Kavimani, M (2018) Effectiveness of Selected School Based Intervention on Level of BMI among Overweight Obese Children in Selected Schools at Erode. Doctoral thesis, The Tamil Nadu Dr. M.G.R. Medical University, Chennai.
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Abstract
Overweight and obesity are among the most prevalent nutritional problem in developed and developing nations. In developing countries such as India, especially in urban populations, childhood obesity is emerging as a major health problem. This study was attempted to identify the contributing factors of overweight/obesity and also to assess the effectiveness of school based intervention on the level of BMI among school children in selected Schools at Erode. The study objectives were, 1. To determine the prevalence of overweight /obesity among school children. 2. To identify the contributing factors of overweight /obesity in control and study group of school children. 3. To find out the association between the selected variables and the other contributing factors of overweight /obesity in control and study group of overweight/obese school children. 4. To assess the pretest and post test BMI in control and study group of overweight /obese school children. 5. To evaluate the effectiveness of selected school based intervention on the level of BMI among overweight /obese school Children in study group. 6. To find out the correlation between the parental knowledge and the lifestyle practices of children in control and study group of overweight /obese school children. 7. To find out the association between the selected variables and the post test level of BMI in control and study group of overweight /obese school children. Based on the study objectives null hypotheses were formulated. Conceptual framework of the study was based on the Pender’s Health Promotion Model and the review of literatures were done on following headings; prevalence of overweight and obesity among school children, factors contributing to overweight/obesity among school children, school based intervention among overweight/obese school children, awareness programme regarding overweight and obesity on school children. A Quasi experimental research design with control and study group -pretest and post test time series was used in this study. Major variables of the study were BMI, parental knowledge regarding overweight andobesity, lifestyle practices of children and diet pattern. Study was conducted at two private schools namely Bharathi Vidhya Bhavan Matriculation and Higher Secondary School-control group, The Bharathi Vidhya Bhavan - Study group. Total enumerative sampling technique was used for screening of overweight and obesity among school children through Quetelet Index BMI status. Then consecutive sampling method was used to recruit the samples for study and control group children. Schools were randomly selected for control and study group. After screening, based on the sampling criteria children were included into the study.Resesarch tools were prepared by the researchers. Informed consent for both the groups was obtained and the study was approved by the Institutional Ethical Committee. Structured Questionnaire was used to collect the data regarding contributing factors of overweight /obesity among school children. Followed by the pretest on parental knowledge, lifestyle practices of children and diet diary were sent to the parents to fill and return. Then study group children were involved for aerobic exercise programme 40 minutes for 3 days a week up to 16 weeks through structured video instruction under the supervision of Physical education teacher and also by the researcher. Parental awareness programme regarding overweight/obesity was given twice with the help of Power point presentation cum discussion. At the end of 16th week post test of parental knowledge, lifestyle practices of children and diet diary were done.BMI of school Children were measured at 8th week of intervention and at the end of 16th week of intervention. • A total of 2291 school children were screened for BMI. Participants from both sex were included in the study and boys were 1283 in numbers (56%) and girls were 1008 (44%). Among them majority 1952 (85.2%) had normal BMI (below 25), 219(9.6%) were overweight and 120 (5.2%) were obese. None of the children were under weight. • Among 1008 girls screened, 810 (80.4%) had normal BMI, 129(12.8%) were overweight and 69 (6.8) were obese and among the boys who were screened has shown that among 1283 boys, 1139 (88.9%) had normal BMI, 90 (7.1%) were overweight and 51(4%) were obese. It can be observed that the prevalence of overweight and obesity were higher among girls in comparison with boys. • Distribution of Overweight were found to be high in the age group of 13 and 14 years among the girls (11.8%,13.6%), as well as boys (8.6%, 10.9%) respectively. Similarly the prevalence of obesity also was found to be high in the age group of 13 years and 14 years among the girls (7.4%, 8.6%) and the boys (5%, 6.5%) respectively. • Majority of the children in control and study group were in the age of 14 years (44.4%, 39.7%) and girls (63.7%, 56.3%), were Hindus (83.9%, 73%), living in urban area (95.2%, 88.1%), first born in the family (48.4%,54%), had one sibling (84.7%, 84.9%), belonged to nuclear family (75%, 70.6%) and their parents were responsive not demanding (38.7%, 44.4%) in control and study group respectively. There was no significant difference (p>0.05) between the groups except with regard to gender where girls were more in both groups. • Majority of the fathers of school children in both control and study group were undergraduates (59.7%, 54.8%), doing business / self-employed (50%, 31%) mothers were graduates (71%, 61.9%) and were home makers (74.6%, 66.1%) and most of their family income was above Rs.40000/-. • Majority of the school children in control and study group had no history of gestational diabetes (93.5%, 96%), conception was natural (92.7%, 97.6%), were full term (89.5%, 89.7%), had normal birth weight (92.7%, 85.7%), received both bottle and breast feeding (62.5%, 53.2%), their dietary preferences were non vegetarian (87.1%, 87.3%) respectively in control and study group. There was no significant association between the control group and study group of overweight/obese school children. • Among the control group of school children none of the contributing factors of obesity / overweight were significant and only the combined factors caused 3.5% variance (R2=.035). Among the study group of school children, physical activity factor (B=31.3%, t=3.094) at p<0.01 and dietary factors (B=22.1%, t=2.187) at p<0.05 were the significant contributing factors of overweight and obesity compared to other contributing factors. The combined factors caused 12.9% variance (R2=.129). • The control group pretest mean BMI was 29.083, SD= 3.335 and the overall post test mean was 30.314, SD=3.248. The mean difference was 1.231. The calculated ‘t’ value 18.309 was also significant at p<0.01. Whereas in study group pretest mean was 28.583, SD= 4.801 and post test mean was 25.610, SD=1.865. The mean difference was 2.973. The obtained ‘t’ value 37.639 was significant at p<0.01 in study group. • The control group pretest parental knowledge mean score was 11.333, SD=2.739and post test mean score was 11.524, SD=2.658.The calculated ‘t’ value 2.955 was statistically significant at p<0.01 in control group. And the study group pretest parental knowledge mean score was 11.145, SD=0.868 and the overall post test mean score was 14.056, SD=2.053. The mean difference was 2.911 and the calculated ‘t’ value 13.828 was significant p<0.01 in study group. • In the control group mean score of pretest lifestyle practices of children was 18.579, SD=6.092 and post test mean was 18.794, SD= 5.775. The mean difference was 0.215. The calculated ‘t’ value 2.9187 was statistically significant (p<0.01) in control group. The study group pretest mean score of lifestyle practices of children was 18.234, SD= 5.507 and the post test mean was 31.315, SD= 4.135. The mean difference was 13.081. The calculated ‘t’ value 25.488 was significant at p<0.01 in study group overweight/obese school children. • The control group pretest mean Energy, Protein and Fat were 2666.2 (SD = 365.2), 45.74 (SD = 6.75) and 50.95 (SD = 6.69) respectively and the post test mean were 2689.0 (SD= 359.8), 46.19 (SD=5.88) and 51.49(SD = 6.54) respectively .The calculated ‘t’ value -0.722 (Energy), -0.941 (protein), - 0.91(Fat) were not significant (p>0.05) in control group . The study group pretest mean of Energy, Protein and Fat were 2649.9 (SD= 357.9), 46.05 (SD=5.69) and 50.88 (SD=6.67) respectively and the post test mean were 2428.9 (SD=295.7), 47.61 (SD=6.55) and 47.88 (SD=4.17) respectively. The obtained ‘t’ value 15.706 (Energy), 4.389 (protein), were significant at p<0.01 in study group and the calculated ‘t’ value 0.818 of fat was not significant p>0.05. • Among Post test BMI of control group was 31.4 and SD=3.248 and the overall post test mean of study group was 25.610, SD= 1.865, Mean difference between the groups was 4.704. The calculated ‘t’ value 14.126 was statistically significant at p<0.001. • With reference to control group, the post test mean parental knowledge score was 11.524, SD=2.658 and whereas in study group the mean post test parental knowledge score was 14.056, SD=2.053. Mean difference between the groups was - 2.532 and the obtained ‘t’ value 8.497 was significant at p<0.001. • Regarding control group, overall obtained post test mean score of lifestyle practices of children was 18.794, SD=5.775 and in study group the overall mean score of lifestyle practices of children was 31.315, SD= 4.135. The mean difference between the groups was -12.521 and the calculated ‘t’ value 19.843 was significant at p<0.001. • Post test diet dairy between control and study group of overweight/obese school children. In the control group, the post test mean of energy, protein, fat were 2689.0 (SD= 359.8), 46.19(SD=5.88) and 51.49 (SD=6.54) respectively and in study group, the post test mean of energy, protein, fat were 2428.9 (SD= 295.7), 47.61 (SD=6.55) and 47.88 (SD=.17) respectively. The calculated ‘t’values were 6.289, 1.818 and 5.239 in respect to energy, protein and fat were significant at p<0.001. • Comparison of BMI on pretest, at 8th week and post test among overweight/obese school children in study group. The overall mean of pretest, at 8th week and post test were 28.583 (SD=2.191), 27.258 (SD=2.077) and 25.1.865 (SD=1.865) respectively. The obtained F value 65.579 was significant at p<0.15. • Regarding parental knowledge and lifestyle practices of children in both control and study group and found to be significant (p<0.01). It reveals that there was a high positive correlation (r=0.795) between parental knowledge score and lifestyle practices of children in study group overweight/obese school children where as in control group the obtained ‘r’ value 0.258 shows that there was mild positive correlation between the parental knowledge and the lifestyle practices of children in control group. • Regarding level of satisfaction, 87.90% of children were highly satisfied with the school based intervention on level of BMI among study group overweight and obese school children. The study results revealed that there was a significant reduction on the level of BMI. Hence it was inferred that the school based interventions; aerobics exercises and parental awareness program were effective in reducing the level of BMI. School based program is cost effective, fun as group activity among children peer involvement and motivation, the family involvement helps to monitor them at home. And also the school samples become captive population, so that implementing the weight reduction strategies at schools become much easier compare to other settings.
| Item Type: | Thesis (Doctoral) |
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| Additional Information: | 28487/2012 |
| Uncontrolled Keywords: | Effectiveness, School Based Intervention, Body Mass Index (BMI), Overweight / Obese Children, Schools. |
| Subjects: | NURSING > Paediatric Nursing |
| Depositing User: | Subramani R |
| Date Deposited: | 07 Nov 2021 03:02 |
| Last Modified: | 07 Nov 2021 03:02 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/18609 |
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