Rizvi Jaun Z, Kumar Pawan, Kulkarni Muralidhar M, Kamath Asha
Department of Community Medicine, Mayo Institute of Medical Sciences, Gadia, Barabanki, Uttar Pradesh, India (225001), Ex-Postgraduate Student Cum Tutor, Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Principal and Controller, RVRS Government Medical College, Bhilwara, Rajasthan, India (311001), Ex- Professor, Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
J Educ Health Promot. 2022 Dec 28;11:400. doi: 10.4103/jehp.jehp_369_22. eCollection 2022.
Obesity has been identified as a serious global health concern whose prevalence doubles almost every 10 years. Health education regarding physical activity and healthy diet imparted to adolescents could prove to be fruitful in reducing obesity-risk. Objectives of this study were to evaluate the effect of health education intervention on knowledge, attitude, and practices (KAP) regarding obesity-risk reduction and to estimate the postinterventional change in body mass index (BMI) and total body fat (%) among adolescent school children in South India.
Stratified cluster randomized controlled trial was carried out among 398 students recruited at baseline including 206 and 192 participants in intervention and control group respectively selected through simple random sampling from eligible government aided and private schools to assess KAP regarding physical activity and diet using pretested and validated questionnaire by making three school visits 6 months apart. Anthropometric measurements were recorded in first and third visit only, while health education intervention was given in first visit to intervention and third visit to control group after taking their responses on the questionnaire. Data were entered and analyzed using SPSS version 15.
Overall dropout rate was 13.5% with dropout in intervention and control group being 12.6% and 14.5% respectively, making 180 participants in intervention and 164 in control group available for analysis. Mean physical activity KAP score improved significantly from 16.19 ± 4.61 to 19.46 ± 10.07 in intervention group. Mean dietary KAP score also improved significantly from 21.38 ± 4.07 to 23.43 ± 4.53 in intervention group ( < 0.001). Mean BMI decreased significantly within intervention group ( < 0.001) as compared to control group ( = 0.908). Based on cut-off level for total body fat (%) to categorize obesity-risk among participants, statistically significant decline in proportions from 26.1% to 13.3% was observed in intervention group ( < 0.001).
Results depicted better KAP in intervention group than control group in all the three visits while it improved significantly within both groups. Hence, the health education was found to be effective in improving the overall KAP regarding modifiable risk factors of obesity among the study participants. Further studies to screen the adolescents for obesity-risk and successive health education sessions must be carried within schools in order to bring about change in knowledge, attitude, and practices regarding obesity-risk.
肥胖已被确认为一个严重的全球健康问题，其患病率几乎每10年就会翻一番。事实证明，对青少年进行有关体育活动和健康饮食的健康教育，可能有助于降低肥胖风险。本研究的目的是评估健康教育干预对降低肥胖风险的知识、态度和行为（KAP）的影响，并估计印度南部青少年在校儿童干预后体重指数（BMI）和全身脂肪百分比（%）的变化。
对398名基线招募的学生进行分层整群随机对照试验，其中干预组和对照组分别有206名和192名参与者，通过简单随机抽样从符合条件的政府资助学校和私立学校中选取，每隔6个月进行三次学校访问，使用经过预测试和验证的问卷评估体育活动和饮食方面的KAP。仅在第一次和第三次访问时记录人体测量数据，在干预组第一次访问和对照组第三次访问时，在获取他们对问卷的回答后进行健康教育干预。使用SPSS 15版输入和分析数据。
总体辍学率为13.5%，干预组和对照组的辍学率分别为12.6%和14.5%，干预组有180名参与者，对照组有164名参与者可供分析。干预组的平均体育活动KAP得分从16.19±4.61显著提高到19.46±10.07。干预组的平均饮食KAP得分也从21.38±4.07显著提高到23.43±4.53（<0.001）。与对照组相比，干预组的平均BMI显著下降（<0.001）（对照组为0.908）。根据参与者中肥胖风险分类的全身脂肪百分比（%）的临界值，干预组的比例从26.1%显著下降到13.3%（<0.001）。
结果表明，在所有三次访问中干预组的KAP均优于对照组，且两组内均有显著改善。因此，发现健康教育在改善研究参与者中关于肥胖可改变风险因素的总体KAP方面是有效的。为了改变关于肥胖风险的知识、态度和行为状况，必须在学校内进一步开展针对青少年肥胖风险筛查的研究以及后续的健康教育课程。
