The Impact of School-Based Intervention for 9-13-year-old School Children with Overweight and Obesity

The Impact of School-Based Intervention for 9-13-year-old School Children with Overweight and Obesity: Nutrition Knowledge, Attitudes, Self-Efficacy, Fruit and Vegetable Intake, and Anthropometry

Childhood obesity is a major issue for the United Arab Emirates (UAE). Interventions modifying people's nutritional behavior and changing their dietary habits can potentially address this problem. This study assessed the effectiveness of the 6-month school-based nutritional educational intervention on fruit and vegetable intake, nutrition knowledge, anthropometric measures, and practice, attitude, and self-efficacy measures.

Study Overview

• Status: Completed
• Conditions: Obese Children and Adolescents; Overweight Children
• Intervention / Treatment: Other: Anthropometric measurements; Other: Questionnaire; Other: Educational sessions

Detailed Description

The problem of childhood obesity is a critical issue for the UAE. Findings of recent studies illustrate that nutritional interventions seeking to modify people's nutritional behavior and change their dietary habits have the potential to address this problem. This article reports the results of the study that was dedicated to the influence of the school-based nutritional educational intervention on fruit and vegetable intake, anthropometric measures, practice, attitude, self-efficacy, and knowledge scores of schoolchildren. The intervention was carried out among 9-13-year-old schoolchildren at public schools from Dubai and Sharjah (n=403). The sample included three groups, including the control group (n=114), Intervention Group 1 (n=148), and Intervention Group 2 (n=141). The control group was exposed to a conventional curriculum on healthy nutrition. Group 1 participated in the intervention involving children, and Group 2 participated in the intervention involving students, peers, and parents.

• Study Type: Interventional
• Enrollment (Actual): 403
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United Arab Emirates
  • Ain
    • Al Ain, Ain, United Arab Emirates
      • United Arab Emarites University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• WHO BMI-for-age growth charts, Students with BMI from the 85th to the 95th percentile were categorized as "overweight," and those who were above the 95th percentile were categorized as "obese"
• Attending Government school.
• Within Grades 6-9.
• Live in Dubai or Sharjah
• Female and male students

Exclusion Criteria:

• Students with BMI below the 85th percentile for the WHO BMI-for-age growth charts.
• Not attending a government school
• Living in another emirate (not Dubai or Sharjah)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: students one-one; During the intervention, 30-minute in person sessions and lectures are held on a one-on-one basis .; Lectures were conducted daily for five days during the first month of the intervention; The students were exposed to the school nutrition education curriculum, which may also be considered an intervention as it introduced students to new nutrition knowledge. The school nutrition education curriculum presented general information about nutrition in accordance with official guidelines issued by the UAE Ministry of Education. Topics covered included the dangers of obesity, the prevalence of obesity in the UAE, and potentially effective ways to prevent this problem, the information in this program was broad and did not provide practical recommendations to students except for a set of general suggestions.; The topics covered included a healthy eating lifestyle, energy balance, food portion control, healthy snacking, the importance of physical activity and healthy eating, dietary	Other: Anthropometric measurements; Anthropometric measurements of the students, including weight, height, muscle mass, fat quantity, and waist circumference, were measured. The WHO BMI charts were utilized for classification. Stratified Random selection; Other: Questionnaire; The collection of data was performed using the "Atlas questionnaire" (Al-Hazzaa et al., 2011) and "nutrition knowledge and healthy lifestyle behavior" questionnaire (Kalender et al., 2011) with additional questions related to self-efficacy and dietary practices adapted from the literature (Becher, 2009; Voss et al., 2017; Kowalski et al., 2004). Stratified Random selection; Other: Educational sessions; The topics that covered included a healthy eating lifestyle, energy balance, food portion control, healthy snacking, the importance of physical activity and healthy eating, dietary practices, and nutrition-related self-efficacy.
Other: Peers; 30-minute in person sessions were introduced to all the school children, and 10-minute question-and-answer sections were held at the end of each lesson to support knowledge acquisition.; Lectures were conducted daily for five days in the first month of the study.; The students were exposed to the school nutrition education curriculum, which may also be considered an intervention as it introduced students to new nutrition knowledge. The school nutrition education curriculum presented general information about nutrition in accordance with official guidelines issued by the UAE Ministry of Education. Topics covered included the dangers of obesity, the prevalence of obesity in the UAE, and potentially effective ways to prevent this problem, the information in this program was broad and did not provide practical recommendations to students except for a set of general suggestions.; The topics covered included a healthy eating lifestyle,	Other: Educational sessions; The topics that covered included a healthy eating lifestyle, energy balance, food portion control, healthy snacking, the importance of physical activity and healthy eating, dietary practices, and nutrition-related self-efficacy.
No Intervention: Control group; The students in the control group did not receive any nutrition intervention except for the usual school curriculum-based nutrition education program. Participants in the intervention and control groups were recruited from different sections of the same schools.
Other: parents; 30-minute in person sessions and 10-minute question-and-answer sections were held at the end of each lesson to support knowledge acquisition.; Lectures were conducted daily for five days in the first month of the study.	Other: Educational sessions; The topics that covered included a healthy eating lifestyle, energy balance, food portion control, healthy snacking, the importance of physical activity and healthy eating, dietary practices, and nutrition-related self-efficacy.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Nutrition Knowledge and Self-Efficacy	- Change in students' knowledge and self-efficacy scores from baseline values in overweight and obese UAE students aged 9-13 using a validated questionnaire(Arab Teens Lifestyle Questionnaire). The statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) software, and the IBM, USA computer software (version 29). Likert scales, were expressed as weighted mean ± SD. An independent t-test (parametric test) was used to analyze the effect of 2-level qualitative variables on quantitative variables, and one way ANOVA (parametric test) was used to analyze the effect of >2-level qualitative variables on quantitative variables in each questionnaire section	6 months
Nutrition Knowledge and Self-Efficacy	- Change in the percentage of children consuming at least five servings of fruits and vegetables and using a validated questionnaire(Arab Teens Lifestyle Questionnaire). The statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) software, and the IBM, USA computer software (version 29). Likert scales, were expressed as weighted mean ± SD. An independent t-test (parametric test) was used to analyze the effect of 2-level qualitative variables on quantitative variables, and one way ANOVA (parametric test) was used to analyze the effect of >2-level qualitative variables on quantitative variables in each questionnaire section	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Anthropometric Data	Change in body measurements(Weight in kilogram, BMI in kg/m^2) The statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) software, and the IBM, USA computer software (version 29).The anthropometric measurements of the control and intervention groups were compared using ANOVA before and after the nutritional education intervention.	6 months
Anthropometric Data	Change in body measurements(waist circumference in cm) The statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) software, and the IBM, USA computer software (version 29).The anthropometric measurements of the control and intervention groups were compared using ANOVA before and after the nutritional education intervention.	6 months
Anthropometric Data	Change in body measurements( Muscle Mass in kilogram) The statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) software, and the IBM, USA computer software (version 29).The anthropometric measurements of the control and intervention groups were compared using ANOVA before and after the nutritional education intervention.	6 months
Anthropometric Data	Change in body measurements( Body Fat percentage using using Tanita BC730W) The statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) software, and the IBM, USA computer software (version 29).The anthropometric measurements of the control and intervention groups were compared using ANOVA before and after the nutritional education intervention.	6 months

Collaborators and Investigators

• Sponsor: United Arab Emirates University
• Investigators: Study Director: Habiba Ali, UAEU; Study Chair: ESE Research Office, Emarites School Establishment

Publications and helpful links

General Publications

• Hwalla N, Chehade L, O'Neill LM, Kharroubi S, Kassis A, Cheikh Ismail L, Al Dhaheri AS, Ali HI, Ibrahim S, Chokor FAZ, Mohamad MN, Ayesh W, Nasreddine L, Naja F. Total Usual Nutrient Intakes and Nutritional Status of United Arab Emirates Children (4 Years-12.9 Years): Findings from the Kids Nutrition and Health Survey (KNHS) 2021. Nutrients. 2023 Jan 2;15(1):234. doi: 10.3390/nu15010234.

Study record dates

Study Major Dates

• Study Start (Actual): August 27, 2021
• Primary Completion (Actual): March 19, 2022
• Study Completion (Actual): February 28, 2023

Study Registration Dates

• First Submitted: August 29, 2024
• First Submitted That Met QC Criteria: November 1, 2024
• First Posted (Estimated): November 4, 2024

Study Record Updates

• Last Update Posted (Estimated): November 4, 2024
• Last Update Submitted That Met QC Criteria: November 1, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: Overweight; Body Weight; Nutrition Disorders; Overnutrition; SchoolChildren; peer pressure
• Additional Relevant MeSH Terms: Nutrition Disorders; Overnutrition; Body Weight; Overweight
• Other Study ID Numbers: ERSC_2022_744

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No