Child Obesity Prevention Intervention in Kuwaiti Summer Camps Targeting Health Behaviors in Nutrition, Physical Activity, and Screen Time
DOI:
https://doi.org/10.31584/jhsmr.2020765Keywords:
child obesity, Kuwaiti public health, modified CATCH program, nutrition and physical activity intervention, screen timeAbstract
Objective: To assess the effectiveness of an eight-week nutrition and physical activity intervention, entitled: “My Healthy Habits”, at summer camps to prevent obesity, reduce screen time, promote healthy eating habits and physical activity among children.
Material and Methods: Eight-week pretest-posttest: intervention versus a comparison group was conducted, in two comparable summer camps in Kuwait and randomized at the site level. Convenient sampling (n=79) included children aged 6-10, receiving 8 weeks of nutrition education: 2 days/week, 40 minutes/day and physical activity sessions: 4 days/week for 20 minutes/day. Outcomes included: the Modified Healthy Habits Survey (items about diet, physical activity and sedentary behavior) and anthropomorphic: Body mass index (BMI) for age and gender percentile and waist-to-height ratio (WHtR). Group changes were measured by independent t-test, and within group changes by the McNemar’s test (categorical data) and paired t-test (interval data).
Results: Significant increases in nutrition knowledge scores (from 4.3±1.7 to 10.5±1.2) and in the total score of the major food groups (from 10.0±2.6 to 13.7±2.2) were observed from pretest to posttest. Healthy eating significantly increased (from 12.8±1.8 to 14.5±1.5) for the intervention group only; however, intake of French fries, chips (FF) and sugarsweetened beverages (SSB) remained the same for both groups. Physical activity increased and screen time decreased,only in the intervention group. The participants’ BMI and WHtR decreased significantly in the intervention group: p-value=0.001.
Conclusion: Healthy food and physical activity increased, while screen time decreased. Consumption of unhealthy food (FF and SSB) remains an issue.
References
World Health Organization. Obesity and overweight [homepage on Internet]. Geneva: WHO; 2018 [cited 2019 May 22]. Available from: https://www.who.int/news-room/fact-sheets/detail/ obesity-and-overweight
Renew Bariatrics. Report: obesity rates by country [homepage on Internet]. Tijiana: Renew Bariatrics, Inc.; 2017 [cited 2019 Apr 10]. Available from: https://renewbariatrics.com/obesityrank- by-countries/
Elkum N, Al-Arouj M, Sharifi M, Shaltout A, Bennakhi A. Prevalence of childhood obesity in the state of Kuwait. Pediatr Obes 2015;11:e30-4.
Al-Hamad N, Solal-Celigny A, Deligia C, Palma G, Dop MC, Food and agriculture organization. Nutrition country profile [homepage on Internet]. State of Kuwait: Food and Agriculture Organization of the State of Kuwait; 2006 [cited 2019 Apr 10]. Available from: http://www.fao.org/3/aq040e/aq040e. pdf
Alabdullah G, Vaccaro J, Abel D, Habib L, Huffman F. Kuwaiti mothers’ perception of their child’s body mass index and their belief in early childhood dietary advice. Curre Res Diabetes Obes J 2018;6. doi: 10.19080/CRDOJ.2018.06. 555693.
Wang Y, Wu Y, Wilson RF, Bleich S, Cheskin L, Weston C. et al. Comparative effectiveness review, no. 115: childhood obesity prevention programs: comparative effectiveness review and meta-analysis [monograph on Internet]. Rockville (MD): Agency for Healthcare Research and Quality (U.S.); 2013 [cited 2019 Oct 23]. Available from: https://www.ncbi.nlm. nih.gov/books/NBK148737/
World Health Organization. Ending childhood obesity [homepage on Internet]. Geneva: WHO; 2016 [cited 2019 Oct 20]. Available from: http://apps.who.int/iris/bitstream/ 10665/204176/1/9789241510066_eng.pdf?ua=1
Kelder S, Hoelscher D, Barroso C, Walker J, Cribb P, Hu S. The CATCH Kids Club: a pilot after-school study for improving elementary students’ nutrition and physical activity. Public Health Nutr 2005;8:133-40.
Jamelske E, Bica LA, McCarty DJ, Meinen A. Preliminary findings from an evaluation of the USDA Fresh Fruit and Vegetable Program in Wisconsin schools. WMJ 2008;107: 225-3.
Tarro L, Llauradó E, Albaladejo R, Moriña D, Arija V, Solà R, et al. A primary-school-based study to reduce the prevalence of childhood obesity – the EdAl (Educació en Alimentació) study: a randomized controlled trial. Trials 2014; 15:58.
Behbehani K. Kuwait National Programme for Healthy Living: first 5-year plan (2013-2017). Med Princ Pract 2014; 23(Suppl 1):32-42.
Tumilowicz A, Ruel MT, Pelto G, Pelletier D, Monterrosa EC, Lapping K, et al. Implementation science in nutrition: concepts and frameworks for an emerging field of science and practice. Curr Dev Nutr 2018;3. doi: 10.1093/cdn/nzy080.
Franckle R, Adler R, Davison K. Accelerated weight gain among children during summer versus school year and related racial/ ethnic disparities: a systematic review. Prev Chronic Dis 2014;11:E101.
Moreno JP, Johnston CA, Chen TA, O’Connor TA, Hughes SO, Baranowski J, et al. Seasonal variability in weight change during elementary school. Obesity 2015;23:422–8.
Tanskey LA, Goldberg J, Chui K, Must A, Sacheck J. The state of the summer: a review of child summer weight gain and Efforts to Prevent It. Curr Obes Rep 2018;7:112-21.
Burke S, Shapiro S, Petrella R, Irwin JD, Jackman M, Person ES, et al. Using the RE-AIM framework to evaluate a community-based summer camp for children with obesity: a prospective feasibility study. BMC Obes 2015;2:21.
Gately P, Cooke C, Butterly R, Mackreth P, Carroll S. The effects of a children's summer camp programme on weight loss, with a 10 month follow-up. Int J Obes 2000;24:1445-52.
George G, Schneider C, Kaiser L. Healthy lifestyle fitness camp: a summer approach to prevent obesity in low-income youth. J Nutr Educ Behav 2016;48:208-12.e1.
Tang Q, Ruan H, Tao Y, Zheng X, Shen X, Cai W. Effects of a summer program for weight management in obese children and adolescents in Shanghai. Asia Pac J Clin Nutr 2014;23: 459-64.
Cooper C, Sarvey S, Collier D , Willson D, Green I, Pories ML, et al. For comparison: experience with a children’s obesity camp. Surg Obes Relat Dis 2006;2:622-6.
Gately P. Children's Residential weight-loss programs can work: a prospective cohort study of short-term outcomes for overweight and obese children. Pediatrics 2005;116:73-7.
National Academy of Medicine (U.S.) Food and Nutrition Board. Nutrition and health aging in the community: workshop summary. Washington: National Academies Press (U.S.); 2012 [cited 2020 Jun 29]. Available from: https:// pubmed.ncbi.nlm.nih.gov/22787687/
CATCH Information.org. CATCH PE: resources for the physical educator [homepage on Internet]. California: CATCH; 2014 [cited 2019 Feb 14]. Available from: https://catchinfo.org/ wp-content/uploads/2014/10/Catch-PEnew.pdf
Bandura A. Social foundations of thought and action. Englewood Cliffs, N.J.: Prentice-Hall; 1986.
Flaghouse. CATCH® Kids Club healthy habits and nutrition grade k-5. Hasbrouck Heights, N.J: Flaghouse; 2011.
Alabdullah G. Promoting healthy eating habits and physical activity among school-aged children in Kuwait – “My Healthy Habits Summer Camp” [Dissertation]. Miami: Florida International University; 2018.
Hall E, Chai W, Koszewski W, Albrecht J. Development and validation of a social cognitive theory-based survey for elementary nutrition education program. Int J Behav Nutr Phys Act 2015;12:47.
World Health Organization. Growth reference 5-19 years. [homepage on Internet]. Geneva: WHO; 2017 [cited 2019 Feb 5]. Available from: http://www.who.int/growthref/tools/ en/
Fryar CD, Gu Q, Ogden CL. Anthropometric reference data for children and adults: United States, 2007–2010. NCHS Vital Health Stat 2012;252:1-48.
Magalhães EI, Sant'Ana LF, Priore SE, Franceschini Sdo C. Waist circumference, waist/height ratio, and neck circumference as parameters of central obesity assessment in children. Rev Paul Pediatr 2014;32:273-81.
Whitehead AL, Julious SA, Cooper CL, Campbell MJ. Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable. Stat Methods Med Res 2016;25:1057-73.
Eisenmann J, Gentile D, Welk G , Callahan R, Strickland S, Walsh M, et al. SWITCH: rationale, design, and implementation of a community, school, and family-based intervention to modify behaviors related to childhood obesity. BMC Public Health 2008;8:223
Gentile D, Welk G, Eisenmann J , Reimer RA, Walsh DA, Russell DW, et al. Evaluation of a multiple ecological level child obesity prevention program: Switch® what you do, view, and chew. BMC Med 2009;7:49.
Werner D, Teufel J, Holtgrave P, Brown S. Active generations: an intergenerational approach to preventing childhood Obesity. J Schl Health 2012;82:380-6.
Hashem R, Rey-López JP, Hamer M, McMunn A, Whincup PH, Owen CG et al. Physical activity and sedentary behaviors levels of Kuwaiti adolescents: the study of health and activity among adolescents in Kuwait. J Phys Act Health 2018;15:255- 62.
Hashem R, Rey-López JP, Hamer M, McMunn A, Rowlands A, Whincup P, et al. Associations between objectively assessed and questionnaire-based sedentary behaviour with body mass index and systolic blood pressure in Kuwaiti adolescents. BMC Res Notes 2019;12:588.
Sigmund E, El Ansari W, Sigmundová, D. Does school-based physical activity decrease overweight and obesity in children aged 6–9 years? A two-year non-randomized longitudinal intervention study in the Czech Republic. BMC Public Health 2012;12:1-12.
Speroni K, Tea C, Earley C, Niehoff V, Atherton M. Evaluation of a pilot hospital based community program implementing fitness and nutrition education for overweight children. J Spec Pediatr Nurs 2008;13:144-53.
Dzewaltowski DA, Rosenkranz RR, Geller KS, Coleman KJ, Welk GJ. Hastmann TJ, et al. HOP’N after-school project: an obesity prevention randomized controlled trial. IJBNPA 2010; 7:1-12.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
