School-based Intervention Study Research Articles

Serum bone turnover markers were associated with bone mass in late prepuberty and early puberty.

To analyse the association between bone turnover markers and bone mass in children and young adults. This descriptive study followed 132 children (68 boys/64 girls) from Malmö, Sweden, as controls in a school-based intervention study (2000-2017). Height, weight, Tanner stage and bone mass were measured annually from ages 8 to 15 years, with follow-ups at 19 and 23 years of age. Serum markers for bone formation (bone-specific alkaline phosphatase (bALP), N-terminal propeptide of collagen type 1 (PINP), osteocalcin) and resorption (C-terminal telopeptide crosslinks (CTX), tartrate-resistant acid phosphatase (TRAcP 5b)) were collected at ages 9.9 ± 0.6 (mean ± SD) (n = 78), 12.0 ± 0.6 (n = 64), 14.9 ± 0.8 (n = 52), 18.8 ± 0.3 (n = 34) and 23.3 ± 0.6 years (n = 56). Compared to girls, boys showed higher bone turnover markers at ages 15, 19 and 23 years (all p < 0.05). At 10 years of age (Tanner stage 1 and 2), bALP and TRAcP 5b correlated with current bone mass (adjusted for age and sex), while bALP, PINP, osteocalcin and CTX correlated with bone mass change over the next 2 years (adjusted for age, sex and interval) (all p < 0.05). Bone turnover markers in early Tanner stages predicted both current bone mass and subsequent bone mass changes.

The most optimal school recruitment strategies for school-based obesity prevention and health promotion research in the United States: A systematic review with Delphi study.

This systematic review with the Delphi study aimed to identify effective and resource-efficient (optimal) strategies for recruiting schools into health promotion interventions in the United States. A literature search was conducted in PubMed, Cochrane Library, and CINAHL (EBSCO). A total of 116 interventions reported in 160 articles were included. Most school-based interventions did not report data regarding school recruitment duration (81%), target school size (63%), and school recruitment strategies (78%). Further, no details were provided regarding the reasons for declining to participate despite being eligible. For the Delphi, responses from 23 researchers in school-based clinical trials were collected. A qualitative descriptive approach was used for coding responses and collapsed into higher-order categories based on school recruitment strategies. Delphi participants reported that (1) creating new or leveraging pre-existing partnerships, (2) intervention champion, (3) minimal school disruptions, (4) working with open mind/flexibility, and (5) transparent communication are the most optimal school recruitment strategies. Staff time and travel were the most frequently reported costs for implementing those strategies. The overall trend in school-based obesity prevention intervention studies illustrates the importance of a better understanding school recruitment. Improved reporting can allow researchers to budget their time and resources better and provide greater confidence in reaching their target school size.

Waist circumference as a parameter in school-based interventions to prevent overweight and obesity - a systematic review and meta-analysis

BackgroundPreventing childhood obesity remains an important public health issue worldwide. Since visceral fat in particular is understood as an important risk factor for many chronic diseases, waist circumference is recommended as a measurement parameter for global obesity surveillance. This systematic review and meta-analysis focused on waist circumference as an outcome parameter for studies of school-based interventions to prevent overweight and obesity.MethodsA systematic literature search was conducted at the end of 2019 in nine data bases, including Medline and Embase, in order to identify relevant studies evaluating interventions in schools aimed at preventing obesity. Eligibility criteria admitted randomised and non-randomised controlled trials. After screening titles, abstracts and full texts, the data of the identified studies were systematically extracted. Risk of bias was assessed according to study type with the appropriate Cochrane Risk of Bias Tool. The review gives a qualitative overview over all included studies structured by extracted data. Separate meta-analyses were done for the outcome mean difference in change in waist circumference, measured in cm or reported as z-score value, using an inverse variance random-effects model due to study design.ResultsA total of 2421 publications were screened based on titles, abstracts and full texts. Complemented by results of a former systematic literature search 44 studies were identified for inclusion, comprising a total of 39.837 participants (age range: 6 to 18 years). Nearly half of the studies were conducted in Europe, two-thirds combined diet and exercise-based interventions. Likewise two thirds of the studies were conducted as cluster-randomised trials. Most of the reported effects favoured the experimental groups, indicating the basic effectiveness of school-based measures. Based on reported data, only one third of the studies could be included in the meta-analyses. For the difference in mean change of the outcome parameter waist circumference measured in cm (95% CI), we found a pooled effect estimate of -0.95 (-1.87; -0.46). For the difference in mean change of the outcome parameter waist circumference reported as z-score value (95% CI), the pooled effect estimate was -0.10 (-0.15; -0.05). Both effect estimates were in favour of the experimental group. The overall effect sizes were small with a p-value < 0.05.ConclusionsPooled effect estimates were small but in favour of the experimental groups. The same applies to the majority of the effects reported in the included studies. The included cluster of randomised controlled trials demonstrated an especially sound methodological standard. The possibility of achieving larger effects in studies of preventive interventions and health promotion is limited. Schools can only realise their full potential in preventing overweight and obesity in children and adolescents if they are accompanied by measures in other areas of the obesogenic environment.

Classroom intervention to improve behavioral intention toward regular physical activity among adolescents.

During adolescence, a critical phase in human life, the groundwork for a healthful future is established. Physical inactivity poses a significant risk factor for non-communicable diseases (NCDs) and related mortality worldwide. To assess adolescents' behavioral intentions regarding regular physical activity, the Theory of Planned Behavior (TPB) examines 'Attitude,' 'Subjective norm,' and 'Perceived behavioral control.' Utilizing TPB, this study focuses on evaluating the impact of a school-based health promotion intervention on behavioral intentions toward physical activity among urban adolescents in West Bengal, India. A school-based nonrandomized controlled interventional study with parallel group design was conducted among adolescents aged between 12 and 16 years. Behavioral intention towards performing regular physical activity was determined with the measurements of the constructs from the TPB. Cluster analysis was conducted using measurements from both the intervention and control groups. Participants with higher mean scores in the constructs were classified as intenders, while the rest were considered non-intenders. The intervention's impact was evaluated by calculating the Relative Risk (RR) through a generalized linear model with robust standard error estimates, to ascertain the probability of belonging to the higher intention cluster. Following the intervention, construct-wise scores improved significantly, particularly the perceived behavioral control mean score in the intervention group. The Relative Risk (RR) of becoming an intender for regular physical activity in the intervention group was 1.24 (95% CI: 1.04-1.48) when compared to the control group. Health Promoting Schools has been recognized as a strategic and cost-effective vehicle to promote positive development and healthful living, and the current evidence suggests they can effectively reduce the emergence of significant NCD risk factor like physical inactivity. Schools must establish strong partnerships with diverse stakeholders to address barriers beyond the school environment and enhance their control over critical issues.

Smartwatch Measures of Outdoor Exposure and Myopia in Children

Time spent outdoors has been proven effective in preventing myopia, but little is known about the association of outdoor exposure patterns with myopia. To examine the association of outdoor exposure patterns with myopic shift in children. This 1-year prospective cohort study from December 2017 to December 2018 was a secondary analysis of a cluster-randomized trial (Shanghai Time Outside to Reduce Myopia [STORM]). STORM was a school-based intervention study, recruiting 16 schools from 8 districts in Shanghai, from October 2016 to December 2018. Children without myopia at baseline who consistently wore a smartwatch for a minimum of 6 hours daily, sustained for at least 90 days, and who had complete information were included. Data analysis was performed from December 2017 to December 2018. The outdoor exposure pattern was defined as the episode of time outdoors and instant sunlight intensity over a continuous period. Myopic shift was defined as the absolute change in refraction between the initial spherical equivalence and the follow-up spherical equivalence. This study included 2976 students (mean [SD] age, 7.2 [0.6] years; 1525 girls [51.2%]). The mean (SD) daily time outdoors was 90 (28) minutes, and the mean (SD) sunlight intensity was 2345 (486) lux. Of the 12 outdoor exposure patterns, the major outdoor exposure patterns were time outdoors with at least 15 minutes, accounting for 74.9% of minutes (33 677 584 of 45 016 800 minutes). Only patterns with at least 15 minutes accompanied with no less than 2000 lux were associated with less myopic shift in refraction (for ≥15 minutes and 2000 to 3999 lux, -0.007 diopter [D] [95% CI, -0.011 to -0.002 D]; for ≥15 minutes and ≥4000 lux, -0.006 D [95% CI, -0.010 to -0.002 D]). The isotemporal substitution of patterns with at least 15 minutes and 2000 lux for other outdoor exposure patterns was positively associated with less myopic shift. In this 1-year prospective cohort study of children with smartwatches, continuous outdoor exposure with at least 15 minutes accompanied with no less than 2000 lux sunlight intensity was associated with less myopic shift. These findings suggest that future outdoor interventions should focus not only on the overall time outdoors but also on the effective outdoor exposure patterns, as a means to effectively prevent myopia in children.

Physical activity interventions in European primary schools: a scoping review to create a framework for the design of tailored interventions in European countries.

Schools provide a unique environment to facilitate physical activity for children. However, many school-based physical activity interventions have not been effective. We propose a new approach, which allows schools to tailor interventions to their specific context. This scoping review aimed to identify intervention components from previous school-based physical activity interventions to form the basis of a tailored approach in a European setting. Joanna Briggs Institute guidelines for conducting scoping reviews were followed. European school-based intervention studies aimed at increasing physical activity in children aged 7-11 years published in English since 2015 were included. Databases searched were Ovid Medline, Embase, PsycINFO, Web of Science Social Sciences Citation Index, ERIC and British Education Index. Data was extracted on intervention components, context-related factors (geographical location, school size, child socioeconomic status and ethnicity), feasibility, acceptability and cost-effectiveness. A data-driven framework was developed to summarize the identified intervention components. 79 articles were included, constituting 45 intervention studies. We identified 177 intervention components, which were synthesized into a framework of 60 intervention component types across 11 activity opportunities: six within the school day, three within the extended school day and two within the wider school environment. Interventions most frequently targeted physical education (21%), active and outdoor learning (16%), active breaks (15%), and school-level environmewnt (12%). Of the intervention components, 41% were delivered by school staff, 31% by the research team, and 24% by external organizations. Only 19% of intervention studies reported geographical location and only 10% reported school size. Participant ethnicity and socioeconomic information was reported by 15% and 25%, respectively. Intervention acceptability was reported in 51% of studies, feasibility in 49%, and cost effectiveness in 2%. This review offers a first step in developing a future framework to help schools to develop context-specific, tailored interventions. However, there was a lack of reporting of contextual factors within the included studies, making it difficult to understand the role of context. Future research should seek to measure and report contextual factors, and to better understand the important aspects of context within school-based physical activity.

Systematic review on social/moral competence interventions in Physical Education

Abstract Study aim: This systematic review drew the significant findings of carefully selected interventions to promote the social and moral competence (SC and MC, respectively) of children and adolescents mostly by investigating the effect of these interventions and focusing on strategies used. Material and methods: A number of English written, electronic databases (e.g., EBSCO, EBSCOhost Web, ERIC, Master FILE Premier, SPORT, SPORT Discus, and Web of Science) and grey literature – from 2005 to the present – were consulted from September 2021 to December 2021. School-based intervention studies that assessed moral competence (MC) or social competence (SC) were eligible for inclusion. The studies were stratified by pre-school and primary school children (&lt;12 years of age) and adolescents (≥12 years of age). A total of N = 24 documents referring to different intervention studies were included in the review. N = 10 interventions focused on children; while N = 14 targeted adolescents. Results: The most used strategies in the interventions were the ones that included components of MC or evaluated SC using specific protocols and tools. Conclusions: This review pointed at socio-emotional and moral skills which remained underdeveloped in school children unless physical education (PE) teachers adjusted teaching contents and methods during instruction; and implement them into interventions with strategies that targeted elements fostering the sound socio-moral development of a child into adulthood. A model-based approach appeared to be the most, but not the only effective designs in the examined interventions.

Evaluating modified effects of family factors on intervention to protect primary school students from the impact of heatwave

Identifying the factors that may impact intervention effectiveness of primary students is crucial for developing targeted intervention strategies on heatwave adaption. The purpose of the study was to assess how the family factors could affect the intervention effects of primary school students to adapt heatwave, using the data from a previously conducted primary school-based intervention study. The study recruited 648 students (9–13 years old) and their parents from two primary schools in Dongtai of Jiangsu province, China. From May to September 2017, a 5-mon intervention for enhancing knowledge, attitude and practice (KAP) was implemented at the intervention school. The students' KAP scores and the family-related information were measured by designed self-administered questionnaires at intervention school and control school separately before and after intervention. The effects of the intervention were explored through the propensity score matching and difference-in-difference method (PSM-DID), and stratified analysis were conducted by family factors. The overall KAP score increased by 2.391 (95% CI: 1.881, 2.902) after intervention, which shows that the intervention was effective. The students whose parents with higher school educational attainment, parents with employment, and household number ≤3 achieved significantly higher increment of KAP scores than their counterparts. Although students whose parents in marriage achieved higher score increasing than parents not in marriage, the difference was non-significant. Our findings indicated that parental education status, working status and the household size were the influence factors of heatwave adaption interventions for primary school students. Future interventions should take parental education status, working status and household size into account to improve the effectiveness of heatwave adaption intervention for primary school students.

School-based physical activity interventions: a discourse analysis

ABSTRACT School-based physical activity (PA) interventions stand out as a highly valued knowledge technology in relation to attempts to promote daily physical activity (DPA) among school youth. The purpose of the paper is to explore technologies of knowledge that guide school-based PA interventions in lower secondary schools and discuss their power-related implications. Foucault’s notion of discourse as the ensemble of regulated, deliberate, and finalised ways of doing things underpins the analysis of six school-based PA intervention studies that were identified in the literature between the years 2003 and 2021. The analysis concerned the scientific domain of the studies, their justification of school-based PA interventions, the purpose and results of the interventions, and problems with implementing the interventions. The analysis indicated a distinct narrative where researchers within medical science and psychology proposed that (a) young people's level of PA is too low and therefore they are increasingly exposed to the risk of lifestyle diseases; (b) schools appear as the obvious context for attempts to increase the PA of young people, for example through interventions; (c) contextual factors are often pointed out as significant for the success of the interventions, yet these factors are not systematically placed under the research magnifying glass; (d) few studies demonstrate any tangible change in student behaviour because of the interventions; (e) non-occurring behaviour changes are explained by contextual factors, or that school staff simply do not adhere enough to the intervention efforts. These results are discussed through Foucault’s concept of governmentality, that is, the integration of technologies of knowledge, power, and the self. It is concluded that the examined research gain function within a neoliberal governmentality where scientific knowledge aims to change the individual self, rather than to change the social structures in which individuals live their lives.

Effectiveness of School-Based Occupational Therapy Interventions on School Skills and Abilities Among Children with Attention Deficit Hyperactivity and Autism Spectrum Disorders: Systematic Review

ABSTRACT This systematic review aimed to synthesize the best available research evidence regarding the effectiveness of school-based occupational therapy interventions on school skills and abilities among children with ADHD (attention deficit hyperactivity disorder) and ASD (autism spectrum disorder). The review was conducted according to JBI (Joanna Briggs Institute) guidelines . A three-step search strategy was conducted from five electronic databases (CINAHL, PubMed, OTDBASE, Google Scholar, and Oula-Finna) in January 2022. This review considered randomized and quasi-randomized studies that evaluated school-based occupational therapy interventions for children on school skills and abilities, specifically outcomes of social interaction and process skills, and cognitive abilities. This review includes thirteen studies with a total sample size of 375 participants. Results are divided into two categories: school-based occupational interventions for children with ADHD (three studies) and school-based occupational interventions for children with ASD (ten studies). Results from school-based occupational therapy intervention studies for children and adolescents with ADHD indicate that this group of students benefits from manualized interventions that focus on social interaction skills, process skills, and cognitive abilities. Positive responses to these outcomes were found when using interventions concerning mindfulness, weighted vests, and executive function training programs. Results from school-based occupational therapy intervention studies for children and adolescents with ASD emphasize using interventions that affect social interaction skills.

Government-Industry-Academia Alliance: A multisectoral collaboration for improved nutrition of children and well-being of mothers

Introduction: Consistent with the Sustainable Development Goal 17 highlighting partnership to achieve development, this study demonstrated the convergence among government, industry and academe in carrying out a nutrition intervention to improve the nutritional status, knowledge, attitude and behaviour of school community (school children and mothers). Methods: A school-based intervention study comprising of school lunch feeding and nutrition lessons was conducted. Quasi-experimental design was used in the intervention research. Data were analysed using Stata 12.0. Descriptive statistics were generated using the survey module (svy) of Stata. The food and nutrition intervention mix composed of the governmentpartner School Feeding Programme (SFP) and the nutrition education campaign. The government-partner SFP involved lunch feeding of 7 to 9 years old students based on the standardised Pinggang Pinoy® recipes. The government-partner nutrition education component involved teaching of the developed modules to students and their mothers. Results: The intervention resulted in improvements in nutritional status, knowledge, attitude and behaviour of students. Investing an average of Php 15.00 or USD 0.29 (as of 2017) in a school feeding programme following the government-partner food and nutrition intervention mix improved nutritional status and shifted the number of underweight children to normal nutritional status by 25.3% after 120 feeding days. This intervention was implemented through a multisectoral collaboration during the pre-implementation, implementation, and post-implementation phases of the study. Conclusion: Partnerships among stakeholders provided the context towards healthier children as demonstrated by improved nutritional status, knowledge, attitude and behaviour of participants.

Time outdoors positively associates with academic performance: a school-based study with objective monitoring of outdoor time

BackgroundTo explore the relationship between outdoor time and academic performance among school-aged children.MethodsThis study was designed as a cross-sectional study. Data were derived from a school-based prospective children myopia intervention study (STORM). Outdoor time was recorded by self-developed algorithm-validated wristwatches in real-time and calculated as the cumulative average of 10 months. The academic performance was recorded and provided by the participating schools and further standardized. Other information was collected using an online standardized questionnaire. Mixed-effects model and B-Spline method were used to investigate the association between time spent on different types of daily activity, including outdoor activity and academic performance.ResultsA total of 3291 children with mean age 9.25 years were included in the final analysis. Overall, outdoor time was associated with academic performance in a non-linear manner; specifically, not exceeding 2.3 h per day, outdoor time was positively associated with academic performance; exceeding 2.3 h per day, this association became non-significant. Likewise, daily sleep duration and out-of-school learning time were associated with academic performance in a non-linear manner, resulting in turning points of 11.3 and 1.4 h per day, respectively. Separate analysis showed that outdoor time and sleep duration but not out-of-school learning time were positively associated with academic performance in Chinese, mathematics and English.ConclusionOutdoor time, sleep duration and out-of-school learning time were associated with academic performance in a non-linear manner. Promotion of outdoor time may not negatively impact on academic performance.Trial registrationOur study was registered in ClinicalTrials.gov (Identifier: NCT02980445).

Creative dance studies in elementary schools: a systematic search and a narrative review

ABSTRACT This is a systematic search and a narrative review of school-based Creative Dance (CreaDa) programs and intervention studies in elementary education. Advanced searches with PRISMA methodology resulted in 19 eligible studies, which were further analyzed based on the GREET checklist criteria. The main categories of the extracted data were the description of programs and interventions, their delivery and participants’ characteristics, the findings of the studies and limitations referred. Each category included many sub-categories of analysis, which shed light on topics related to CreaDa implementation from the researchers’ and the practitioners’ perspective. The descriptive analysis and presentation of each sub-category was complemented with figures, narrations, comments, discussion and in some cases suggestions. It seems that CreaDa implementation in elementary schools has the tremendous potential to mainly cultivate children cognitively and psychosocially. Essential information for future research and practice and further considerations based on sections’ analyses were summed up and presented.

The association between childhood motor performance and developmental trajectories of sport participation over 5 years in Danish students aged 6–16-year-old

Sports participation has potential to promote physical activity in youth. Unfortunately, sports participation and physical activity may decline from childhood to adolescence and into adulthood. Globally, only 20% of 13–15-year-olds meet the World Health Organisation recommendations for physical activity. This study aimed to investigate the 5-year trajectories of sports participation and their association with baseline motor performance in Danish school children as part of the Childhood Health Activity and Motor Performance School Study-Denmark (CHAMPS-DK), a school-based physical activity intervention study which investigated the health benefits of increased physical education lessons. Five distinct trajectories were identified, with group 1 maintained a stable trajectory of little to no sports participation, and group 2 showing a low decreasing trend. Group 3–5, the most sports active, demonstrated increasing sport participation at different rates. Baseline motor performance score was associated with the two most active sports participation groups. Students who were more physically active during school hours participated less in organised leisure time sports. This suggest focusing on improving motor performance in youth may support future sports participation and thus health-related physical activity. But also, that it might be necessary to engage and maintain children and adolescents in leisure time sports while implementing physical activity promotion interventions.

High School Students' and Teachers' Mental Health Literacy Levels in Istanbul, Turkey: AComprehensive Analysis.

Mental health literacy is important for awareness of mental illnesses in adolescence, which is the initial period of mental disorders. Determining the levels of mental health literacy guides studies in activities promoting mental health. This study aimed to determine the mental health literacy levels of high school students and teachers and related factors. Our study is a cross-sectional study. A total of 1051 people (students and teachers) were included in the Fatih District of Istanbul were included in our study. The mental health literacy levels of the participants were evaluated with the Mental Health Literacy Questionnaire. This questionnaire includes scenarios about mental problems called "vignettes" and questions about them. Students' recognition percentages of depression, schizophrenia, and social phobia vignettes were found to be 28.1%, 46.5%, and 5.9%, respectively. For the person who was described in the vignettes, the "family physician" was chosen as the least by students and teachers. A statistically significant relationship was found between students' mental health literacy levels and sex, grade, father education levels, and experiencing vignette similar issues (p < .005). Additionally, teachers who were not school administrators and experienced vignette similar issues levels were higher (p < .005). These results showed us that mental health literacy levels are low in high schools. School-based intervention studies on this issue are of critical importance. In addition, it is seen that individuals do not consider asking for help with mental health problems from primary care services. This shows the inadequacy of the integration of primary health care services and mental health services.

Effectiveness of instructional teaching package on knowledge regarding first aid and safety measures among school children

: Henry Sigerist, the medical historian, stated that “the people’s health ought to be the concern of the people themselves. They must struggle for it and plan for it. The war against disease and for health cannot be fought by physicians alone. It is the people’s war in which the entire population must be mobilized permanently.This school-based interventional study was conducted in Radharani Siksha Mandir High School located in Paltagarh, Singur Block of Hooghly district, West Bengal, among students of Class VI and Class VII on February–March. The middle school students were chosen keeping in view of their mid-adolescent age that makes them prone to injuries and accidents. All students of 6th standard and 7th standard were eligible to participate. Although educational intervention was imparted to all those present on the day of intervention, post intervention knowledge was assessed among only those students whose pre interventional knowledge score was available. Out of 230 students, 60% of the students belonged to Class VII and the rest in Class VI and half of them who participated in the study were girls (53.5%). The mean age of the study participants was 12.5 ± 0.73 years. Background data revealed that majority of their parents were educated up to tenth standard (48.7% fathers and 37.8% of mothers); father of 25.2% were farmers, 24.7% were daily laborers, 18.6% were doing business, 26.5% of them were skilled laborers, and 5.0% of them were in service while mothers of all students were homemakers. All of the students had heard of the term “first aid” and out of them, only 14 of them (6 girls and 8 boys) had reported any past practical experience of administering first aid. Among those who had heard about first aid, TV/radio was the major source of information (38.7%), followed by parents (24.3%), teachers (17.4%), friends (11.7%), and relatives (4.8%). 36.5% of the students answered that there was a chapter on first aid in their science book while the rest either denied (54.3%) or could not even remember (9.2%) any such chapter. However, all of them unanimously agreed that it was not taught as a part of their syllabus. The present study revealed that all the students had heard of the name of first aid which were similar to the findings of Priyangika and Hettiarachhi in a study conducted in Sri Lanka while Dasgupta et al. reported in her study that merely (15.2%) of the study subjects knew about the correct definition of the term first aid.”

"You Measure Us and You Depress Us": Healthism and the Subjective Impact of Body Measurements on Secondary School Students.

This study explores adolescents' subjective experiences when facing body measurements at school, performed to evaluate the effects of a school-based intervention to promote physical activity. Three semi-structured interviews (n = 3) and two focus groups (n = 7 and 3) were conducted with adolescents after measuring some variables related to their weight and adiposity. Observational data (n = 88) collected by the two researchers in charge of the measurements were also obtained. Findings derived from our thematic analysis question the suitability of body measurements as social contexts where the core ideas of healthism emerge. Some adolescents lived body measurements as negative social experiences, promoting body dissatisfaction, social comparison, embarrassment, and simplistic associations between health and body shape, which could hinder their adherence to healthy habits. We emphasize the role of qualitative research when evaluating pre/posttests of school-based intervention studies, not just the interventions themselves, to generate knowledge to improve research protocols and prevent unwanted psychological outcomes in participants.

Systematic Review of the Economics of School-Based Interventions for Dating Violence and Gender-Based Violence.

Dating and relationship violence (DRV) and gender-based violence (GBV) among children and young people incur a high cost to individuals and society. School-based interventions present an opportunity to prevent DRV and GBV early in individuals' lives. However, with school resources under pressure, policymakers require guidance on the economics of implementing interventions. As part of a large systematic review funded by the National Institute for Health and Care Research (NIHR), we searched for economic evaluations and costing studies of school-based interventions for DRV and GBV. No formal economic evaluations were identified. Seven studies reporting costs, cost savings, or resource use for eight interventions were identified. The largest costs of implementing interventions were related to staff training and salaries but savings could be made by implementing interventions on a large scale. The potential cost savings of avoided DRV and GBV far outweighed the costs of implementation.

Compensation of overall physical activity in (pre)adolescent girls – the CReActivity project

BackgroundAccording to the ActivityStat hypothesis more physical activity (PA) in one timespan is compensated by increased sedentary time (ST) in the following timespan and vice versa to maintain an overall stable PA level. Until now, existing literature revealed inconsistent results regarding compensatory behaviour across children and adolescents. Thus, the aim of the present study is (1) to investigate whether ST in the morning is compensated by active behaviour in the afternoon and (2) whether ST during the week is compensated by active behaviour during the weekend in (pre)adolescent girls. Additionally, we aimed to differentiate between positive and negative compensatory behaviour and examine whether it is moderated by socioeconomic status (SES), age or weight status.MethodsThe participants were 370 sixth grade school girls (mean age 11.6 years) from Munich that participated in the CReActivity study, a school based intervention study aiming to identify the mechanisms of behavioural changes in PA among girls. ST and PA were measured over seven consecutive days using accelerometery. Descriptive determination of compensatory behaviour, as well as Bayesian multivariate multilevel analysis were conducted with data clustered on the individual (ID), class and school level.ResultsDescriptive analysis revealed rather constant compensatory behaviour of about 60% for after-school days and weekends over all observation points. However, regarding all girls, compensation was predominantly negative. Differentiated analysis indicated that all girls with low ST levels in the morning or on weekdays, compensated for this behaviour with lower PA levels in the afternoon or on weekends. Multilevel covariate analysis indicated great variability between the participants. Furthermore, differences in compensatory behaviour can also be seen on class and school levels. Interestingly, PA compensatory behaviour is not associated with age, weight status or SES.ConclusionOur findings could neither confirm nor reject the ActivityStat Hypothesis. Overall, due to the great variability across the girls, it seems that compensation depends on individual factors. In the future, to prevent negative compensation, school-based interventions that have the potential to provide opportunities to be physically active, should not neglect (pre)adolescents’ leisure time behaviour.Trial RegistrationDRKS00015723 (date of registration: 2018/10/22 retrospectively registered).

Prevalence and clinical characteristics of metabolically healthy obese versus metabolically unhealthy obese school children.

IntroductionChildren with obesity in the absence of traditional cardiometabolic risk factors (CRF) have been described as metabolically healthy obese (MHO). Children with MHO phenotype has a favorable metabolic profile with normal glucose metabolism, lipids, and blood pressure compared to children with metabolically unhealthy obese (MUO) phenotype. This study aimed to compare several parameters related to obesity between these two groups and to examine the predictors associated with the MHO phenotype.MethodsThis study included a cross-sectional baseline data of 193 children with obesity (BMI z-score > +2 SD) aged 8-16 years enrolled in MyBFF@school program, a school-based intervention study conducted between January and December 2014. Metabolic status was defined based on the 2018 consensus-based criteria with MHO children had no CRF (HDL-cholesterol > 1.03 mmol/L, triglycerides ≤ 1.7 mmol/L, systolic and diastolic blood pressure ≤ 90th percentile, and fasting plasma glucose ≤ 5.6 mmol/L). Those that did not meet one or more of the above criteria were classified as children with MUO phenotype.ResultsThe prevalence of MHO was 30.1% (95% CI 23.7 – 37.1) among schoolchildren with obesity and more common in younger and prepubertal children. Compared to MUO, children with MHO phenotype had significantly lower BMI, lower waist circumference, lower uric acid, higher adiponectin, and higher apolipoprotein A-1 levels (p < 0.01). Multivariate logistic regression showed that adiponectin (OR: 1.33, 95% CI 1.05 – 1.68) and apolipoprotein A-1 (OR: 1.02, 95% CI 1.01 – 1.03) were independent predictors for MHO phenotype in this population.ConclusionsMHO phenotype was more common in younger and prepubertal children with obesity. Higher serum levels of adiponectin and apolipoprotein A-1 increased the possibility of schoolchildren with obesity to be classified into MHO phenotype.