LIVELY: MuLtidimensional school-based and family Involved interVentions, to promote a hEalthy and sustainable LifestYle for the childhood obesity primary prevention, a Study Protocol (Preprint)

Abstract

Childhood obesity has become a significant public health concern over the past two decades, posing multifactorial challenges that include modifiable factors like dietary habits and physical activity. Prevention efforts require a comprehensive approach, including educational interventions, collaboration among multidisciplinary teams, and community engagement. Given that schools play a central role in children's lives, they are an ideal setting for promoting healthy habits.

The LIVELY study focuses on assessing the prevalence of overweight and obesity in primary school children and identifying contributing factors within families. Additionally, it aims to implement and evaluate a multidimensional, multidisciplinary intervention to foster a sustainable and healthy lifestyle, ultimately working towards preventing obesity in school-aged children.

The study is being conducted at Istituto Comprensivo "Luigi Cadorna", a public primary school in Milan, Italy, and it will last one full school year, from October 2023 until October 2024. At baseline (T0), data regarding children's (clinical history, anthropometric measures, and lifestyle habits) and their families (socio-economic status, environmental influences, and behavioral determinants) have been collected throughout a set of structured questionnaires. All the data collected at baseline will be assessed at six (T1) and at twelve months (T2) from the beginning of the study to evaluate possible changes in relation to the intervention. At T1 the feasibility of the intervention will be assessed in terms of satisfaction, learning, and organization through ad-hoc questionnaires addressed to teachers, families, and children. During the school year, each class will be individually involved in a multidimensional educational intervention that will cover the topics of healthy and sustainable nutrition and lifestyle. Children will also be involved in a multimedia lab to create an animated cartoon. The lectures will act on several fronts using frontal teaching, games and drawing activities to stimulate and maximize children's learning and involvement.

Data collection began in October 2023 and will last until October 2024. A sample of 227 children from 14 classes was included in the study. The mean age was 8.9±1.2 years (min 6; max 12 yo); 48% were males. Among the overall sample, 18.1% (95% CI: 13.7%-23.7%) presented overweight, while 5.3% (95% CI: 3.0%-9.0%) presented obesity. Males had higher prevalence of obesity than females (9.1% vs 1.7%, p=0.03 respectively). Otherwise, the prevalence of central obesity was similar between the two sexes (p=0.329). Data analysis and presentation of the complete results will be available after the end of 2024.

The authors believe that the study could lead to the structuring of an educational intervention model in school settings aimed at preventing childhood obesity. Moreover, it could help raise awareness of the issue of childhood obesity and it could help prevent such an evident public health problem.

ClinicalTrials.gov NCT05966051