Research On Overweight And Obesity Status And Comprehensive Intervention Strategy Of Primary And Middle School Students In Jilin Province

The teenage period of children is crucial in the development of physicalqualities and physical and mental health. In this process, schools are importantplaces for children and adolescents to obtain the healthy knowledge and developtheir proper behaviors; teachers play a main role in the education and training ofpupils. Both of them play an important role in improving children’s healthy levels.Nevertheless, in recent years overall unbalanced energy between the total energyintake and the total energy consumption caused by physical activities has resulted inthe increased detection rate of overweight and obesity during the school age oryoung adulthood annually, younger problem is became more serious. Theoverweight and obesity are the risk factors to cause noninfectious chronic diseasessuch as hypertension, coronary heart disease, cerebral apoplexy, etc. The obesitystarting from the childhood will cause a higher prevalence of chronic diseases thanthat of obesity starting from adults. The overweight and obesity happened in theteenage period are the results of environmental factors and socio-economic andcultural factors such as genetic factors, unhealthy eating behaviors and sedentary lifestyle, of them, irrational eating behaviors. For example, high-energy diets, chosensnacks inappropriate and skipping breakfast and so on, are the main risk factors ofthe obesity in children and adolescents. Accordingly, it has become a significantglobal public health problem to control the risk factors of chronic, that is to controlits popularity of the obesity in children and adolescents, starting from the solving theunhealthy lifestyle behaviors. 【Objective】Aiming at the risk factor of irrational eating behaviors, the healthexamination survey and intervention evaluation with the overweight and obesity asthe point of penetration ranged from the schools of the Province have beenconducted positively, taking schools as the platform and combining with theteachers’ health literacy survey and guidance, sequentially the targeted groupintervention strategies can be made and carried out in order to change children andadolescents’ unhealthy lifestyle behaviors, by this, it promotes their awareness andcapabilities for self-health protection, resulting in providing scientific basis for theexploration of the establishment of “Health Promoting Schools” Mode.【Methods】In the health status survey stage, the method combining the physicalexamination with the questionnaire survey had been adopted to investigate the heathstatus and influencing factors of the overweight and obesity among17893schoolchildren (from8-15years old) and2085teachers both in elementary andsecondary schools in Jilin Province. The contents of the questionnaire survey include:the general conditions of the schoolchildren and teachers, the status of theoverweight and obesity, knowledge, attitudes, behavior factors about the diets andsports. In groups intervention and evaluation stage, the method of questionnairesurvey had been adopted to investigate the base line before intervention among14175schoolchildren in Jilin Province, the contents of the questionnaire surveyinclude: the general conditions of the pupils, their cognition and behavior factorsabout the energy distribution of three meals, breakfast, nutrients and snacks,accordingly reasonable diet skills trainings were implemented, resulting in theeffectiveness evaluation with DID Mode fitting after intervention.【Results】1. The analysis result of the overweight and obesity status andinfluencing factors among schoolchildren shows: the overall rate of overweight is15.0%, the obesity rate is15.5%，the total detection rate of the overweight andobesity is30.5%. The schoolboys’ rate of the overweight and obesity is36.9%. Theschoolgirls’ rate of the overweight and obesity is23.5%. The highest incidence of theoverweight and obesity at8years old is40.1%. The lowest incidence of the overweight and obesity at15years old is23.4%.2. The analysis result of “KAP” status about the diet movement of theschoolchildren and influencing factors shows: among fat schoolchildren, only24.1%of them know the correct measures how to control weight,62.9%of them are willingto do exercises everyday, and23.4%of them can keep exercises for more than oneand a half hours every day. It is known by the establishment of the structuralequation model (SEM) that there are four significant channels influencing theoverweight and obesity:1). Knowledge-Belief-Behavior-Overweight and obesity.2). Knowledge-Behavior-Overweight and obesity.3). Belief-Knowledge-Behavior-Overweight and obesity.4). Belief-Behavior-Overweight and obesity.3. The influencing result of the consistency analysis between the self-evaluationof schoolchildren bodies and BMI and the weight reduction behaviors shows: only62.9%among the schoolchildren can evaluate their self-body correctly,37.1%ofthem estimate their own bodies wrongly, of them, the underestimated rate is31.4%,and the overvalued rate is5.7%. The result of the consistency checking involvingKappa further shows that the consistency degree on the evaluation betweenself-evaluation of schoolchildren bodies and BMI presents relatively weak. It isknown by the mediating effect test that the self-evaluation of body presents a fullintermediation between BMI evaluation and weight reduction behaviors ofschoolchildren, which means the BMI evaluating values of actual weight has aneffect on their weight reduction behavior through different self-evaluations of body.4. The evaluation result of the intervention effects on the reasonable diet skillsof schoolchildren shows: in intervention group, there are only396persons(accounting for8.8%) who can answer the knowledge about the reasonable dietcorrectly and adopt the relatively correct behaviors, which mean that they havecomprehensive skills about the reasonable diet before intervention. The mentionednumber has increased to4080persons (accounting for91.2%) with skills afterintervention. In comparison, in the control group, the persons with skills are only809(accounting for50%) before intervention, the number is810(accounting for50%) after intervention. It is known by using DID model fitting, the interventionimplementation of the reasonable diet skill has some effect. Excluding the effect ofthe population sociology on the accuracy, the implementation of interventionmeasures has made the accuracy of the schoolchildren reasonable diet skill increasedby39.5%.5. The result of the teachers’ overweight and obesity status and health literacylevels shows: teachers’ overall prevalence of the overweight is19.8%, the obesityprevalence is4.6%. The total detection rate of the overweight and obesity is24.4%,and6.7%of them belong to weight towards to thin. Only6%of them know well thenutritional characteristics of western fast food,61%of them are willing to supporttheir pupils to have necessary movement time,27.7%of them often tell movementnutritional knowledge to their pupils,28%of them have vegetarian food mainly and48%of them do exercises enough.【Conclusions】It is not optimistic about the overall status of the schoolchildrenoverweight and obesity in Jilin Province, the schoolboys’ incidence of theoverweight and obesity is higher than that of schoolgirls; With age, the incidence ofthe overweight and obesity will fall; the incidence of the overweight and obesityhappened in different areas presents a significant difference. The incidence betweenthe overweight, obesity and those who don’t know how to control their weight,cannot keep exercise everyday and cannot maintain proper times to eating meatpresents a significant positive correlation. The consistency degree on the evaluationbetween self-evaluation of schoolchildren bodies and BMI presents relatively weak.The school girls’ concordance is relatively better than that of the schoolboys. Theconcordance found in junior high schools is relatively better than that in elementaryschools. The self-evaluation of body presents a full intermediation between BMIevaluation and weight reduction behaviors of schoolchildren, which means the BMIevaluating values of actual weight has an effect on their weight reduction behaviorthrough different self-evaluations of body. The intervention implementation of thereasonable diet skill has some effect, by which the comprehensive accuracy of schoolchildren reasonable diet skills is increased to some extent, of them, except thatthe accuracy of the behavior of “Have Breakfast Everyday” presents no greatimprovement, all other items have presented a significant improvement. It can beknown that it is time to control the overweight and obesity of schoolchildren. Theintervention of junior class children should be conducted first as early as possiblestarting from their lifestyle behaviors such as healthy diet and movement habitsaiming at the early prevention and training their healthy lifestyle behavior, and thenestablishing the comprehensive intervention network mode of “Family-School”.