A school-based comprehensive intervention for childhood obesity in China: a cluster randomized controlled trial

BACKGROUND: A comprehensive approach involving both environmental and individual strategies offers opportunities to strengthen school-based interventions for childhood obesity. OBJECTIVES: To evaluate a theory-based comprehensive intervention implemented within primary schools for childhood obesity in China. METHODS: A 1-year, cluster randomized controlled trial was conducted in twelve primary schools (7-11 years old) in Beijing, China. Environmental and individual factors were improved in the intervention group (6 schools, 930 children) to promote knowledge and behaviors related to energy balance. The control group (6 schools, 959 children) did not receive any intervention. The primary outcome was body mass index (BMI) and its Z-score at 12 months. Generalized linear mixed models were used controlling for the cluster effect of school. RESULTS: No significant differences were found between groups on BMI (0.07 kg/m2 [95% confidence interval (CI) -0.16 to 0.31, p = 0.54]) and its Z-score (0.02 [95% CI: -0.08 to 0.11, p = 0.73]) at 12 months. Self-reported knowledge, daily consumption of sugar-sweetened beverage, and frequency of moderate to vigorous physical activity improved at 12 months. CONCLUSIONS: The intervention did not mitigate excess weight gain, but did improve children's knowledge and several behaviors related to energy balance.