Can the Healthy Primary School of the Future offer perspective in the ongoing obesity epidemic in young children? A Dutch quasi-experimental study

Objectives Schools play an important role in promoting healthy behaviours in children and can offer perspective in the ongoing obesity epidemic. The ‘Healthy Primary School of the Future’ (HPSF) aims to improve children’s health and well-being by enhancing school health promotion. The current study...

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Main Authors: Onno C P Van Schayck, Marije Oosterhoff, Bjorn Winkens, Nina H M Bartelink, Patricia van Assema, Stef P J Kremers, Hans H C M Savelberg, Maartje Willeboordse, Maria W J Jansen
Format: Article
Language:English
Published: BMJ Publishing Group 2019-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/10/e030676.full
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author Onno C P Van Schayck
Marije Oosterhoff
Bjorn Winkens
Nina H M Bartelink
Patricia van Assema
Stef P J Kremers
Hans H C M Savelberg
Maartje Willeboordse
Maria W J Jansen
author_facet Onno C P Van Schayck
Marije Oosterhoff
Bjorn Winkens
Nina H M Bartelink
Patricia van Assema
Stef P J Kremers
Hans H C M Savelberg
Maartje Willeboordse
Maria W J Jansen
author_sort Onno C P Van Schayck
collection DOAJ
description Objectives Schools play an important role in promoting healthy behaviours in children and can offer perspective in the ongoing obesity epidemic. The ‘Healthy Primary School of the Future’ (HPSF) aims to improve children’s health and well-being by enhancing school health promotion. The current study aims to assess the effect of HPSF on children’s body mass index (BMI) z-score after 1 and 2 years follow-up and to investigate whether HPSF has different effects within specific subgroups of children.Design A longitudinal quasi-experimental design.Setting Four intervention and four control schools participated; located in a low socioeconomic status region in the Netherlands.Participants 1676 children (aged 4–12 years).Interventions HPSF uses a contextual systems approach and includes health-promoting changes in the school. Central to HPSF is the provision of a daily healthy lunch and structured physical activity sessions each day. Two intervention schools implemented both changes (full HPSF), two intervention schools implemented only the physical activity change (partial HPSF).Main outcome measures BMI z-score, determined by measurements of children’s height and weight at baseline, after 1 and 2 years follow-up.Results The intervention effect was significant after 1-year follow-up in the partial HPSF (standardised effect size (ES)=−0.05), not significant in the full HPSF (ES=−0.04). After 2 years follow-up, BMI z-score had significantly decreased in children of both the full HPSF (ES=−0.08) and the partial HPSF (ES=−0.07) compared with children of the control schools, whose mean BMI z-score increased from baseline to 2 years. None of the potential effect modifiers (gender, baseline study year, socioeconomic status and baseline weight status) were significant.Conclusions HPSF was effective after 1 and 2 years follow-up in lowering children’s BMI z-scores. No specific subgroups of children could be identified who benefitted more from the intervention.Trial registration number NCT02800616.
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spelling doaj-art-589e9f2ea0f742f387bf9c780c9b15232024-12-14T07:45:07ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2019-030676Can the Healthy Primary School of the Future offer perspective in the ongoing obesity epidemic in young children? A Dutch quasi-experimental studyOnno C P Van Schayck0Marije Oosterhoff1Bjorn Winkens2Nina H M Bartelink3Patricia van Assema4Stef P J Kremers5Hans H C M Savelberg6Maartje Willeboordse7Maria W J Jansen8Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands1 Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre (MUMC+)/Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands4 Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands2 Department of Health Promotion, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands1 Department of Health Promotion, Maastricht University, Maastricht, The Netherlands1 Department of Health Promotion, Maastricht University, Maastricht, The Netherlands2 Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, The NetherlandsDepartment of Family Medicine, Maastricht University, School for Public Health and Primary Care, Maastricht, The Netherlands6 Academic Collaborative Centre for Public Health Limburg, Heerlen, The NetherlandsObjectives Schools play an important role in promoting healthy behaviours in children and can offer perspective in the ongoing obesity epidemic. The ‘Healthy Primary School of the Future’ (HPSF) aims to improve children’s health and well-being by enhancing school health promotion. The current study aims to assess the effect of HPSF on children’s body mass index (BMI) z-score after 1 and 2 years follow-up and to investigate whether HPSF has different effects within specific subgroups of children.Design A longitudinal quasi-experimental design.Setting Four intervention and four control schools participated; located in a low socioeconomic status region in the Netherlands.Participants 1676 children (aged 4–12 years).Interventions HPSF uses a contextual systems approach and includes health-promoting changes in the school. Central to HPSF is the provision of a daily healthy lunch and structured physical activity sessions each day. Two intervention schools implemented both changes (full HPSF), two intervention schools implemented only the physical activity change (partial HPSF).Main outcome measures BMI z-score, determined by measurements of children’s height and weight at baseline, after 1 and 2 years follow-up.Results The intervention effect was significant after 1-year follow-up in the partial HPSF (standardised effect size (ES)=−0.05), not significant in the full HPSF (ES=−0.04). After 2 years follow-up, BMI z-score had significantly decreased in children of both the full HPSF (ES=−0.08) and the partial HPSF (ES=−0.07) compared with children of the control schools, whose mean BMI z-score increased from baseline to 2 years. None of the potential effect modifiers (gender, baseline study year, socioeconomic status and baseline weight status) were significant.Conclusions HPSF was effective after 1 and 2 years follow-up in lowering children’s BMI z-scores. No specific subgroups of children could be identified who benefitted more from the intervention.Trial registration number NCT02800616.https://bmjopen.bmj.com/content/9/10/e030676.full
spellingShingle Onno C P Van Schayck
Marije Oosterhoff
Bjorn Winkens
Nina H M Bartelink
Patricia van Assema
Stef P J Kremers
Hans H C M Savelberg
Maartje Willeboordse
Maria W J Jansen
Can the Healthy Primary School of the Future offer perspective in the ongoing obesity epidemic in young children? A Dutch quasi-experimental study
BMJ Open
title Can the Healthy Primary School of the Future offer perspective in the ongoing obesity epidemic in young children? A Dutch quasi-experimental study
title_full Can the Healthy Primary School of the Future offer perspective in the ongoing obesity epidemic in young children? A Dutch quasi-experimental study
title_fullStr Can the Healthy Primary School of the Future offer perspective in the ongoing obesity epidemic in young children? A Dutch quasi-experimental study
title_full_unstemmed Can the Healthy Primary School of the Future offer perspective in the ongoing obesity epidemic in young children? A Dutch quasi-experimental study
title_short Can the Healthy Primary School of the Future offer perspective in the ongoing obesity epidemic in young children? A Dutch quasi-experimental study
title_sort can the healthy primary school of the future offer perspective in the ongoing obesity epidemic in young children a dutch quasi experimental study
url https://bmjopen.bmj.com/content/9/10/e030676.full
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