Effectiveness of an Overweight and Obesity Prevention Program in Preschool Age Children
In developed countries 10 % of preschool children are overweight and 60 % of obese children remain obese adults, increasing the possibility of premature death and disability in the future (IOTF , 2005). Sedentary childhood lifestyle with lower physical activity and a fast food and processed foods dietary and the low socioeconomic status of families increase the risk of childhood obesity (Lobstein T.et al , IOTF , 2005; Larse L. et al , 2006; Rama P., J. Breda ; Rita A. 2010) .
Portugal is one of the five European countries with the highest prevalence of childhood obesity where 19 % of preschool age children are overweight and 30% of school age children are overweight and 11 % are obese (COSI , 2008; Plataforma Contra a Obesidade, 2010) . Actually, 13,9% of the children are obese and 31,6% are overweight (COSI, 2015). Preschool children have already developed health behaviors, however this age is a privileged period and an opportunity to promote healthy behaviors through the development of new skills and competences (Lucas L. ; Freucht A. , 2010; Pender N., 2012).
The promotion of healthy eating and physical activity in preschool is an opportunity to contribute to the reduction of overweight and obesity in childhood. Several systematic and simple educational and behavioral multidisciplinary interventions are described as an effective approach to prevent the overweight and obesity in childhood (Mellin , A., Lenner R.A. , 2008; Wyatt , K. M. et al , 2011; Greening , L. et al , 2011; Tucker , S. et al, 2011).
Keywords: health promotion; pre-school children; obesity; overweight; school
What is the effectiveness of an overweight and obesity prevention school-based program in preschool age children?
METHODOLOGY (Complex Interventions Medical Research Council (2008) / CReDECI (2012))
Developing and evaluating a complex intervention to evaluate the effectiveness of an overweight and obesity prevention school-based program in preschool age children.
Phase I: DEVELOPMENT
1. Identifying the evidence base - systematic review of literature
2. Developing theory – Health Promotion Model (Nola Pender); Social Learning Theory (Albert Bandura)
3. Modelling process and outcomes
● Development and training of the intervention team (pre-school teachers; school nurses, nursing student)
● Identification of the intervention‘s elements of an overweight and obesity prevention school-based program in preschool age children
● Evaluation of the effectiveness of an overweight and obesity prevention school-based program in preschool age children
Phase 2: FEASIBILITY AND PILOTING
STUDY 1 (cross sectional study) PRESCHOOL AGED CHILDREN AND FAMILIES EATING AND PHYSICAL ACTIVITY BEHAVIORS, AND NUTRITIONAL STATUS
AIMS: Identify pre-school age children and families eating and physical activity behaviors - questionnaire
Evaluate pre-school age children anthropometric measures (body mass index, body mass index and abdominal fat measured)
STUDY 2 (focus group): OVERWEIGHT AND OBESITY PREVENTION SCHOOL-BASED PROGRAM IN PRESCHOOL AGED CHILDREN VIABILITY
AIMS: Identify the acceptance and feasibility of the school-based program among the preschool age children and families
STUDY 3 (quasi-experimental pilot study): OVERWEIGHT AND OBESITY PREVENTION SCHOOL-BASED PROGRAM IN PRESCHOOL AGE CHILDREN
Intervention school - overweight and obesity prevention school-based program in preschool age children
Control school – Education and Science Ministry and School Health National Board standard program EANS Winter Summit 2016 Effectiveness of an overweight and obesity prevention program in preschool age children
ETHICAL PROCEDURES: Lisbon Regional Health Authority Health Ethics Committee (approved); Ministry of Education and Science (approved); Pre-School Pedagogic Council (approved); National Data Protection (approved); Families Consent (approved).
Childhood Obesity Surveillance Initiative – COSI Portugal 2008 (2010). Ministério da Saúde. Instituto Nacional Dr. Ricardo Jorge, Direção Geral da Saúde.
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Greening, L. et al (2011). Efficacy of a school-based program in a rural southern community: TEAM Mississipi project. Obesity, volume 19, number 16, june 2011.
Larse et al (2006). Childhood Obesity. Prevention practices of nurse practioners. Journal of the American Academy of Nurse Practioners, 18, 70-79.
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Mellin, A.; Lenner R. A. (2008). Prevention of further weight gain in overweight school children, a pilot study. Scandinavian journal of caring sciences DOI 10.1111/j. 1471-6712.2008.00651.x.
Pender, N. (2012). The Health Promotion Model – Manual. Disponível em: http://nursing.umich.edu/faculty-staff/nola-j-pender
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Tucker, S. et al (2011). A School Based Community Partnership for Promoting healthy habits for life. Journal of Community Health, 36: 414-422 DOI 10.1007/s 10900-010-9323-9.
Wyatt, K. M. et al (2011). The development, feasibility and acceptability of school-based obesity prevention: results from three phases of piloting. Births Medical Journal Open. 1e000026. Doi: 10.1136/bmjopen-2010-000026