Qingpu District Primary School Obesity Prevention Interventions In Schools - Family - Community Linkage Model

In this study,we took intervention measures in pupils with health promotion strategies and school-family-community co-operative module according to the status of their knowledge-attitude-practice(KAP)on obesity in Qing pu District,evaluated the scientific,feasibility and effect of the module,and validated the effect of the intervention measures on focus,such as health education,balanced diet,enhancing exercises.The results of this study might provide guidance for the control and prevention of obesity.A cross- sectional survey and experimental interventions in groups were conducted in this study.There were two parts as follows:1.Analysis of KAP on obesity and some indexes about health of the pupilsJia He School and Qing Hua School were sampled by cluster sampling which were comparative in the fields of economic and teaching conditions.Jia He School was intervened and the other was not intervened.Subjects were the pupils in Grade 3 of the two schools.At the beginning,466 pupils were surveyed,264 of them were from Jia He School(139 males,125 females),and the other 202 were from Qing Hua School(100males,102 females).The mean age was 9 years old.A structured questionnaire was used to investigate the KAP on obesity,and physical examinations were conducted to obtain the data of height,weight,glucose,lipids(cholesterol,TG, LDL,HDL),and so on.All the data above were described to know the status of KAP on obesity in pupils,and levels of overweight,fat,glucose and lipids.Results:(1) The awareness of knowledge on obesity was very poor,only 10% of the pupils knew the cause and danger of obesity well,45.4%of them did outdoor exercises more than one hour per day;45%of them watched TV more than two hours per day;52%of them liked eating hamburgers and French fries;47%of them liked eating chocolates,sweets and ice cream.In common,the diets of the pupils were at a high level of sugar and lipid.Therefore,we should enhance the health education to prevent obesity,in the group of pupils and middle school students and correct the unreasonable habits of diet or exercises.(2) The main risk factors of obesity in this study were "like eating sweet food","watch TV every day","either of the parents is fat",and "born of a high level of weight".Babies born at a high level of weight tended to be delivered by cesarean section,and most of them weren't fecd by breast,while manual feeding was often excessive which might lead to obesity later in one's life.(3) There weren't any statistical significance of differences in the rates of obesity and abnormal rates of glucose between the two schools.The mean value of triglyceride and abnormal rate of it in Qing Hua School was higher than that in Jia He School,while the other indexes of lipids weren't different.2.Evaluation of the effect of the interventions by school-family-community co-operative module.On the base of the survey above,we took measures such as health education. balanced diet,enhancing exercises with health promotion strategies and the school-family-community co-operative module in the intervened group in Jia He School,The interventions lasted one year.While the control group in Qing Hua School was just routinely monitored.The results showed:(1) Rates of obesity:The rate of obesity in the intervened group was 27.2%,while that in the control group was 27.2%.The rate of obesity later was a little lower in the intervened group,but there was no statistic significance of difference between the two groups(P＞0.05). The reason might be that it was too short of time for the pupils to understand and accept the interventions and then improve their behaviors in our study.However. there was a trend for them to change their health behaviors.(2) Changes of other indexes:The abnormal rate of glucose later was 0.0%in the intervened group,while that in the control group was 8.33%later(When one's glucose was low.it was indentified as abnormal).The abnormal rate of glucose later in the control group was higher than that in the intervened group with a statistical significance(P＜0.01).The abnormal rates of cholesterol later were both lower in the two groups,which was 2.9%in the intervention group,and 3.8%in the control group,there was no statistical significance of the difference of such rates(P＞0.05).The abnormal rate of TG later was 2.89%in the intervention group,while it was12.20%in the control group.The abnormal rate of TG in the control group was higher than that in the intervention group with a statistical significance(P＜0.05).The abnormal rate of HDL later was 0.41%in the intervention group,while it was 2.77%in the control group,it was higher in the control group than that in the intervention group (P＜0.05).Thc abnormal rate of LDL later was 0.80%,while it was 18.8%in the control group.it was higher in the control group than that in the intervention group (P＜0.05).(3) The change of KAP:The awareness of knowledge about obesity changed from 76.8%to 96.6%with a statistical significance(P＜0.05) in the intervention group.While the awareness in the control group changed from 77.1%to 81.6%with no statistical significance(P＞0.05).The awareness of knowledge in the intervention group was higher than that in the control group in the end(P＜0.05). Therefore,the pupils in the intervention group have acquired more knowledge about obesity.Also,the pupils in the intervention group have changed their attitudes to prevent obesity obviously.The rate of pupils thinking that it was necessary to propagandize how to prevent obesity changed from 63.3%to 98.1%,it was higher after the inventions(P＜0.05).The rate of pupils who would like to accept health education on knowledge about obesity changed from 53.4%to 93.6%,it was higher after the inventions(P＜0.05) too.Meanwhile,there were almost no any changes of the attitudes to obesity in the control group(table 2-25).Still,some of the pupils have changed their behaviors,which set a good foundation for developing good habits,controlling one's weight and preventing diseases.In this study,we conclude that it is easier to improve one's knowledge than to change his behavior. Bad habits would not develop in a short time.It needs a long period of time from knowledge acquiring to behavior changing,and the risk factors might be complex. As the dose of interventions increased,we should transform their knowledge to their behaviors so that the effectiveness can be better.In this study,we formed a module to prevent obesity in pupils which was to take invention measures by school-family-community co-operative module and health promotion strategies.Pupils whether fat or not were intervened in the union of communities,schools and families.Some departments of sanitation,education and communities might be involved in the working net for preventing obesity of pupils under the support of Health Bureau,Education Bureau and the Govemment.All the people in communities should accept health education to improve their KAP on obesity.Still,organizing guarantee and adequate materials should be supplied. Meanwhile,salt spoons and oilers were delivered to develop their skills for health promoting.Under the support of communities,schools and families,the effect of obesity preventing might be better.The practice has been proved that it was feasible and effective to take intervention measures to prevent obesity by the school-family-community co-operative module and health promoting strategies.