HLSC641 Effect of Physical Activity To Reduce Obesity in Elementary School Children Assessment Answer
THE EFFECT OF PHYSICAL ACTIVITY INTERVENTION BASED IN SCHOOLS TO REDUCE OBESITY IN ELEMENTARY SCHOOL CHILDREN: A SYSTEMATIC REVIEW
The rising rate of obesity among children is a growing concern in the world. The prime factor identified to be strongly responsible is widespread and predominant inactivity among children, as well as the unhealthy lifestyle and food habits.
The major objective of the study is to study the effect that PA Interventions at primary schools have on reducing childhood obesity among children aged between 2 and 10.
A thorough and refined search was conducted using two public medical database websites; namely, Scopus and PubMed. It helps in gathering relevant academic journals and research articles published on the subject of interest.
A journal by Sigmund, El Ansari &Sigmundová (2012) was considered to be appropriate for the purpose as it chiefly focused on the interventions and effects of physical activity on the elementary school children. The researchers performed a controlled experiment on the 92 boys and 84 girls, aged 6-9 over a period of two years.
It was established from the research journal that the children demonstrated almost three times fewer chances of being obese after a year of starting the PA interventions at school.
According to reports from the World Health Organisation, it has been established that the number of young obese children globally has increased to 41 million in the year 2016, from the previous 32 million in 1990 (WHO, 2017). In addition to that, the WHO has stated that the percentage of obese children in developing countries is approximately 30% more than children in developed countries (WHO, 2017). In order to mitigate the identified issue, a number of initiatives and programs have been undertaken by governments, health organisations, as well as primary schools, which play a crucial role in the development of the children. It is to be stated in this context that more than 2 million deaths occur all over the world, each year primarily due to the lack of physical activity (WHO, 2017). Physical inactivity has been found to be at the core of all the issues. Hence, various initiatives by schools to engage children in activities which passively cause the movement and exercise of the body have been found to be quite effective in this regard. Moderate-to-vigorous physical activity, commonly known as MVPA, has been implemented in several schools globally, to reduce obesity among school children (Hollis et al. 2016).
Furthermore, generating feedback related to BMI or Body Mass Index and planning the approach accordingly have also been considered. Therefore, engaging children in physical activity (PA) and planning interventions in achieving the same has been considered for addressing the pressing issue. Hence, it is imperative to identify and evaluate the effectiveness of health interventions implemented in elementary schools to reduce the risk of the incidence of childhood obesity.
It may be stated in this context that physical inactivity could be one of the causes of number of diseases and even deaths in several cases all over the world. The risk of premature heart disease and diabetes are the most common instances of physical illness related to inactivity (Fröberg, 2015). However, it may be stated that the initiatives considered by schools to reduce the risk of obesity among children have been found to be quite effective. According to the series of studies conducted by Sigmund, El Ansari &Sigmundová (2012), the enhanced implementation of PA incompatible active environments have been found to be quite effective in strongly reducing the chances of obesity and obesity itself among school children aged between 6 and 9. According to the reports in WHO (2017), there is evidence supporting that the incidence of multiple diseases, such as cardiovascular disease, musculoskeletal disorders, (namely, osteoarthritis), insulin resistance as well as certain cancers, including colon, breast and endometrial cancers, can be attributed to inactivity of the body. In addition to that, it has been identified that the current lifestyle, food habits and food types, as well as lack of information actively contribute to the massive risk of childhood obesity among school children (WHO, 2017).
Figure 1: Rate of the prevalence of childhood obesity aged 2 to 19
(Source: Stateofobesity, 2019)
As per the reports of Wanjek (2014), it has been evident that obesity can be the outcome of the "snowball effect", which makes it difficult to engage in physical activities due to being overweight actively. In order to prevent that, and to develop an increasing awareness related to the heightened rates of childhood obesity in the world, with predictions of the number reaching more than 70 million by 2025, adequate measures are being implemented to engage children in vigorous physical activity (WHO, 2017). Hence, this study chiefly addresses the rising issue of childhood obesity. The elementary schools have started implementing several interventions for creating awareness about physical activity among the school children. The impact and effectiveness of the same on the reduction of obesity in the children are evaluated in this study, through the review of various articles and published studies on the subject.
It may be stated in this context that a link between the BMI or the Body Mass Index of the sample population or the elementary school children and the incidence of obesity. As per the identified prediction of WHO regarding the increasing rate of childhood obesity, several measures have been considered for the mitigation of the identified issues. It is to be noted that educational institutions have joined in the collaboration to reduce and significantly address the pressing challenges of childhood obesity. Thus, a research design considering the impact or the significance of the physical interventions which elementary schools have planned to engage the young pupils actively is an appropriate measure in this context. Furthermore, the major benefits PA Interventions have been identified as improved musculoskeletal, cardiovascular, as well as neuromuscular system functions (WHO, 2017).
The causes of physical inactivity and the major effects they have on the children is to be assessed in this aspect.
The objectives of this study have been identified as:
- To assess the effect that PA Interventions at primary schools have on reducing childhood obesity among children
- To evaluate the causes of physical inactivity and the major effects on the children
- To identify and investigate the interventions or initiatives planned and implemented by elementary schools to promote physical activity among school children
The review questions developed for this study are as follows:
- What is the effect that PA Interventions at primary schools have on reducing childhood obesity among children?
- What are the causes of physical inactivity and the major effects on the children?
- What are the interventions or initiatives planned and implemented by elementary schools to promote physical activity among school children?
In order to conduct a systematic review of the existing literature on the subject, the Senior Library coordinator at Australian Catholic University, Ms Kathryn Duncan, was actively consulted in this context. Ms Duncan had significantly aided in the process of searching and developing search strategies to refine the search and identify relevant research in the subject. It was identified that the use of specific keywords could aid in narrowing down the search results and enhance the relevance to the topic for the systematic review. Additionally, multiple truncations, as well as Booleans, were used in order to refine the search and gather significant and relevant results to the topic. The major keywords used in this context are as follows:
- “Physical activity” or PA
- "Physical activity interventions."
- “Obesity in children” or "Pediatric obesity."
- "Inactivity and obesity."
- “Elementary schools” or "primary schools."
- "Diseases from obesity."
Considering the search made with these keywords on the public websites of PubMed and Scopus, there were 456 sources evident which were somewhat relevant to the subject. However, further screening revealed that 136, out of the identified 456 sources were duplicates from endnotes, which were further reviewed for relevance. 308 of the articles were rejected on the basis of the abstract notes for the study conducted. The abstract or summary of the works was studied, and no significant relationship between the topic of interest and the search results could be established. Furthermore, compliance with the established inclusion criteria was matched, along with the ethical considerations for the works. After confirming the aforementioned pattern, one article was shortlisted for further systematic evaluation on the subject.
Types of studies
The types of study which was considered for carrying out this systematic evaluation are chiefly, observation studies, randomised control trials, evaluation studies, pre/post-intervention study as well as pilot studies with the research design of 50 or more sample size or participants. Further refining of the search outcomes had been restricted or narrowed down to the following filter criteria:
- Language: English
- Age of subject: Between 2 to 10
- Type of source: Academic publications or Research journals
- Publication date: Between 2010 and 2018
- Search mode: Find all the keywords
The aforementioned design for database search yielded a total of 456 results, 337 from the website Scopus and 119 from the public medical database PubMed. The screening procedure involved a thorough evaluation of the abstract or summary provided for the research works. About 308 journals were excluded due to the lack of relevance in the topic of interest and the subject. 12 articles were finally narrowed down, with only 1 being suitable for the review, considering the ethics involved, combined with the inclusion criteria. The article chiefly focused on the non-randomised and longitudinal intervention study of obese children aged between 6 and 9, to study the impact that elementary school-based physical interventions have on the reduction of obesity in the children. The study further involves the sample size of 92 boys and 84 girls, monitored with the aid of Caltrac accelerometer and Yamax pedometer, with the participation of 4 schools (2 each for control and intervention) (Sigmund, El Ansari &Sigmundov, 2012). It was established that the researcher had conducted the research ethically and had used Caltrac accelerometer and Yamax pedometer for the purpose of the research
The inclusion criteria for the search included the following:
- Studies and trials comparing the effects or impact of PA in elementary schools on the children, with the children not subjected to physical activity interventions
- Studies conducted on children between the ages of 2 and 10
- Settings: Elementary schools
- No restriction of geographical barrier
- Inclusion of at least 50 or more sample size for the research
- Association with childhood obesity
- Inclusion of Elementary school children as the target control group
- Preferred research demonstrating control and intervention
A PICO statement was designed in order to address the intervention and its potential impact on the reduction of the prevalent rates of obesity among elementary school children.
|Patient/ population/ problem||Intervention||Comparison of control||Outcome of interest|
|Elementary school children (Aged between 6-9)||Engagement in vigorous physical activity||Inactivity, lack of exercise||Reduction in the risk of incidence of obesity|
Table 1: PICO Statement
(Source: Author’s creation)
The exclusion criteria for the selection of the research article were determined to be:
- Studies without a control group
- Studies including other age groups
- Studies showing other diseases and risk factors
- Interventions interconnected to obesity, but not directly related
The ethical considerations involve the behaviour of the researcher toward the subjects or participants of the research (Hammersley, 2015). Any unethical behaviour or unjustified actions, which may be offensive, is regarded as a violation of the Code of Ethical Conduct (Vallgårda, 2018). The selected research complied with the established standards of considerations and ethical principles.
PRISMA Flow Diagram
Retrieved from: http://prismastatement.org/PRISMAStatement/FlowDiagram.aspx
Limitations of the review
Only 1 article could be shortlisted from the initially identified 456 results, as it is in compliance with the vast inclusion criteria and ethical considerations required for conducted a project. Additionally, since the study was limited to elementary school children, the children from other backward classes or communities who do not attend school, could not be taken into consideration, which constitutes a substantial number. Furthermore, the study by Sigmund, El Ansari &Sigmundová (2012) did not cover key aspects such as the elimination of other health risk factors related to obesity and more.
This study thoroughly evaluates the effectiveness of the chosen article on the desired outcomes that physical intervention programs or activities in elementary schools have on the rising rate of obesity among school children aged between 6 and 9. It was identified whether the identified research complied with the set inclusion criteria as well as the ethical considerations necessary for conducting research.