Efficacy of a School-based Obesity Prevention Program in Mexican Schoolchildren: Cluster Randomized Controlled Trial

NCT ID: NCT05461703

Last Updated: 2023-02-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-12-05

Study Completion Date

2024-11-30

Brief Summary

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There is evidence that obesity prevention programs show positive effects on obesity and lifestyle parameters. However, the effect of the programs delivered by different implementers is unknown, and in Mexico, the available studies present methodological limitations. The aim of this study is to evaluate the feasibility and efficacy of a school-based obesity prevention program implemented by nutrition and physical activity advanced students compared to a control group and implemented by school teachers compared to a control group of Mexican schoolchildren. This is a cluster randomized controlled trial. Schoolchildren from different public schools in Hermosillo , Sonora will be invited to participate. The schools will be randomly assigned to one option:1) the Planet Nutrition Program (PPN) delivered by advanced students, 2) PPN by school teachers, or 3) a control group. A 6-month pilot study with a follow-up at 8 months (after the summer holidays), followed by a definitive study with a follow-up at 8 and 12 months will be conducted.The intervention will consist of nutrition education sessions, physical activity, and the provision of nutrition information for parents. The BMI Z-score, body fat, other obesity, and lifestyle parameters will be evaluated at baseline and at the end of the study. A mixed effects model will be used to evaluate the differences between the groups. The investigators expect that the program could be a model of obesity prevention with a high potential for dissemination in Mexican schools.

Detailed Description

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This is a cluster randomized controlled trial. The study will be conducted in two phases. The first phase will be a 6-month pilot study with a follow-up at 8 months (after the summer holidays) to evaluate the feasibility: of retention, adherence, acceptability, and fidelity (Eldridge et al, 2010). The second will be a definitive study of 6 months with a follow-up at 8 and 12 months to evaluate the efficacy. The study will consist of three parallel, three-arm groups with a 1:1:1 allocation ratio.

To perform the protocol of the study, the SPIRIT 2013 guide was followed. The study was approved by the Research Ethics Committee of the University of Sonora Department of Nursing (EPD-007-2022).

Fifteen public schools (300 to 450 students) from Hermosillo, Sonora, Mexico will be conveniently invited to participate in the pilot study. The sample size was determined based on the capacity of providing the program and on finding possible positive effects on the variables of interest . The calculation of the sample size is not essential in a pilot study, where its main objective is to know the feasibility of the intervention and information regarding the response variables to later carry out the sample size calculation for a future definitive trial (Eldridge, 2016).

Once the informed consent and assent have been signed by the parents and children (respectively), the baseline measurements will be made over 4 weeks. The schools and participants that meet the inclusion/exclusion criteria will be randomly assigned to one of the three arms. 1). Planet Nutrition Program (PNP) implemented by nutrition and physical activity advanced students (studying the last semesters of the degree or who have completed subjects but do not have the degree), 2). PNP implemented by school teachers and 3). a control group. An independent person from the recruitment and the intervention will perform the random allocation of the schools. This will be stratified by socioeconomic level. The random number sequence will be generated using the software "Research Randomizer" https://randomizer.org/.

The baseline characteristics will be analyzed among groups, and an ANOVA analysis will be used for the quantitative variables, and a chi-square test for the categorical outcomes in order to assure that groups are similar in all variables. If there are significant differences among groups at baseline, an adjustment will be made in the analysis. To evaluate the differences between groups in the change of the BMI Z-score, body fat, and the other secondary variables at the beginning and at the end of the intervention, a mixed model will be used to consider the effect between groups and within groups. All analyzes will be performed by the intention to treat. If data is not obtained for any reason or subjects were excluded due to a protocol violation, they will be replaced by their baseline measurement. The R studio software will be used to perform the analysis.

Conditions

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Pediatric Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a cluster randomized controlled trial. The study will be conducted in two phases. The first will be a 6-month pilot study with a follow-up at 8 months (after the summer holidays) and the second a definitive study of 6 months with a follow-up at 8 and 12 months. The study will consist of three parallel, three-arm groups with a 1:1:1 allocation ratio.
Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Investigators
The person in charge of the allocation of the schools will be blinded. The outcome assessors will also be blinded to the group allocation of the schools.

Study Groups

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Planet Nutrition Program (PNP) implemented by nutrition and physical activity advanced students

The PNP consists of:

Nutrition education sessions: Nutrition advanced students of the University of Sonora will provide 1 face-to-face group class of one hour per week. The PNP handbook will be used to bring the different topics and dynamics to reinforce learning. The program will be focused on establishing some health-related goals.

Physical activity sessions: Three classes of 1 hour per week will be implemented by physical activity advanced students of the University of Sonora, independent of the school's curricular physical activity classes. A physical activity handbook designed by the study team will be used. Children will work on developing different skills.

Parents participation: They will receive one printed brochure with nutrition topics weekly. Also, they will be asked for their Facebook user (to create a private group) or the email to upload the information of the brochure and other didactic materials. Nutrition students will be in charge of providing the information.

Group Type EXPERIMENTAL

Planet Nutrition Program

Intervention Type BEHAVIORAL

It is a 6-month school-based obesity prevention program that includes: nutrition education sessions, physical activity and family participation.

Planet Nutrition (PNP) implemented by school teachers

The PNP consists of:

Nutrition education sessions: Fourth grade school teachers will provide 1 face-to-face group class of one hour per week. The PNP handbook will be used to bring the different topics and dynamics to reinforce learning. The program will be focused on establishing some health-related goals.

Physical activity sessions: Three classes of 1 hour per week will be implemented by physical activity advanced students of the University of Sonora, independent of the school's curricular physical activity classes. A physical activity handbook designed by the study team will be used. Children will work on developing different skills.

Parents participation: They will receive one printed brochure with nutrition topics weekly. Also, they will be asked for their Facebook user (to create a private group) or the email and upload the information of the brochure and other didactic materials. School teachers will be in charge of providing the information.

Group Type EXPERIMENTAL

Planet Nutrition Program

Intervention Type BEHAVIORAL

It is a 6-month school-based obesity prevention program that includes: nutrition education sessions, physical activity and family participation.

Control Group

Scholars of this group will continue with their normal school nutrition and physical activity classes. At the end of the study they will have access to the program materials through a web page.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Planet Nutrition Program

It is a 6-month school-based obesity prevention program that includes: nutrition education sessions, physical activity and family participation.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Schools:

* school directors and teachers wish to participate.
* availability of space for physical activity classes.
* the school has at least 20 children per 4th-grade group.
* Schoolchildren:

-be a 4th grade student (9 to 11 years old).
* Implemeters:

* receive 80% of the program training.
* respond satisfactorily to a questionnaire that tests knowledge of the program

Exclusion Criteria

* Schools: participating in another similar study.
* Schoolchildren: Having a personal condition that prevents physical activity or a condition that parents consider should not involve the child.
Minimum Eligible Age

9 Years

Maximum Eligible Age

11 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Centro de Investigación en Alimentación y Desarrollo A.C.

OTHER

Sponsor Role collaborator

Instituto Nacional de Geriatria, Mexico

OTHER_GOV

Sponsor Role collaborator

Universidad de León

OTHER

Sponsor Role collaborator

Universidad de Sonora

OTHER

Sponsor Role lead

Responsible Party

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Rolando Giovanni Díaz Zavala

Full-time professor and researcher

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rolando G Díaz Zavala, PhD

Role: PRINCIPAL_INVESTIGATOR

Universidad de Sonora

Locations

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Public Schools

Hermosillo, Sonora, Mexico

Site Status RECRUITING

Countries

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Mexico

Central Contacts

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Rolando G Díaz Zavala, PhD

Role: CONTACT

6622592250

Diana L Ramírez Rivera, MSc

Role: CONTACT

References

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Other Identifiers

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PNP02

Identifier Type: -

Identifier Source: org_study_id

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