IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0272291.html
   My bibliography  Save this article

Battling the obesity epidemic with a school-based intervention: Long-term effects of a quasi-experimental study

Author

Listed:
  • M Willeboordse
  • N H M Bartelink
  • P van Assema
  • S P J Kremers
  • H H C M Savelberg
  • M T H Hahnraths
  • L Vonk
  • M Oosterhoff
  • C P van Schayck
  • B Winkens
  • M W J Jansen

Abstract

Background: School-based health-promoting interventions are increasingly seen as an effective population strategy to improve health and prevent obesity. Evidence on the long-term effectiveness of school-based interventions is scarce. This study investigates the four-year effectiveness of the school-based Healthy Primary School of the Future (HPSF) intervention on children’s body mass index z-score (BMIz), and on the secondary outcomes waist circumference (WC), dietary and physical activity (PA) behaviours. Methods and findings: This study has a quasi-experimental design with four intervention schools, i.e., two full HPSFs (focus: diet and PA), two partial HPSFs (focus: PA), and four control schools. Primary school children (aged 4–12 years) attending the eight participating schools were invited to enrol in the study between 2015 and 2019. Annual measurements consisted of children’s anthropometry (weight, height and waist circumference), dietary behaviours (child- and parent-reported questionnaires) and PA levels (accelerometers). Between 2015 and 2019, 2236 children enrolled. The average exposure to the school condition was 2·66 (SD 1·33) years, and 900 participants were exposed for the full four years (40·3%). After four years of intervention, both full (estimated intervention effect (B = -0·17 (95%CI -0·27 to -0·08) p = 0·000) and partial HPSF (B = -0·16 (95%CI-0·25 to -0·06) p = 0·001) resulted in significant changes in children’s BMIz compared to control schools. Likewise, WC changed in favour of both full and partial HPSFs. In full HPSFs, almost all dietary behaviours changed significantly in the short term. In the long term, only consumption of water and dairy remained significant compared to control schools. In both partial and full HPSFs, changes in PA behaviours were mostly absent. Interpretation: This school-based health-promoting intervention is effective in bringing unfavourable changes in body composition to a halt in both the short and long term. It provides policy makers with robust evidence to sustainably implement these interventions in school-based routine.

Suggested Citation

  • M Willeboordse & N H M Bartelink & P van Assema & S P J Kremers & H H C M Savelberg & M T H Hahnraths & L Vonk & M Oosterhoff & C P van Schayck & B Winkens & M W J Jansen, 2022. "Battling the obesity epidemic with a school-based intervention: Long-term effects of a quasi-experimental study," PLOS ONE, Public Library of Science, vol. 17(9), pages 1-17, September.
    • Handle: RePEc:plo:pone00:0272291
    DOI: 10.1371/journal.pone.0272291
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0272291
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0272291&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0272291?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Han, Euna & Norton, Edward C. & Powell, Lisa M., 2011. "Direct and indirect effects of body weight on adult wages," Economics & Human Biology, Elsevier, vol. 9(4), pages 381-392.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Raymundo M. Campos-Vazquez & Roy Nuñez, 2019. "Obesity and labor market outcomes in Mexico/Obesidad y el mercado de trabajo en México," Estudios Económicos, El Colegio de México, Centro de Estudios Económicos, vol. 34(2), pages 159-196.
    2. Lennon, Conor, 2021. "Are the costs of employer-sponsored health insurance passed on to workers at the individual level?," Economics & Human Biology, Elsevier, vol. 41(C).
    3. Mukhopadhyay, Sankar, 2021. "Do employers discriminate against obese employees? Evidence from individuals who are simultaneously self-employed and working for an employer," Economics & Human Biology, Elsevier, vol. 42(C).
    4. Andrea Moro & Sebastian Tello‐Trillo & Tommaso Tempesti, 2019. "The Impact of Obesity on Wages: The Role of Personal Interactions and Job Selection," LABOUR, CEIS, vol. 33(2), pages 125-146, June.
    5. LIU Xing & SIERMINSKA Eva, 2014. "Evaluating the effect of beauty on labor market outcomes: A review of the literature," LISER Working Paper Series 2014-11, Luxembourg Institute of Socio-Economic Research (LISER).
    6. Groves, Jeremy & Wilcox, Virginia, 2023. "The impact of overweight and obesity on unemployment duration among young American workers," Economics & Human Biology, Elsevier, vol. 51(C).
    7. Kesaite, Viktorija & Greve, Jane, 2024. "The impact of excess body weight on employment outcomes: A systematic review of the evidence," Economics & Human Biology, Elsevier, vol. 54(C).
    8. Pekkurnaz, Didem, 2023. "Causal effect of obesity on the probability of employment in women in Turkey," Economics & Human Biology, Elsevier, vol. 51(C).
    9. Han, Euna & Powell, Lisa M. & Isgor, Zeynep, 2012. "Supplemental nutrition assistance program and body weight outcomes: The role of economic contextual factors," Social Science & Medicine, Elsevier, vol. 74(12), pages 1874-1881.
    10. Campos-Vazquez, Raymundo M. & Gonzalez, Eva, 2020. "Obesity and hiring discrimination," Economics & Human Biology, Elsevier, vol. 37(C).
    11. Berning, Joshua, 2015. "The role of physicians in promoting weight loss," Economics & Human Biology, Elsevier, vol. 17(C), pages 104-115.
    12. Chiao-Yu Huang & Duan-Rung Chen, 2019. "Association of weight change patterns in late adolescence with young adult wage differentials: A multilevel longitudinal study," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-14, July.
    13. Carr, Deborah & Jaffe, Karen, 2012. "The psychological consequences of weight change trajectories: Evidence from quantitative and qualitative data," Economics & Human Biology, Elsevier, vol. 10(4), pages 419-430.
    14. Fouarge, Didier & Kriechel, Ben & Dohmen, Thomas, 2014. "Occupational sorting of school graduates: The role of economic preferences," Journal of Economic Behavior & Organization, Elsevier, vol. 106(C), pages 335-351.
    15. Khasnobis, Poulomi & Dinda, Soumyananda, 2017. "Height differentiated Wage Premium in West Bengal, India: An Empirical Study," MPRA Paper 89600, University Library of Munich, Germany, revised Mar 2017.
    16. Pachara Pimpawatin & Nopphol Witvorapong, 2023. "Direct and Indirect Effects of Parenthood on Later-Life Happiness: Evidence from Older Adults in Thailand," Journal of Family and Economic Issues, Springer, vol. 44(2), pages 249-266, June.
    17. Nuñez, Roy, 2020. "Obesity and labor market in Peru," MPRA Paper 105621, University Library of Munich, Germany.
    18. Liisa T. Laine & Ari Hyytinen, 2022. "Temporary and persistent overweight and long-term labor market outcomes," International Journal of Health Economics and Management, Springer, vol. 22(2), pages 181-203, June.
    19. Qihua Qiu & Jaesang Sung, 2021. "The effects of graduated driver licensing on teenage body weight," Health Economics, John Wiley & Sons, Ltd., vol. 30(11), pages 2829-2846, November.
    20. Pinkston, Joshua C., 2017. "The dynamic effects of obesity on the wages of young workers," Economics & Human Biology, Elsevier, vol. 27(PA), pages 154-166.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0272291. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.