Effectiveness of school health programs in reducing obesity in children

Abstract

Locally, obesity prevalence is on the increase (Grech & Farrugia Sant' Angelo, 2009). Since children spend most of their time at school, it is a pivotal place where to implement an intervention. A research question using the PICOT framework, to evaluate the effectiveness of school-health programs to reduce obesity in children, aged 5 to 12 years, was formulated. PICOT question: Are school-health programs (I) longer than 3 months (T) effective in reducing obesity (0) in primary school children (P)? The inclusion and exclusion criteria were established. Studies had to be in English language with full text. Interventions had to be done at school, with a duration 2:3 months and include body mass index as an outcome variable. Systematic reviews and pre- and after-school interventions were excluded. In all, 13 databases were searched which resulted in 81 published data. However, only 24 articles were eligible to the criterion. The CASP tools were used to critically appraise the methodological framework of each study and the ethical issues were highlighted. Results of the studies were mainly focused on nutrition and physical activity components; and active parental involvement. It could be concluded that school-health programs are effective in reducing obesity in children. However, the more intense the program, the better the outcome are. It is suggested that thematic teaching could be used to incorporate nutrition and physical activity in the school curriculum. Additionally, a school nurse and active parental involvement could assist children to adopt a healthy lifestyle. Further research should focus on the impact on children's diet by socio-economic status and level of parental educa6on. The strengths and limitations of the study were also discussed.