A Randomized Trial of Multiple Interventions for Childhood Obesity in China

INTRODUCTION: Family- and school-based interventions for childhood obesity have been widely applied; however, the prevalence of childhood obesity remains high. The purpose of this RCT is to evaluate the effectiveness of a family-individual-school-based comprehensive intervention model. DESIGN: Cluster RCT. SETTING/PARTICIPANTS: Fourteen primary schools were selected from 26 primary schools in a district of Shanghai, China, and then randomly divided into intervention and control groups with seven schools in each. The trial started with first-grade students. A total of 1,287 students in the intervention group and 1,159 in the control group were studied overall. INTERVENTION: The baseline study was conducted in January 2011, and family-individual-school-based interventions started in March 2011 and ended in December 2013 for intervention group students. Three follow-up studies were conducted in January 2012, January 2013, and January 2014. Data analysis was conducted in March 2014. MAIN OUTCOME MEASURES: Students' weight and height were measured. The prevalence of obesity/overweight and BMI z-scores were calculated and analyzed using a generalized estimating equation approach. RESULTS: The overall prevalence of overweight/obesity declined from 28.92% in 2011 to 24.77% in 2014, with a difference of 4.15% in the intervention group compared with a 0.03% decline (from 30.71% to 30.68%) in the control group. The intervention group had significantly lower odds of developing obesity or overweight and had decreased average BMI z-scores compared with the control group, especially for obese or overweight students. CONCLUSIONS: The family-individual-school-based comprehensive intervention model is effective for controlling childhood obesity and overweight.