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Using routinely collected growth data to assess a school-based obesity prevention strategy.
Int J Obes (Lond). 2013 Jan; 37(1):79-85.IJ

Abstract

BACKGROUND

Studies of school-based anti-obesity interventions have yielded inconsistent results. Using growth screening data from a school administrative database, we re-evaluated an obesity prevention strategy that was previously reported to have a beneficial effect on weight status of a sample of students in grades 5-7.

METHODS

Ten K-8 schools (five control and five intervention) participated in a 2-year cluster-randomized trial of a multi-component nutrition education intervention. We obtained student height and weight data for 6 consecutive school years and imputed missing baseline and follow-up measurements (53% and 55%, respectively) and defined the target population based on the intent-to-treat principle. We analyzed changes in body mass index (BMI) Z-scores via mixed-effects linear regression and in the prevalence of overweight/obesity via conditional logistic regression. We also assessed incidence and remission of overweight/obesity and long-term effects.

RESULTS

We analyzed data for 8186 (96%) K-8 students in the 10 schools (4511 in intervention; 3675 in control). From baseline to the end of the intervention period, mean increases in BMI Z-score were 0.10 and 0.09 in the control and intervention groups, respectively (P=0.671). The prevalence of overweight/obesity increased by 3% in both groups (P=0.926). There was no significant intervention effect on the incidence or remission of overweight/obesity. Among 5469 students who attended study schools during both years of the intervention, there was no significant intervention effect. Furthermore, there was no long-term effect among students with up to 2 years of data beyond the end of the intervention.

CONCLUSION

Using routinely collected data for the entire target population, we failed to confirm earlier findings of an intervention effect observed in a subset of students in grades 5-7. Volunteer bias in the prior evaluation and/or measurement error in the routinely collected data are potential reasons for the discrepant findings.

Authors+Show Affiliations

Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA. elizabeth.rappaport@jefferson.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22945605

Citation

Rappaport, E B., et al. "Using Routinely Collected Growth Data to Assess a School-based Obesity Prevention Strategy." International Journal of Obesity (2005), vol. 37, no. 1, 2013, pp. 79-85.
Rappaport EB, Daskalakis C, Sendecki JA. Using routinely collected growth data to assess a school-based obesity prevention strategy. Int J Obes (Lond). 2013;37(1):79-85.
Rappaport, E. B., Daskalakis, C., & Sendecki, J. A. (2013). Using routinely collected growth data to assess a school-based obesity prevention strategy. International Journal of Obesity (2005), 37(1), 79-85. https://doi.org/10.1038/ijo.2012.126
Rappaport EB, Daskalakis C, Sendecki JA. Using Routinely Collected Growth Data to Assess a School-based Obesity Prevention Strategy. Int J Obes (Lond). 2013;37(1):79-85. PubMed PMID: 22945605.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Using routinely collected growth data to assess a school-based obesity prevention strategy. AU - Rappaport,E B, AU - Daskalakis,C, AU - Sendecki,J A, Y1 - 2012/09/04/ PY - 2012/9/5/entrez PY - 2012/9/5/pubmed PY - 2013/6/26/medline SP - 79 EP - 85 JF - International journal of obesity (2005) JO - Int J Obes (Lond) VL - 37 IS - 1 N2 - BACKGROUND: Studies of school-based anti-obesity interventions have yielded inconsistent results. Using growth screening data from a school administrative database, we re-evaluated an obesity prevention strategy that was previously reported to have a beneficial effect on weight status of a sample of students in grades 5-7. METHODS: Ten K-8 schools (five control and five intervention) participated in a 2-year cluster-randomized trial of a multi-component nutrition education intervention. We obtained student height and weight data for 6 consecutive school years and imputed missing baseline and follow-up measurements (53% and 55%, respectively) and defined the target population based on the intent-to-treat principle. We analyzed changes in body mass index (BMI) Z-scores via mixed-effects linear regression and in the prevalence of overweight/obesity via conditional logistic regression. We also assessed incidence and remission of overweight/obesity and long-term effects. RESULTS: We analyzed data for 8186 (96%) K-8 students in the 10 schools (4511 in intervention; 3675 in control). From baseline to the end of the intervention period, mean increases in BMI Z-score were 0.10 and 0.09 in the control and intervention groups, respectively (P=0.671). The prevalence of overweight/obesity increased by 3% in both groups (P=0.926). There was no significant intervention effect on the incidence or remission of overweight/obesity. Among 5469 students who attended study schools during both years of the intervention, there was no significant intervention effect. Furthermore, there was no long-term effect among students with up to 2 years of data beyond the end of the intervention. CONCLUSION: Using routinely collected data for the entire target population, we failed to confirm earlier findings of an intervention effect observed in a subset of students in grades 5-7. Volunteer bias in the prior evaluation and/or measurement error in the routinely collected data are potential reasons for the discrepant findings. SN - 1476-5497 UR - https://www.unboundmedicine.com/medline/citation/22945605/Using_routinely_collected_growth_data_to_assess_a_school_based_obesity_prevention_strategy_ L2 - http://dx.doi.org/10.1038/ijo.2012.126 DB - PRIME DP - Unbound Medicine ER -