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Cluster randomised trial of a school-community child health promotion and obesity prevention intervention: findings from the evaluation of fun 'n healthy in Moreland!

Waters, Elizabeth, Gibbs, Lisa, Tadic, Maryanne, Ukoumunne, Obioha C, Magarey, Anthea, Okely, Anthony D, de Silva, Andrea, Armit, Christine, Green, Julie, O'Connor, Thea, Johnson, Britt, Swinburn, Boyd, Carpenter, Lauren, Moore, Graham, Littlecott, Hannah and Gold, Lisa 2017, Cluster randomised trial of a school-community child health promotion and obesity prevention intervention: findings from the evaluation of fun 'n healthy in Moreland!, BMC public health, vol. 18, pp. 1-16, doi: 10.1186/s12889-017-4625-9.

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Title Cluster randomised trial of a school-community child health promotion and obesity prevention intervention: findings from the evaluation of fun 'n healthy in Moreland!
Author(s) Waters, Elizabeth
Gibbs, Lisa
Tadic, Maryanne
Ukoumunne, Obioha C
Magarey, Anthea
Okely, Anthony D
de Silva, Andrea
Armit, Christine
Green, Julie
O'Connor, Thea
Johnson, Britt
Swinburn, Boyd
Carpenter, Lauren
Moore, Graham
Littlecott, Hannah
Gold, LisaORCID iD for Gold, Lisa orcid.org/0000-0002-2733-900X
Journal name BMC public health
Volume number 18
Article ID 92
Start page 1
End page 16
Total pages 16
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2017-08-03
ISSN 1471-2458
Keyword(s) child obesity prevention
cluster RCT
schools
adiposity
body weight
child
child, preschool
cross-sectional studies
drinking
exercise
female
fruit
health behavior
health promotion
humans
male
pediatric obesity
school health services
urban population
vegetables
Victoria
science & technology
life sciences & biomedicine
public, environmental & occupational health
Summary BACKGROUND: Multi-level, longer-term obesity prevention interventions that focus on inequalities are scarce. Fun 'n healthy in Moreland! aimed to improve child adiposity, school policies and environments, parent engagement, health behaviours and child wellbeing.

METHODS: All children from primary schools in an inner urban, culturally diverse and economically disadvantaged area in Victoria, Australia were eligible for participation. The intervention, fun 'n healthy in Moreland!, used a Health Promoting Schools Framework and provided schools with evidence, school research data and part time support from a Community Development Worker to develop health promoting strategies. Comparison schools continued as normal. Participants were not blinded to intervention status. The primary outcome was change in adiposity. Repeated cross-sectional design with nested longitudinal subsample.

RESULTS: Students from twenty-four primary schools (clusters) were randomised (aged 5-12 years at baseline). 1426 students from 12 intervention schools and 1539 students from 10 comparison schools consented to follow up measurements. Despite increased prevalence of healthy weight across all schools, after 3.5 years of intervention there was no statistically significant difference between trial arms in BMI z score post-intervention (Mean (sd): Intervention 0.68(1.16); Comparison: 0.72(1.12); Adjusted mean difference (AMD): -0.05, CI: -0.19 to 0.08, p = 0.44). Children from intervention schools consumed more daily fruit serves (AMD: 0.19, CI:0.00 to 0.37, p = 0.10), were more likely to have water (AOR: 1.71, CI:1.05 to 2.78, p = 0.03) and vegetables (AOR: 1.23, CI: 0.99 to 1.55, p = 0.07), and less likely to have fruit juice/cordial (AOR: 0.58, CI:0.36 to 0.93, p = 0.02) in school lunch compared to children in comparison schools. More intervention schools (8/11) had healthy eating and physical activity policies compared with comparison schools (2/9). Principals and schools highly valued the approach as a catalyst for broader positive school changes. The cost of the intervention per child was $65 per year.

CONCLUSION: The fun n healthy in Moreland! intervention did not result in statistically significant differences in BMI z score across trial arms but did result in greater policy implementation, increased parent engagement and resources, improved child self-rated health, increased fruit, vegetable and water consumption, and reduction in sweet drinks. A longer-term follow up evaluation may be needed to demonstrate whether these changes are sustainable and impact on childhood overweight and obesity.
Language eng
DOI 10.1186/s12889-017-4625-9
Field of Research 1117 Public Health And Health Services
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30108772

Document type: Journal Article
Collections: School of Health and Social Development
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.