Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China.
Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
Public Health Nutr. 2020 Jul;23(10):1838-1845. doi: 10.1017/S1368980019004592. Epub 2020 Apr 13.
We aimed to investigate the associations between school-level characteristics and obesity among Chinese primary school children with consideration of individual-level characteristics.
This cross-sectional study was conducted in 2015/2016. School-level characteristics were assessed using an interviewer-administered school questionnaire, and a 'school-based obesity prevention index' was further developed. Individual-level characteristics were collected by self-administered questionnaires. Objectively measured height and weight of students were collected, and obesity status was classified according to the International Obesity Task Force criteria for Asian children. Generalised linear mixed models were used to estimate the associations among the school- and individual-level characteristics and obesity of students.
Thirty-seven primary schools from an urban and a rural district of Beijing, China.
School staffs, 2201 students and their parents.
The school-based obesity prevention index involved the number of health professionals, availability of students' health records, monitoring students' nutrition status, frequency of health education activities, reporting achievements of obesity prevention activities to parents, duration of physical activity during school time and availability of playground equipment. The prevalence of obesity was lower in schools with the higher index value compared with that in schools with the lower index value (OR 0·56; 95 % CI 0·40, 0·79). Some individual-level characteristics were negatively associated with childhood obesity: liking sports, duration of screen time ≤2 h/d, perceived lower eating speed, parental non-overweight/obesity.
Irrespective of individual-level characteristics, the specific school-level characteristics had a cumulative effect on obesity among Chinese primary school children. Further school-based obesity intervention should consider these characteristics simultaneously.
本研究旨在探讨考虑个体特征后，学校特征与中国小学生肥胖的相关性。
本横断面研究于 2015/2016 年进行。使用访谈者管理的学校问卷评估学校特征，并进一步制定“基于学校的肥胖预防指数”。个体特征通过自我管理的问卷收集。收集学生的身高和体重的客观测量值，并根据国际肥胖工作组针对亚洲儿童的标准对肥胖状况进行分类。使用广义线性混合模型估计学校和个体特征与学生肥胖之间的相关性。
来自中国北京市城乡区的 37 所小学。
学校工作人员、2201 名学生及其家长。
基于学校的肥胖预防指数涉及卫生专业人员的数量、学生健康记录的可用性、监测学生营养状况、健康教育活动的频率、向家长报告肥胖预防活动的成果、学校时间内体育活动的持续时间和操场设备的可用性。与指数值较低的学校相比，指数值较高的学校肥胖患病率较低（OR 0.56；95 % CI 0.40，0.79）。一些个体特征与儿童肥胖呈负相关：喜欢运动、屏幕时间≤2 h/d、感知较慢的进食速度、父母不超重/肥胖。
不论个体特征如何，特定的学校特征对中国小学生肥胖具有累积效应。进一步的基于学校的肥胖干预应同时考虑这些特征。
