Piloting a school based program to reduce childhood obesity in Tamil Nadu, India, a research grant proposal

Abstract

According to World Health Organisation (WHO) “overweight or obesity is defined as accumulation of excess fat in the body that may impair health”. Body Mass Index (BMI) is considered as an alternative for body fat measurements. When a child’s BMI is between one to two standard deviations above the mean the child is classified as overweight and when it is above two standard deviations the child is classified as obese. Although overweight or obesity is a multifactorial disease, it ultimately results from chronic imbalance in calorie intake and expenditure. Overweight or obesity affects both physical and psychological health. Children who are in the top tenth centile of BMI during their early adolescents are five to nine times more likely to develop into obese adults.Rapid socio-economic growth, modernisation, urbanisation and adaptation of western lifestyle led to nutritional transition in many low middle-income countries (LMIC) including India. A systematic analysis published in 2016, included a pooled prevalence from 52 studies in different states of India. The study showed a 19.3% prevalence of childhood overweight and obesity. The aim of the proposal is to implement and evaluate a school-based multicomponent program to reduce overweight and obesity among sixth and seventh grade students in Chennai, Tamil Nadu. The program has the following objectives:1) By the end of 10 months after the implementation of the school-based program, the prevalence of overweight/obese students in intervention group will be 6% lower as compared to the control group after adjusting for baseline prevalence.2) By the end of five months after the implementation of the school-based program, average nutrition knowledge score will be 15% higher in the intervention group as compared to the control group after adjusting for baseline. 3) By the end of five months after the implementation of the school-based program, the percentage of students performing physical activity according to the guidelines of WHO which recommends 60 minutes of moderate to vigorous intensity workout every day, will be 30% higher in the intervention group as compared to the control group after adjusting for baseline.The pilot program will include five randomly selected privately run matriculation schools in Chennai. At the first stage of the program four sixth and seventh grade class teachers and physical education teachers will be educated and trained to educate students on a variety of issues related to obesity. At the second stage of the program the trained class teachers will conduct two lectures every month, throughout the duration of the program (10 months). Every month an educational booklet will be given to the students and the content will be explained by the teachers. Physical education teachers will provide training on cardio workouts and strength training. The evaluation will be done with a panel group using quasi-experimental, non-equivalent control design. A total of 10 schools will be selected and 260 participants from each school will be surveyed. Simple random sampling will be used to select participants for the evaluation. The proposal is reviewed and approved by the Institutional Review Board (IRB) of the American University of Armenia (AUA).It is important to control obesity in childhood to help prevent the development of serious health issues in adulthood. The proposed school-based multicomponent program will help to reduce overweight and obesity among sixth and seventh grade students studying in Chennai, Tamil Nadu.