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Childhood obesity prevention through a community-based cluster randomized controlled physical activity intervention among schools in China: the health legacy project of the 2nd world summer youth Olympic Games (YOG-Obesity study)
Wang Z, Xu F, Ye Q, Tse L, Xue H, Tan Z, Leslie E, Owen N, Wang Y
International Journal of Obesity 2018 Apr;42(4):625-633
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Childhood obesity has been becoming a worldwide public health problem. We conducted a community-based physical activity (PA) intervention program aiming at childhood obesity prevention in general student population in Nanjing of China, the host city of the 2nd World Summer Youth Olympic Games (YOG-Obesity study). METHODS: This was a cluster randomized controlled intervention study. Participants were the 4th (mean age +/- SE 9.0 +/- 0.01) and 7th (mean age +/- SE 12.0 +/- 0.01) grade students (mean age +/- SE 10.5 +/- 0.02) from 48 schools and randomly allocated (1:1) to intervention or control groups at school level. Routine health education was provided to all schools, while the intervention schools additionally received an one-year tailored multi-component PA intervention program, including classroom curricula, school environment support, family involvement and fun programs/events. The primary outcome measures were changes in body mass index, obesity occurrence and PA. RESULTS: Overall, 9,858 (97.7%) of the 10,091 enrolled students completed the follow-up survey. Compared with the baseline, PA level increased by 33.13 min/week (SE 10.86) in the intervention group but decreased by 1.76 min/week (SE 11.53) in the control group (p = 0.028). After adjustment for potential confounders, compared with the control group, the intervention group were more likely to have increased time of PA (adjOR 1.15, 95%CI 1.06 to 1.25), but had a smaller increase in mean BMI (0.22 (SE 0.02) versus 0.46 (0.02), p = 0.01) and BMI z-score (0.07 (0.01) versus 0.16 (0.01), p = 0.01), and were less likely to be obese (adjOR 0.7, 95%CI 0.6 to 0.9) at study end. The intervention group had fewer new events of obesity/overweight but a larger proportion of formerly overweight/obese students having normal weight by study end. CONCLUSIONS: This large community-based PA intervention was feasible and effective in promoting physical activity and preventing obesity among the general student population in a large city in China. Experiences from this study are the lessons for China to control the childhood obesity epidemic.

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