is classified to be a major threat to public health and wellbeing. The
problem is not just in the context of the UK but also worldwide. Though, this current
research paper is focusing on the childhood obesity problem in the UK. Prevalence of
childhood obesity in the UK has significantly increased over the past few decades.
Based on the report published by the UK's National Health Service or NHS that 20.2%
of children measured during their study were obese (NHS, 2019b). Yet, the first annual
report by NHS reported only 2.4% during 2006. Furthermore, more than 26,000 children
that are around 4.4% of the studied children were severely obese. According to the
World Obesity Federation, 250 million school-aged children will be obese by 2030.
According to a report published by the UK chief medical officer Davies (2019), the
reason behind this increasing trend in childhood obesity is unhealthy diets and
increasing fast food consumption. These unhealthy diets and insufficient physical
activities are the reason behind some diseases among children such as osteoarthritis,
diabetes, heart diseases (Lopes et al., 2018). This subject matter has been chosen for
this research because of multiple reasons; every adult in the UK has a responsibility to
point out the extent of obesity in the children's prevalence in the country. Furthermore,
and several studies have already shown the severity of this problem among the children
in the UK. This is why constructing a research study based on the school-based

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intervention programs points out the necessity of viable strategy implementation and
finding a potential solution (Hung et al., 2015). This research also focuses on the
outcome assessment for their effectiveness as well. Overall, evaluation of the short-
term effects of an education-based intervention and based on the result, longitudinal
school-based educational interventions can be recommended for long-term impact on
childhood obesity prevention.
1.5. Justification of Research:
As several recent studies are reporting childhood obesity is increasing in the UK, other
obesity-associated issues or diseases are also on the rise. As a result, heart diseases
and strokes are now very common among young people because of this obese
childhood problems. Furthermore, diabetes, asthma, sleep apnea and osteoarthritis are
also reportedly the obesity-associated diseases among the children. As per NHS,
insufficient physical activity and poor diet is the reason behind this obesity issue.
1.6. Significance of the Research:
WHO has cited childhood obesity to be the most serious health challenges for public
wellbeing. Childhood obesity examination programs are necessary and also such
examinations reports about several organs in the body, this, as a result, can also
identify the risk of other diseases in the future as well (Reinehr, 2018). Effectiveness of
these programs means, attaining the significant positive behaviour change among the
children following nutritional knowledge gained from obesity education. Considering the
association of obesity and lifestyle, this study is important as it will focus on the
attribution of a decisive role to achieve voluntary changes in children's behaviour.

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1.7 Summary:
This introduction chapter has focused on the main coverage of current research paper.
This overview has presented the research subject and also presented the importance of
the research by the establishment of the research subject using several statistics. By
assessing the value of the problem, this chapter has also focused on the significance of
this research paper as well.

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CHAPTER 2: LITERATURE REVIEW
2.0 Introduction:
The objective of this chapter is the establishment of the effective intervention of
childhood obesity programs, as a part of the feasibility study. This chapter will focus on
the theoretical framework concepts in relation to this current study. It starts with broad
literature reviews on this topic; this review will focus on the identification of the root
causes or contributing factors, strategic deployment of school-based programs and the
effectiveness of such programs. Furthermore, this chapter will also discuss the
theoretical frameworks or theories in terms of childhood obesity and will critically review
the school-based interventions and the role of such programs. Literature reviews allow
to highlight gaps in previous research, obtain critical observations and also allows the
researcher to re-focus on the study topic.
Relevant literature was extracted and reviewed by evaluating them using a checklist.
The guidelines of this checklist were to evaluate the quality of the research methods
used in those studies. Key components were the data collection methods, appropriate
analysis methods in context to the current study.
2.1. Determinants of childhood obesity in the UK:
The reviewed literature never focused on indicating a specific cause behind childhood
obesity; rather, they documented various possible reasons. Based on the study
performed by Wilkie et al. (2018), the most common causes behind obesity among
children are genetic, lack of physical activity, unhealthy dietary patterns or combination

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of these aforementioned factors. The National Health Services of UK has categorised
the childhood obesity causes to be genetic, social and behavioural.
Genetical Factors: The study by Hart (2018) explains that a child born to a family with
a history of overweightness is more prone to become obese as they are genetically
predisposed to such condition. This is why hormonal disorders are also known to
predispose the obesity problem to a child. There are two types of causes come under
genetical factors. The first one is mutation in a single gene in the leptin- melanocortin
pathway. The second one is the effect of multiple genes, which result in the promotion
of weight gaining.
Social or Environmental Factors: Based on the research study by Manioc et al.
(2018), social or environmental factors are the actions that are promoting the increased
consumption of unhealthy and fast foods, furthermore the discouragement activities
such as awareness advertisements and encouraging awareness for proper dietary
charts. Also, limited access to healthy, affordable foods that attract the children, high
energy-dense food availability and lack of appealing places for playing are also the root
cause behind the obesity among UK children.
Behavioural Factors: According to Bates et al. (2018), obesity causing behavioural
factors are the dietary patterns that these children and their patents are following, lack
of physical activity, inadequate sleep, forced educational pressures by the school and
parents. These factors are actually taking these children towards obesity problems.
According to Knai et al., (2016), with the increased academic pressure on this very
young demographic from both the institutes and parents they involve in lesser physical
activities. As a result, they are now more prone to obesity. Furthermore, increased

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digital gadget usage during free time has also decreased their physical activity.
Inadequate sleep and fatigue are also important factors influencing hormonal changes
to cause obesity as well.
2.1.2 School-based Interventions:
In order to prevent childhood obesity, school-age and school-based settings are
identified to offer strategic benefits. The study performed by Micha et al. (2018)
suggests that school-based programs are very vital for the prevention of obesity in
young age because prevention of obesity in this age impacts the adulthood obesity
cases. Because there is a clear relationship between increased BMI during childhood
and adulthood obesity. This is why improved school food environment can execute
healthy children behaviours. Additionally, this will help them to educate about food
purchasing decision based on dietary values without parental presence.
As the early-age is the best time to teach essential skills, school-based programs can
be effective and will also have long term effect as well. In the view of Turner et al.
(2015), physical activities during school time, such as outdoor games will also provide
the required physical activities among children. This is why the major reasons to select
a school-based program are:
1. This is the best responsive stage to intervene with health awareness
2. Schools also offer a common setting for children gathering
3. Offers room for education to transform their attitude

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2.1.3 Effectiveness of School-based Interventions:
Based on the study performed by Clarke et al. (2015), school-based programs are
effective in terms of awareness creation among the children and also among their
parents as well. Children's behaviour and parental negligence’s that develops the
dietary inadequacies and lesser interests towards the physical activities are being
addressed during these school-based intervention programs. Adab et al. (2018) stated
that even though the reviewed studies reported different levels of outcome to their
research in terms of their effectiveness and feasibility, the common finding was the
positive influence of these interventions on both children and their parents.
The study undertaken by Manios et al. (2018), suggested that small but statistically
significant effect on BMI improvement awareness among the children and their parents.
Also, this study found increased fruit and vegetable intakes, as well as increased water
consumption and increased physical activities among the children under such a school-
based program. This significant and positive outcome means a multilateral approach
can become beneficial. Conclusion of these studies was consistent in terms of
behavioural pattern changes.
2.2 Theoretical Framework:
Health awareness promotions employ educational activities to promote health practice
and modify behavioural patterns. Yet, the ground reality of such health awareness and
the promotional program is that they are not always successful. This is why health
intervention theories and its application is important because they offer an organised
way to consider events and has set concepts that can clarify events by the illustration of
the relationship between variables. Using these theories in research helps the

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researchers with the identification of appropriate audience and the measurement of the
effectiveness of the research through planning.
School-based interventions cover behavioural topics such as dietary and social aspects
such as sports. Thibodeau and Flusberg (2019), highlighted that while designing and
evaluating a school-based intervention, it is essential to use such theories because
these theories provide the framework with the intervention components development.
Furthermore, these theories also assist the researcher with the selection of effective
assessment and construction of measures as well. In the following section, an
integrative review on Lay Theories of obesity will be developed. With the various
dimensions of this lay theories, it will be easier to understand the psychological
mechanisms that can affect the thought process of people and how they reason about
obesity.
Trait Theory:
The concept of obesity among people is the same as any other physical and
psychological traits. As per Llewellyn and Fildes (2017), this theory characterizes
people's thought process and reasons with it about a variety of traits. These traits are
distinguished by the level to which the trait then classified as malleable. Based on this
theory, people are more open towards lifestyle changes such as embracing a new diet
or routine exercises.
Causal Theories: Casual origins of the obese problem is considered by another
category of lay theories. In order to think about complex problems like obesity, people
sometimes rely on a narrative structure to include extended metaphors and analogies.

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The critical dimensions that differentiate this lay theory are the level to which people
attribute personal responsibilities or blame obese individuals for their overweightness.
There are other lay theories available as well, but depending on the limitation of this
present study, these two important lay theories were taken into consideration and
discussed.
2.3 Conceptual Framework:
Selection of a theory to use in the school-based programs can be problematic. Such
selection is not concrete as several researchers have used different theories in their
studies. The best practice to select a theory will be to select a theory that has already
been tested on a similar population and setting and also supported the research.

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Figure 1: Conceptual Framework Diagram
(Source: Author)
Based on this present school-based intervention, there are two deciding factors, Non-
Modifiable and Modifiable. The non-modifiable factor, in this case, is the genetic factors.
Several sub factors influence these genetic factors. According to Russell and Russell
(2018), as these factors are not controllable, no program can nullify such factors, but
with the help of a program, these factors can be contained. The modifiable factors are

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what this school-based intervention is about. Lifestyle and physical activities are the
sub-factors in this segment. Lifestyle is impacted by the children dietary issues or their
sleeping patterns. The excessive fast food, junk food and sweetened beverages are
what affecting the children's obese problems. According to Boswell et al. (2018), these
unhealthy dietary practices are causing nutritional issues among the children and
resulting in a high number of childhood obesity. Furthermore, the lack of physical
activity among children are also causes of obesity.
As per Witten (2016), this school-based program has to target these two modifiable
factors, based on these factors this program needs to teach a nutrition friendly diet to
the children and their parents as well. Also, schools will promote more physical activities
by playing, and less academic pressure among these children will also reduce mental
stress. As a result, school-based programs will create awareness among the children
early on in their life as well as aware the parents about the factors as well.
2.4 Gaps in the Literature:
On the basis of literature reviews so far conducted for this present paper, it is evident
that these previous researches has not established any conclusive report about the
primary causes of obesity. During the study, it has been observed that there is only
robust evidence from longitudinal and cross-sectional studies to support the lack of
physical activities, energy-dense and high-fat diet is attributed as the cause of obesity.
Also, there are lack of efficacy of accounts about the feasibility of relationship between
healthy diet and physical activity to prevent obesity. Furthermore, they also lacked the
identification of the effective lifestyle factor between these two to combat obesity. This
literature supports the fact that in order to effectively combat obesity, children have to

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adopt more physical activity. But they are not conclusive about why such simple
discovery not yet implemented widely.
Furthermore, there is no effective framework that specifies standard physical activity
guidelines that can reduce obesity or help children to avoid obesity. Also, which
geographical or terrain is the influential factor for obesity development, has not been
discussed by any of these prior researches. It is also not clear from any of these studies
that what could be the average time for such intervention program. In a school-based
intervention, a standard time frame consideration is important for effectiveness. Even
though most of the studies reviewed were based on UK children demographics, they do
not provide a correct representation of the problem as they were not performed on the
scale of the entire UK. Based on the studied demographic size, there can be other
factors on a broader scale.
2.5 Summary:
Based on the reviewed studies, this chapter has identified several criteria that
contributed to those studies. The focus of the study was to identify the childhood obesity
prevalence in the UK; factors influencing the obesity problems and their health
implications. These previous studies have focused on the tackling of obesity problems
among UK children through controlling and preventive measures. The preventive
measures suggested by these studies were school-based interventions. These studies
have suggested nutritional awareness and physical activity building through school-
based programs. These studies have summarized some of the key areas; these key
areas are the aim of the study, study design and their impact as the school-based
interventions. Based on these studies and theories, a conceptual framework was also

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developed. Furthermore, few gaps were identified in these studies by performing a
critical analysis of them.

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CHAPTER 3: RESEARCH METHODOLOGY
3.0 INTRODUCTION TO THE CHAPTER
This chapter details the methods and instruments used for conducting the research
meaning the details of research philosophies, research design, the data sources and
search items used for searching data, as well as ethical considerations. The research
methodology is one of the important parts of the research project, and it will help the
researcher to conduct the research in a more significant manner and positive way.
3.1 PHILOSOPHICAL ASPECTS OF THE RESEARCH
A number of research philosophies are available that can be used for deciding research
design. Research philosophy helps in developing the belief regarding how the research
should be conducted and data should be collected as well as analysed.
As per the positivist research approach, if the reality is stable and observable, then
premises can be described and accepted from an objective point of view considering
the facts that the observed phenomena are repeatable (Kumar, 2019). The research
conducted following this philosophy as highly structured, but the samples should be
large, and measurement should use quantitative methods however in some cases the
qualitative analysis is acceptable. As per pragmatist philosophy concepts are relevant
only if these concepts support action. Pragmatism argues in favour of mixed methods or
adaptation of multiple research methods meaning that analysis should involve both
quantitative and qualitative analysis methods. The ontology is objective or subjective,
and axiology is value-free/biased. The search approach that can be adapted under this
philosophy is deductive or inductive.

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Realist approach is based on the idea of independence of reality. It argues in favour of
the assumption of scientific techniques in the development of knowledge. While direct-
realist is the reflection of human senses while critical realism argues that the senses of
real-world as perceived by humans can be deceptive and does not portray the real
world (Kumar, 2019). Under this philosophy, therefore, the data types and adapted
methods should fit the research subject matter.
The Interpretivism philosophy is based on criticism of positivism philosophy and
researchers interpreting elements of a research study with a philosophical position of
idealism (Ledford and Gast, 2018). This research philosophy allows for in-depth
analysis of small samples using qualitative research investigations. The current
research topic has the aim of investigating the effectiveness of school-based
interventions to prevent overweight, and obesity among children in the UK which would
require examining the current school-based intervention programs at the place and
identifying dap achieved benefits and existing limitations of these programs in
addressing childhood obesity in the UK. Considering this research need, the research
design that needs to be adopted is explanatory research design inductive research
approach. The interpretivist philosophy, therefore, would be most suitable for
conducting the study and thus has been used in this study.
3.2 DATA COLLECTION
Collecting data is a vital part of the research project as it helps the researcher to get the
actual knowledge on the topic. Data collection can be done in various ways, but the
source of the data must be evaluated properly for the authenticity of the project. Two

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general types of data collection methodology are applicable to be adapted in any study,
namely primary data collection and secondary data collection.
Primary data collection is the way of collecting data directly from the respondents.
Primary data collection methods can either be quantitative data collection or qualitative
data collections where data can be collected from human respondents as data sources
using a variety of research methods such as questionnaire, survey, focus group
discussions and interviews (Mackey, and Gass, 2015). The quantitative data collection
methods use mathematical interpretation techniques while qualitative data collection
relies on human emotions, feelings and sounds. In primary data collection process
chances of collecting fresh data is high; it will help the researcher to get the new
information regarding the topic.
Secondary data are data that has been published in journals. Newspapers, online
platforms, books in short sources that are non-human in nature are collected under
secondary data collection methods. The chosen data sources are judged on criteria
such as authors, date of publication (if the article is recent or not), source reliability
(credibility of journal or seminar proceedings), depth of analysis and quality of
discussions (Bresler and Stake, 2017).
As the research philosophy has been chosen is Interpretivism, and the chosen research
design is explanatory qualitative research with small samples is the most appropriate
methods. The current intervention programs at the place in the UK based school
regarding preventing and managing child obesity are available at plenty from secondary
data sources such as books, journal articles and online portals. Thus the chosen data
collection method is secondary data analysis.

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3.3 DATA SOURCES
Like data collection methods sources can be primary and secondary data sources.
Using similar principles as in the case of data collections, primary data sources are
human in nature while secondary data sources are books, journals, news articles, and
websites (Flick, 2015). For this research, secondary data sources which involve only
journal articles have been used because the credibility of sources can be easily
determined from the currency of article, authors, date of publication, reliability of the
journals where the articles have been published the depth of analysis and discussion
carried out in such articles and so on. The systemic keyword search from online
databases like google scholar, EBSCO, PUBMED, CINAHL, EBSCOHOSTM and
EMBASE has been done in this research for gathering valuable data for analysis and
discussions.
1. Obesity or overweight or obese or……..
2. Children or child or infants or …….
3. School based interventions
4. Effectiveness
5. UK or England or London or Scotland or
3.5 INCLUSION AND EXCLUSION CRITERIA
Choice of literature was dependent on inclusion criteria. The inclusion criteria involve
articles being published in international journals, articles that are peer-reviewed, articles
that are most recent, articles having the keywords mentioned in the literature multiple
times, the credibility of the sources and authors. The exclusion criteria focused on

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articles that were published before 2015, that are not peer-reviewed and having the
keywords mentioned only once or twice. This is because such articles will likely omit all
valuable information that can be used in a recent study for having information that is too
old, information that is only hypothetical in nature and articles not having enough data at
all for analysis.
Inclusion Exclusion criteria
Peer reviewed articles with keywords. Articles that are not peer reviewed.
Journals published after 2015. Journals published before 2015.
3.6 DATA ANALYSIS
3.6.1 Quantitative analysis
Data analysis methods can be quantitative, which involves mathematical and statistical
interpretation of data. In this method, the researcher is expected to turn raw numbers
into meaning data using rational and critical thinking as well as statistical and
mathematical interpretations (Silverman, 2016). This method is used usually either to
accept or to reject a hypothesis by calculating frequencies of variables or differences
between variables a number of online and offline analytical instruments can be used for
undertaking quantitative analysis such as Microsoft excel/ google sheets, access, and
SPSS. Therefore, the quantitative analysis is appropriate for primary data collection in
most cases. The analytical method that is used for interpreting non-numeric data
collected from either primary or secondary data sources is called qualitative analysis
method. Content analysis, narrative analysis, disclosure analysis, framework analysis

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and grounded theory. In the case of data collected from secondary sources, thematic
analysis is the most common method used (Fletcher, 2017). Here, by reviewing the data
published in different sources, the research tries identifying common themes, patterns
and relationships following the six stages of thematic analysis. The data is then
summarised in order to draw meaningful conclusions, either tested or untested in
nature. This is because this method would allow undertaking thematic analysis in which
identifying common themes, patterns and relationships can be identified and then
summarised to draw meaningful conclusions either tested or untested in nature.
3.7 DATA SUMMARY TABLE OF JOURNAL ARTICLES
The identified articles are summarised in the data table below.
Authors name and year Research aim Research
methods
Your comments
Race/ethnic disparities in
early childhood BMI,
obesity and overweight in
the United Kingdom and
the United States.
Zilanawala, Davis-Kean,
Nazroo, Sacker,
Simonton, and Kelly.
2015
The study
focuses on
finding the co-
relation between
the problem of
childhood obesity
and the race or
cultural
differences.
Secondary data
analysis
Promoting positive body
image and tackling
The article was
focused on the

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
OVERWEIGHT AMONG CHILDREN IN THE UK
overweight/obesity in
children and adolescents:
A combined health
psychology and public
health approach.
Bray, Slater, Lewis-Smith,
Bird, and Sabey. 2018
problem of
overeating and
resulting risk of
obesity in the
children.
A meta-analysis of
school-based obesity
prevention programs
demonstrates limited
efficacy of decreasing
childhood obesity.
Hung, Tidwell, Hall, Lee,
Briley, and Hunt. 2015.
The article was
focused on
finding if the
current school-
based
interventions are
effective in
preventing the
childhood obesity
through a meta-
analysis of
previous
scholarly studies.
Effect of school-based
interventions to control
childhood obesity: a
The article was a
review of the
previous meta-

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
OVERWEIGHT AMONG CHILDREN IN THE UK
review of reviews.
Amini, Djazayery,
Majdzadeh, Taghdisi, and
Jazayeri, 2015.
analytic reviews
that were aimed
at deciphering the
effect of various
school-based
interventions that
are in practice
currently in
lowering the rate
of development of
childhood obesity
in children.
School-based
interventions to reduce
obesity risk in children in
high-and middle-income
countries.
Evans, Albar, Vargas-
Garcia, and Xu. 2015.
The article was
focused on
finding the
effectiveness of
the school based
interventions in
both the higher
income and the
lower income
countries.
Advances in food
and nutrition
research
Effectiveness of a The article was British Medical

27
EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
OVERWEIGHT AMONG CHILDREN IN THE UK
childhood obesity
prevention programme
delivered through
schools, targeting 6 and
7-year-olds: cluster
randomised controlled
trial (WAVES study).
Adab, Pallan, Lancashire,
Hemming, Frew, Barrett,
Bhopal, Cade, Canaway,
Clarke, and Daley. 2018.
focused on
making an
assessment on a
few school-based
and family based
interventions in
lowering the
childhood obesity
targeting the
children of the
age group from 6
to 7 years.
Journal
Effectiveness of the
Healthy Lifestyles
Programme (HeLP) to
prevent obesity in UK
primary-school children: a
cluster randomised
controlled trial. The
Lancet Child &
Adolescent Health, 2(1),
pp.35-45.
Lloyd, Creanor, Logan,
The study was
focused on
deciphering
whether the
school-based
interventions are
effective in
lowering the body
weight in the 9-10
year old children.
The Lancet Child
& Adolescent
Health

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
OVERWEIGHT AMONG CHILDREN IN THE UK
Green, Dean, Hillsdon,
Abraham, Tomlinson,
Pearson, Taylor, and
Ryan. 2018.
Table 1: Data Summary table
Source: Developed by author
3.8 RESEARCH ETHICS
Ethical consideration is one of the most important aspects of research as research
studies can easily be rejected based on research ethics. The common research
paradigms involve respect and dignity for research participants, privacy and anonymity
of participants, data protection, the involvement of minors, and data collection after
expressed consent, duplication of data without proper acknowledgement or citation to
the original authors, plagiarism issues. For these reasons, researchers must produce
ethics for including any affiliations, sources of funding, and consent details from
participants. The present research being qualitative in nature collecting data from non-
human sources the key ethical considerations involved in this research include
duplication of data without proper acknowledgement or citation to the original authors
and plagiarism issues. The researcher has tried avoiding issues by acknowledging the
works of the authors and citing sources for all information used in this study.
3.9 LIMITATIONS OF THE RESEARCH
Research can involve single or multiple limitations. Common limitations are lack of time
and funding, lack of credible data sources, lack of previous study and scope discussions

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
OVERWEIGHT AMONG CHILDREN IN THE UK
as well as outcomes not aligning with initial aims and objectives. The key limitations of
this study involve limited time and funding for conducting this study for which the sample
size was kept small and analysis as brief as possible.
3.10 SUMMARY OF THE CHAPTER
The chapter presented the details of the methods used for conducting the study,
including the justifications for the chosen methodology. The chosen philosophy
approach and design are Interpretivism, inductive and explanatory, respectively. The
data collection method is chosen in secondary with qualitative analysis methods chosen
for data analysis.

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
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Chapter 4: Results
4.0 Introduction:
The section is going to discuss all the results of the articles chosen for determining the
effectiveness of the school-based interventions in preventing the overweight in the
children. At first all the results are going to be summarized in a table format and after
that they are going to be discussed in brief. Lastly the summarized version of the
section will be provided.
4.1 Summary Table:
Article Results
1. Race/ethnic disparities in early
childhood BMI, obesity and
overweight in the United Kingdom
and the United States.
In US, the black Caribbean children have
highest odds at developing obesity. After
that the odds are high in the black African
children. The Pakistani children are at
lowest odds of developing obesity.
In UK, the white children were less likely
to develop obesity than the Hispanic,
Mexican and the Indian American
children.
2. Promoting positive body image
and tackling overweight/obesity in
children and adolescents: A
combined health psychology and
The article was focused on suggesting a
few school based interventions that
should be adapted in future in order to
lower the risk of obesity in the children.

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
OVERWEIGHT AMONG CHILDREN IN THE UK
public health approach. Those interventions include, development
of a positive image of body by the
adaptation of a whole school approach, in
the curriculum arranged by the school
must set an equal value to both the
physical and the mental health, promotion
of the keep well and feel good attitude
while attempting for the physical exercise
activities and finally the teachers should
be trained to deliver the sessions that
take place in the school, instead of the
external facilitators.
3. A meta-analysis of school-based
obesity prevention programs
demonstrates limited efficacy of
decreasing childhood obesity.
The hypothesis that the school-based
interventions are effective in preventing
obesity was rejected and the conclusion
was that the current school-based
practices are unable to prevent the
problem of obesity in the children.
4. Effect of school-based
interventions to control childhood
obesity: a review of reviews.
The school based interventions were less
effective when those interventions were
multi-component. Though the duration of
an intervention had a large effect on the
level of effectiveness.

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
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5. School-based interventions to
reduce obesity risk in children in
high-and middle-income countries.
The school based interventions targeted
at dietary habits only in the children are
not much effective. Though if the
components like increasing physical
activity and lowering the sedentary
behavior are addressed, the level of
effectiveness of those interventions is
much higher.
6. Effectiveness of a childhood
obesity prevention programme
delivered through schools,
targeting 6 and 7-year-olds: cluster
randomised controlled trial
(WAVES study).
The study concluded that there was no
significant improvement in the BMI score
of the school children after the
implementation of 12 school based
interventions for 15 and 30 months.
7. Effectiveness of the Healthy
Lifestyles Programme (HeLP) to
prevent obesity in UK primary-
school children: a cluster
randomised controlled trial. The
Lancet Child & Adolescent
Health, 2(1), pp.35-45.
The study found that there is no
significant difference in the 9-10 years old
children after 24 months long
implementation of school-based
interventions as a control trial of HeLP.

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
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4.2 Discussion of results:
The first article focuses on finding the co-relation between the problem of childhood
obesity and the race or cultural differences. The study found that the white children are
less at risk of developing obesity than that of the black children. The study was
conducted considering two countries, which are the US and the UK. The researchers,
who conducted this study, were unable to discover the reason behind this differences.
Though there was a suggestion that the effect of migration and the bedtime for the
children might have a causal effect on the children. Another cultural factor may come
from the fact of restrains on breastfeeding and the eating habit of the children. The
study make suggestions on the prevention of obesity in children by starting to take the
measures early in childhood by increased physical activity and developing healthy food
habit in them.
The second article was focused on the problem of overeating and resulting risk of
obesity in the children. The authors reviewed the school based interventions, which are
already at place to control those two problems and then made suggestions on some
improvement strategies that must be adapted in the future in order to overcome these
problems of childhood obesity and overeating. The first suggestion was giving equal
importance to both the physical and the mental health of the children while arranging a
school based curriculum, so the root of those problems can be addressed more deeply
in the children. The second suggestion was making an approach to develop a concept
of positive body image in the children, so there is an additional development of the
confidence in regards to their body in the children. The third suggestion was that the
children should be encouraged to perform the physical activities in order to feel good

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
OVERWEIGHT AMONG CHILDREN IN THE UK
and keep well, instead of following the purpose of building muscles and losing weight.
The fourth suggestion was training the internal teachers so they are capable of
delivering the school based sessions instead of the external facilitators, so the children
are more comfortable in the sessions and there is an improvement in the scalability.
The third article was focused on finding if the current school-based interventions are
effective in preventing the childhood obesity through a meta-analysis of previous
scholarly studies. The researchers found that the interventions that are already in
practice are not effective enough in the prevention of the problem of childhood obesity.
The studies found the interventions based on few factors such as the promotion of
healthy diet, nutritional value of food, parental involvement, professional involvement did
not have very significant effect on reducing the body weight in the children. However,
the study was unable to decipher the effect of physical activity related interventions in
regards to this issue of childhood obesity. The study was unable to point the reasons for
the failure of those interventions.
The fourth article was a review of the previous meta-analytic reviews that were aimed at
deciphering the effect of various school-based interventions that are in practice currently
in lowering the rate of development of childhood obesity in children. The study found
that the multicomponent interventions were mostly ineffective in lowering the childhood
obesity, though the long duration of the implementation has significantly better effect in
solving that problem. The study reviewed various aspects on which the effectiveness of
the interventions depended on. Those aspects include gender, ethnicity, age and risks
of disease in the children. The studies found that the effectiveness of the intervention in
girls were less effective than in the boys in few cases. The interventions aimed at the

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
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children between the age group of 8-10 were mostly ineffective. The matter of ethnicity
cannot be recognized as significant while assessing the effectiveness of the school-
based interventions in lowering the childhood obesity, even though it has been found
that the black children are at higher risk of obesity compared to the white children.
The fifth article was focused on finding the effectiveness of the school based
interventions in both the higher income and the lower income countries. The authors of
this study considered various interventions that are in place for lowering the obesity in
the children. The result of the study showed that the development of healthy dietary
habit such as more consumption of fruit and vegetables along with lower consumption
of sugary snacks can be effective in lowering the childhood obesity. Though the study
also concluded that only changing the dietary habit cannot be that effective if the
components like increased physical activity and the sedentary behavior in the children
are not addressed.
The sixth article was focused on making an assessment on a few school-based and
family based interventions in lowering the childhood obesity targeting the children of the
age group from 6 to 7 years. The study was assessed within a 15 days and a 30 days
model. The implementation of 12 school-based interventions were considered. The
researchers found no significant differences, suggesting reduced BMI in the children,
suggesting the implementation of those interventions had no effect on reducing the rate
of childhood obesity, even though the interventions were focused on improving the
dietary habit and physical activity in children. Additionally there was no harmful effect
observed on the students either resulting from these interventions.

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
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The seventh study was focused on deciphering whether the school-based interventions
are effective in lowering the body weight in the 9-10 year old children. The study period
was 24 months. As a controlled trial of HeLP, the children from 32 schools were
subjected to various school-based interventions. The outcome was measured by the
change in the BMI of the children after 24 months. The researchers found no significant
difference in that aspect. Hence it was concluded that the implication of the school-
based interventions in the 9-10 year old children has no effect in lowering the rate of
obesity in the children.
From all those studies discussed above it can be deciphered that the effectiveness of
the school based interventions in lowering the overweight along with the risk of obesity
depend on various factors. Those factors include the age of the children, gender, ethnic
and racial differences and even the type of the interventions that were at use. The type
of interventions can be described as multi-component or uni-component. In some
studies it was found that the children of age group below 12 years do not respond to the
interventions. While considering the gender, the boys are found to be more responsive
to the interventions than the girls when it is the matter of lowering bodyweight. The
black children are found to be more prone to obesity than that of the white children. The
type of interventions implemented was also important since it was found in several
studies that if the focus of the interventions are only at changing the dietary habits of the
children, it is not as effective compared to the interventions that are focused on
changing the sedentary habit and increased physical activity in the children along with
that.

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
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4.6 Summary:
This chapter enlisted the previous studies that were focused on the school based
interventions in order to prevent the overweight in the children, which increase the risk
of childhood obesity. There are seven studies focusing on the different factors that are
responsible for the effectiveness of those interventions. It was found from those
previous studies that the effectiveness of the interventions depend on various aspects
including the age and gender of the child, cultural differences and the type of
intervention implemented. One of those studies was based on the assessment of the
current interventions that were at place and the future recommendations in order to
improve the outcome.

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Chapter 5: Conclusions and Recommendations
5.0 Introduction:
This chapter aims for summarizing all the chapters discussed previously. At first, the
chapter is going to conclude the introduction chapter listing the aim of the study along
with the problem, background and the significance of the study. Then in an attempt to
conclude the literature review chapter the review of the literature, the conceptual
framework and the gaps in the literature is going to be enlisted. After that the research
methodology chapter is going to be concluded, which is going to be followed by the
conclusion of the result chapter. Next, there will be some recommendations in order to
achieve a better outcome from the school-based interventions in lowering the risk of
development of obesity in children. Lastly, a summary of this chapter is going to be
provided.
5.1 Conclusions:
Obesity among children is a problem that can be recognized globally. The problem is
important because it is also associated with several adverse health issues such as
diabetes, asthma, hypertension, and negative self-image during childhood, sleep
disorders, and so on. The UK is no different when it comes to excess weight among
children. This is why constructing a research study based on the school-based
intervention programs points out the necessity of viable strategy implementation and
finding a potential solution. As several recent studies are reporting childhood obesity is
increasing in the UK, other obesity-associated issues or diseases are also on the rise.
Considering the association of obesity and lifestyle, this study is important as it will

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
OVERWEIGHT AMONG CHILDREN IN THE UK
focus on the attribution of a decisive role to achieve voluntary changes in children's
behaviour.
The literature review section determines the factors associated with the obesity in
children, which are the genetic factors, social and environmental factors and
behavioural factors. The mutations in a single genes or combined effect of multiple
genes can be identified as the genetic factor. Limited access to healthy food can be
determined as the social or environmental factor. The behavioural factors include the
physical inactivity, lack of sleep and many others. The literature review also school-
based programs are very vital for the prevention of obesity in young age because
prevention of obesity in this age impacts the adulthood obesity cases. Because there is
a clear relationship between increased BMI during childhood and adulthood obesity. As
the early-age is the best time to teach essential skills, school-based programs can be
effective and will also have long term effect as well. The conceptual framework is based
on a theory that supports the modifiable factors. There are three gaps in literature that
can be identified. On the basis of literature reviews so far conducted for this present
paper, it is evident that these previous researches has not established any conclusive
report about the primary causes of obesity. Furthermore, there is no effective framework
that specifies standard physical activity guidelines that can reduce obesity or help
children to avoid obesity. Along with that which geographical or terrain is the influential
factor for obesity development, has not been discussed by any of these prior
researches.
The research methodology section enlists the methods and instruments used for
conducting the research meaning the details of research philosophies, research design,

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
OVERWEIGHT AMONG CHILDREN IN THE UK
the data sources and search items used for searching data, as well as ethical
considerations. As per the positivist research approach, if the reality is stable and
observable, then premises can be described and accepted from an objective point of
view considering the facts that the observed phenomena are repeatable. The
Interpretivism philosophy is based on criticism of positivism philosophy and researchers
interpreting elements of a research study with a philosophical position of idealism. As
the research philosophy has been chosen is Interpretivism, and the chosen research
design is explanatory qualitative research with small samples is the most appropriate
methods. For this research, secondary data sources which involve only journal articles
have been used because the credibility of sources can be easily determined from the
currency of article, authors, date of publication, reliability of the journals where the
articles have been published the depth of analysis and discussion carried out in such
articles and so on. The inclusion criteria of choosing the articles involve articles being
published in international journals, articles that are peer-reviewed, articles that are most
recent, articles having the keywords mentioned in the literature multiple times, the
credibility of the sources and authors. The exclusion criteria focused on articles that
were published before 2015, that are not peer-reviewed and having the keywords
mentioned only once or twice. The data was analysed by using the qualitative data
analysis method. The present research being qualitative in nature collecting data from
non-human sources the key ethical considerations involved in this research include
duplication of data without proper acknowledgement or citation to the original authors
and plagiarism issues. The key limitations of this study involve limited time and funding

41
EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
OVERWEIGHT AMONG CHILDREN IN THE UK
for conducting this study for which the sample size was kept small and analysis as brief
as possible.
From all those studies discussed in the result section it can be concluded that the
effectiveness of the school based interventions in lowering the overweight along with
the risk of obesity depend on various factors. Those factors include the age of the
children, gender, ethnic and racial differences and even the type of the interventions
that were at use. It was found that the school-based interventions are not effective in
lowering the body-weight of the children below 12 years age. The black children are
more prone to obesity than the white children. The girls respond less to the
interventions than the boys in lowering the body weight. The multi-component
interventions are more effective in lowering the risk of obesity in the children.
5.2 Recommendation:
From the above study it can be stated that the issue of childhood obesity is one of the
crucial problems for the children of UK. After reviewing most of the studies related to the
obesity among the children a few measures can be recommended. The interventions for
reducing the obesity among the children in UK are as follows-
Enhanced Physical Activity in the School
In various studies it is reported that lack of adequate physical activities among
the students is one of the primary reasons of developing obesity among the children. In
modern time, along with the development of the technology, more number of children
are getting addicted to various type of online gaming and virtual reality based gaming
programs and as a result their regular physical activities are neglected and as a result

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
OVERWEIGHT AMONG CHILDREN IN THE UK
the chances of developing obesity among them are enhancing day by day. Therefore, it
can be stated that intervention of performing physical activities in the school setting in a
regular basis will help to reduce the problem of obesity among the children and in this
regard, it can be stated that such physical activity programs must be launched for all the
students present in the school as it will help to improve the condition of obesity among
the students and along with this it will also help in prevention of obesity development
among the students who are not obese currently. In the study of Li et al. (2014) the
effectiveness of school-based physical activity (PA) intervention was examined by the
authors during a 12 weeks program on obesity and associated health consequences
among the school children. In this randomized control trial study, almost 921 children
under the age group of 7 to 15 years were selected at baseline level. Among them only,
388 children were assigned to the intervention group (n = 388) and they participated in a
program related to the physical activity during 12 weeks which comprised of
supplementary physical activities for the students who were overweight/obese in
nature , physical activities at home, enhancement of physical education and health
literacy for students and also for their parents. On the other hand, only 533 children
participated (n = 533) in the control group and they were engaged in normal practice.
The study result showed that the mean age of the participants were almost 10.4 years
along with a body mass index or BMI of the selected students were almost 19.59 kg/m2.
Among all the students, it was reported that approximately 36.8 per cent of children
were obese or overweight in nature. In the intervention group of the study significant
changes in the BMI of the participants were reported by the authors and it was observed
that the change in the BMI among the intervention group (−0.02 ± 0.06 kg/m2) proven to

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be statistically significant than that of the control group. The BMI change of the control
group was almost 0.41 ± 0.08 kg/m2. Along with this, the application of the physical
activity programs among the school children also showed significant effect on triceps,
abdominal skinfold thickness, subscapular and fasting glucose among the intervention
groups than that of the control group of the study. Not only had this but the changes in
the level of physical activity performances were also reported by the intervention group
children than that of the control group children (Li et al. 2014).
Reduction of Sugar Sweetened Beverage Consumption
The practices of consuming sugar sweetened beverage among the school going
children another primary reason of developing obesity among the children and thus it is
very crucial to prevent consumption of sugar sweetened beverages among the children
in a priority basis so that overall rate of obesity among the children can be reduced. In
this regard, the schools of the children have a huge role in reducing the practice of
consuming the sugar sweetened beverages as the children spend a good amount of
time in the school and so it is the duty of the teachers to take care of their students in
order to help them in gaining a healthy life. The study of Lloyd et al. (2018), stated that
the greater consumption of sugar‐sweetened beverages (SSB) enhances the risk of
weight gain, type 2 diabetes (T2DM), tooth decay and cardiovascular disease among
the children. In the study of (Vézina-Im et al. 2017), it is stated that over a year, in case
every extra daily serving of SSB enhances the BMI by 0.06 kg m−2 and weight by
0.22 kg in children. Therefore, it is very crucial to reduce the SSB in the school and thus
this intervention must be applied for all of the students. The meta-analysis study
reported that applications of interventions for the SSB are quite effective in reducing the

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OVERWEIGHT AMONG CHILDREN IN THE UK
consumption of SSB among the children. Interventions significantly reduced the
consumption of SSBs in children of the intervention groups compared to the controls
approximately by 76 mL d−1 along with a significant p value of less than 0.01 (95% CI
−105 to −46; P < 0.01). In another study by (Vargas-Garcia, Evans and Cade 2015) it is
stated that reduction of SSB consumption and consumption of alternatives such as
consumption of fresh fruit juice helped to reduce the case of obesity and overweight
among the children. Therefore, this intervention can be applied to reduce the obesity
and overweight cases as a part of the intervention. Along with this, the current study
also suggested the change in the water intake behaviour among the students may also
reduce the SSB intake among the students. The study of (Vézina-Im et al. 2017) also
supported the water intake enhancement as a part of the obesity prevention among the
children. The study of (Franken, Smit and Buijzen 2018) showed that increase amount
of water consumption among the students are correlated with lower amount of SSB
consumption among the students. As per the study result of this study, it is observed
that almost 192 children were assigned to the intervention group and in case of control
group the number was almost 185. Intervention group children were exposed to those
people who were promoting consumption of water and in case of control group children
no such exposure were reported by the researchers. The regression analyses indicated
that consumption of water improved in case of intervention group children along with a
high injunctive norm score (p = 0.05) and on the other hand, their intention to consume
more amount of water persisted (p = 0.42). In the children of the intervention group,
reduction in the consumption of SSB was reported by the authors along with a p value

45
EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
OVERWEIGHT AMONG CHILDREN IN THE UK
of 0.04 (p=0.04) and among them the intention to consume more water was also
reported by the researchers.
Change in the Food Practices- Consumption of Healthy Foods
Change in the food habits and consumption of healthy foods is one of the key
interventional changes for reducing obesity among the children. Therefore, it is
observed that consumption of unhealthy foods such as junk foods, noodles, huge
amount of chocolates, alcohol consumptions are associated with the onset of obesity
among the children. In case of the children of school going age, apart from the alcohol
consumption, all other factors are applicable. In this regard, it can be stated that the
consumption of healthy foods such as fresh vegetables, fruits and maintenance of
healthy life styles can easily improve the condition of obesity and overweight among the
children. In this regard, it can be stated that in various studies the effectiveness of the
healthy eating practices has been identified. According to the study of (Laureati,
Bergamaschi and Pagliarini 2014), it is stated that practice of healthy food consumption
among the children is highly effective in reducing obesity and overweight among the
children. In this study by (Laureati, Bergamaschi and Pagliarini 2014), the effectiveness
of the food and vegetable consumption as a part of the intervention was examined by
the authors and almost 560 children under the age group of 6 to 9 years (mean age:
7.9 ± 1.1) were lastly enrolled to join the study (278 girls and 282 boys). Among the total
students, 30 classes were registered; among them 6 1st graders (4 in the experimental
group), 9 students of 2nd grades (4 in the experimental group), 8 students of 3rd grades
(4 for the experimental group), and lastly 7 students of 4th grades (3 for the
experimental group). Among the total students, almost 70 per cent had the normal-

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EFFECTIVENESS OF SCHOOL-BASED INTERVENTIONS TO PREVENT
OVERWEIGHT AMONG CHILDREN IN THE UK
weight, 26 per cent had overweight and the other 4 per cent of the students were obese
in nature. The study result showed that enhancement of healthy eating behaviour
among the children helped to manage the condition of obesity and overweight among
the children in the school setting. As a part of this the teachers of the school also should
encourage the children to consume healthy foods such as vegetables and fruits so that
the health condition of the students can be improved (Kelishadi and Azizi-Soleiman
2014).
5.3. Summary:
The chapter concludes every section of this paper starting with summarizing the
problem, background of the study along with the significance of the study. After that the
literature review section is concluded identifying the literature gap. The research
methodology and the result section is concluded next. Lastly there is a few
recommendation provided addressing this problem.

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References:
Adab, P., Pallan, M.J., Lancashire, E.R., Hemming, K., Frew, E., Barrett, T., Bhopal, R.,
Cade, J.E., Canaway, A., Clarke, J.L. and Daley, A., 2018. Effectiveness of a childhood
obesity prevention programme delivered through schools, targeting 6 and 7 year olds:
cluster randomised controlled trial (WAVES study). bmj, 360, p.k211.
Amini, M., Djazayery, A., Majdzadeh, R., Taghdisi, M.H. and Jazayeri, S., 2015. Effect
of school-based interventions to control childhood obesity: a review of
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