School-Based Intervention Program to Promote Healthy Eating and Physical Activity

NCT ID: NCT03205293

Last Updated: 2023-04-25

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 1500 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2011-03-01
• Study Completion Date: 2024-12-01

Brief Summary

The purpose of this research is to develop, apply, and evaluate a school-based intervention program in East Jerusalem schools, designed to increase knowledge and to improve the attitudes and healthy behavior of schoolchildren, their teachers and their mothers' with regard to healthy eating and physical activity habits. The study tested the hypothesis that the impact of the entire school intervention program on students' lifestyles is mediated by their teachers' engagement in health promotion and by their mothers' involvement in school activity.

Detailed Description

A randomized controlled intervention program trial was carried out in 14 females' schools in East Jerusalem, selected randomly by a stratified sampling of four groups of schools. The primary target population was the students, while the secondary target populations were the mothers and the teachers at these schools. From the schools operating in East Jerusalem (Palestinian Authority, Jerusalem Municipality, private, and United Nations Relief and Works Agency) grades 4 and 5 were considered eligible to participate in the pre- and post-intervention studies.

The study process was designed, using the ecological model, in three stages; Stage one: Need assessment stage (pre-intervention, March-Jun 2011): A semi-structured interview was used with all 14 school principals, and a structured self-administered questionnaire was used with all teachers. A random sample of a 4th and 5th grade classes was selected, in which all mothers and their daughters were eligible to answer a self-administered questionnaire. The height and weight of the children were measured during this stage. These measurements were the baseline for assessing the current situation. In addition to school inspection tours was done to assess the school's health environment.

Stage two: Action stage (intervention, September 2011-June 2013): A random allocation of schools into intervention and control groups was done, followed by participatory planning and administration of the intervention in each of the 7 schools based on their needs assessments and assets. The program was implemented and administered by a steering committee in each of the schools, consisting of teachers, mothers, and children. Teachers underwent trainings in nutrition and physical activity. The program activities were monitored by regular visits twice a month. The implementation team met every four to six weeks to review the progress.

Stage three: Evaluation (post intervention, February-April 2013): Evaluation of the program was done after eighteen months of intervention using the same assessment questionnaires for both intervention and control schools among a different sample of children from grades 4 and 5, their mothers, and all of the teachers.

Conditions

Obesity, Childhood; Health Behavior; Physical Activity; Dietary Habits

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: NONE

Study Groups

Intervention Group

Female Schoolchildren, their mothers and teachers will be exposed to multiple interventions designed through a participatory approach, integrating the ecological model.

Group Type: EXPERIMENTAL

Intervention Program to Promote Healthy Eating and Physical Activity among Palestinian Female Schoolchildren

Intervention Type: BEHAVIORAL

Control Group

Regular school curriculum

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Intervention Program to Promote Healthy Eating and Physical Activity among Palestinian Female Schoolchildren

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• East Jerusalem Female Schoolchildren

Exclusion Criteria

• None

• Minimum Eligible Age: 4 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: Yes

Sponsors

Hadassah Medical Organization

OTHER

Sponsor Role: lead

Responsible Party

Donna R Zwas

Director of Linda Joy Pollin Cardiovascular Wellness Center for Women

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Donna Zwas, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Hadassah Medical Organization

References

Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser. 2003;916:i-viii, 1-149, backcover.

Reference Type: BACKGROUND

PMID: 12768890 (View on PubMed)

Wyatt SB, Winters KP, Dubbert PM. Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Am J Med Sci. 2006 Apr;331(4):166-74. doi: 10.1097/00000441-200604000-00002.

Reference Type: BACKGROUND

PMID: 16617231 (View on PubMed)

Lobstein T, Baur L, Uauy R; IASO International Obesity TaskForce. Obesity in children and young people: a crisis in public health. Obes Rev. 2004 May;5 Suppl 1:4-104. doi: 10.1111/j.1467-789X.2004.00133.x. No abstract available.

Reference Type: BACKGROUND

PMID: 15096099 (View on PubMed)

World Health Organization. The challenge of obesity in the WHO European Region and the strategies for response. Geneva: World Health Organization Regional Office for Europe, 2007.

Reference Type: BACKGROUND

Badran M, Laher I. Obesity in arabic-speaking countries. J Obes. 2011;2011:686430. doi: 10.1155/2011/686430. Epub 2011 Nov 24.

Reference Type: BACKGROUND

PMID: 22175002 (View on PubMed)

Al Sabbah H, Vereecken C, Kolsteren P, Abdeen Z, Maes L. Food habits and physical activity patterns among Palestinian adolescents: findings from the national study of Palestinian schoolchildren (HBSC-WBG2004). Public Health Nutr. 2007 Jul;10(7):739-46. doi: 10.1017/S1368980007665501. Epub 2007 Feb 22.

Reference Type: BACKGROUND

PMID: 17381946 (View on PubMed)

Currie C, Hurrelmann K, Settertobulte W, Smith R TJ (editors). Health Behaviour in School-aged Children: a WHO Cross- National Study ( HBSC) International Report. Copenhagen: World Health Organization Regional Office for Europe; 2000.

Reference Type: BACKGROUND

World Health Organization. WHO AnthroPlus for Personal Computers Manual. Geneva: World Health Organization, 2007.

Reference Type: BACKGROUND

Mikki N, Abdul-Rahim HF, Shi Z, Holmboe-Ottesen G. Dietary habits of Palestinian adolescents and associated sociodemographic characteristics in Ramallah, Nablus and Hebron governorates. Public Health Nutr. 2010 Sep;13(9):1419-29. doi: 10.1017/S1368980010000662. Epub 2010 May 4.

Reference Type: BACKGROUND

PMID: 20441660 (View on PubMed)

Savige G, Macfarlane A, Ball K, Worsley A, Crawford D. Snacking behaviours of adolescents and their association with skipping meals. Int J Behav Nutr Phys Act. 2007 Sep 17;4:36. doi: 10.1186/1479-5868-4-36.

Reference Type: BACKGROUND

PMID: 17868479 (View on PubMed)

Alarcon de la Lastra C, Barranco MD, Motilva V, Herrerias JM. Mediterranean diet and health: biological importance of olive oil. Curr Pharm Des. 2001 Jul;7(10):933-50. doi: 10.2174/1381612013397654.

Reference Type: BACKGROUND

PMID: 11472248 (View on PubMed)

Guasch-Ferre M, Hu FB, Martinez-Gonzalez MA, Fito M, Bullo M, Estruch R, Ros E, Corella D, Recondo J, Gomez-Gracia E, Fiol M, Lapetra J, Serra-Majem L, Munoz MA, Pinto X, Lamuela-Raventos RM, Basora J, Buil-Cosiales P, Sorli JV, Ruiz-Gutierrez V, Martinez JA, Salas-Salvado J. Olive oil intake and risk of cardiovascular disease and mortality in the PREDIMED Study. BMC Med. 2014 May 13;12:78. doi: 10.1186/1741-7015-12-78.

Reference Type: BACKGROUND

PMID: 24886626 (View on PubMed)

Larson NI, Neumark-Sztainer D, Harnack L, Wall M, Story M, Eisenberg ME. Calcium and dairy intake: Longitudinal trends during the transition to young adulthood and correlates of calcium intake. J Nutr Educ Behav. 2009 Jul-Aug;41(4):254-60. doi: 10.1016/j.jneb.2008.05.001.

Reference Type: BACKGROUND

PMID: 19508930 (View on PubMed)

Dietary Guidelines for American 2005. U.S Department of Health and Human Services. Department of Agriculture. Available at: http://health.gov/dietaryguidelines/dga2005/document/pdf/dga2005.pdf (accessed: January 16, 2016).

Reference Type: BACKGROUND

World Health Organization. Young People's Health in Context. Health Behaviour in School-aged Children (HBSC) Study: International Report from the 2001/2002 Survey. World Health Organization/ Europe. Available at: http://www.euro.who.int/en/publications/abstracts/young-peoples-health-in-context.- health-behaviour-in-school-aged-children-hbsc-study-international-report-from-the- 20012002-survey (accessed: January 18, 2016).

Reference Type: BACKGROUND

Rolls BJ, Ello-Martin JA, Tohill BC. What can intervention studies tell us about the relationship between fruit and vegetable consumption and weight management? Nutr Rev. 2004 Jan;62(1):1-17. doi: 10.1111/j.1753-4887.2004.tb00001.x.

Reference Type: BACKGROUND

PMID: 14995052 (View on PubMed)

I.TETENS and S. ALINIA. The role of fruit consumption in the prevention of obesity. J Hortic Sci Biotechnol 2009;84:47-51.

Reference Type: BACKGROUND

World Health Organization. Global Recommendations on Physical Activity for Health.Geneva : World Health Organization. Geneva, 2010. Available from: http://www.who.int/dietphysicalactivity/factsheet_recommendations/en/(accessed: February 11, 2016).

Reference Type: BACKGROUND

American Academy of Pediatrics. Committee on Public Education. American Academy of Pediatrics: Children, adolescents, and television. Pediatrics. 2001 Feb;107(2):423-6. doi: 10.1542/peds.107.2.423.

Reference Type: BACKGROUND

PMID: 11158483 (View on PubMed)

Kanao BJ, Abu-Nada OS, Zabut BM. Nutritional status correlated with sociodemographic and economic factors among preparatory school-aged children in the Gaza Strip. J Public Health 2008;17:113-9.

Reference Type: BACKGROUND

Jildeh C, Papandreou C, Abu Mourad T, Hatzis C, Kafatos A, Qasrawi R, Philalithis A, Abdeen Z. Assessing the nutritional status of Palestinian adolescents from East Jerusalem: a school-based study 2002-03. J Trop Pediatr. 2011 Feb;57(1):51-8. doi: 10.1093/tropej/fmq042. Epub 2010 Jul 31.

Reference Type: BACKGROUND

PMID: 20675716 (View on PubMed)

Temple JL, Giacomelli AM, Kent KM, Roemmich JN, Epstein LH. Television watching increases motivated responding for food and energy intake in children. Am J Clin Nutr. 2007 Feb;85(2):355-61. doi: 10.1093/ajcn/85.2.355.

Reference Type: BACKGROUND

PMID: 17284729 (View on PubMed)

Veldhuis L, Vogel I, Renders CM, van Rossem L, Oenema A, HiraSing RA, Raat H. Behavioral risk factors for overweight in early childhood; the 'Be active, eat right' study. Int J Behav Nutr Phys Act. 2012 Jun 15;9:74. doi: 10.1186/1479-5868-9-74.

Reference Type: BACKGROUND

PMID: 22704042 (View on PubMed)

Ouwens MA, Cebolla A, van Strien T. Eating style, television viewing and snacking in pre-adolescent children. Nutr Hosp. 2012 Jul-Aug;27(4):1072-8. doi: 10.3305/nh.2012.27.4.5805.

Reference Type: BACKGROUND

PMID: 23165544 (View on PubMed)

Pate RR, Mitchell JA, Byun W, Dowda M. Sedentary behaviour in youth. Br J Sports Med. 2011 Sep;45(11):906-13. doi: 10.1136/bjsports-2011-090192.

Reference Type: BACKGROUND

PMID: 21836174 (View on PubMed)

McDonald CM, Baylin A, Arsenault JE, Mora-Plazas M, Villamor E. Overweight is more prevalent than stunting and is associated with socioeconomic status, maternal obesity, and a snacking dietary pattern in school children from Bogota, Colombia. J Nutr. 2009 Feb;139(2):370-6. doi: 10.3945/jn.108.098111. Epub 2008 Dec 23.

Reference Type: BACKGROUND

PMID: 19106320 (View on PubMed)

Mirmiran P, Sherafat-Kazemzadeh R, Jalali-Farahani S, Azizi F. Childhood obesity in the Middle East: a review. East Mediterr Health J. 2010 Sep;16(9):1009-17.

Reference Type: BACKGROUND

PMID: 21218730 (View on PubMed)

Neuman M, Kawachi I, Gortmaker S, Subramanian SV. Urban-rural differences in BMI in low- and middle-income countries: the role of socioeconomic status. Am J Clin Nutr. 2013 Feb;97(2):428-36. doi: 10.3945/ajcn.112.045997. Epub 2013 Jan 2.

Reference Type: BACKGROUND

PMID: 23283503 (View on PubMed)

Doak CM, Visscher TL, Renders CM, Seidell JC. The prevention of overweight and obesity in children and adolescents: a review of interventions and programmes. Obes Rev. 2006 Feb;7(1):111-36. doi: 10.1111/j.1467-789X.2006.00234.x.

Reference Type: BACKGROUND

PMID: 16436107 (View on PubMed)

Hebert JR, Clemow L, Pbert L, Ockene IS, Ockene JK. Social desirability bias in dietary self-report may compromise the validity of dietary intake measures. Int J Epidemiol. 1995 Apr;24(2):389-98. doi: 10.1093/ije/24.2.389.

Reference Type: BACKGROUND

PMID: 7635601 (View on PubMed)

Other Identifiers

2310SBI-HMO-CTIL

Identifier Type: -

Identifier Source: org_study_id