| ObjectiveTo study the current situation and influencing factors of early and middle adolescence children's the Knowledge-Attitude-Practice(KAP)related to obesity and quality of life(QOL).To explore the effects of"student-school-family"comprehensive intervention measures on reducing childhood obesity rate,improving obesity-related KAP and QOL,to provide theoretical basis for improving obesity status and QOL of early and middle adolescence children.MethodBaseline survey of 2650 students selected from eight schools including rural/urban each two elementary school(4-6grade),two middle school(8-9 grade)in Chongqing Shapingba district by stratified sampling method.Make use of general questionnaire,obesity-related KAP questionnaire,Quality of Life Scale for Children in Puberty and calculate the Body Mess Index(BMI)by physical examination results and classified as normal,overweight and obese and compare the KAP and QOL in different BMI groups.Eight schools were divided into intervention group and control group(each group includes two elementary school and two middle school)for"student-school-family"comprehensive intervention measures from March 2017 to May and two investigators would supervise and check the intervention activities while recording in April,May 2017.The control group took no action.A final survey was conducted immediately after the intervention(June 2017)to evaluate the effects of the intervention on obesity-related KAP and QOL.The used questionnaires in the survey were designed by the subjuect team.Results1.Baseline conditionBaseline survey showed differences in BMI distribution between boys and girls,higher obesity rates among boys(34.9%)than girls(28.7%).And the obesity rate of children and adolescents in middle school(38.3%)was higher than that in primary school(27.0%).The mean scores of knowledge of obesity-related KAP was 13.08±4.50,the mean scores of attitude was35.47±3.66,the mean scores of practice was 36.69±2.67,the mean scores of total points was 85.24±7.95.Statistical differences in KAP were found among the groups with different BMI groups.General Linear Model analysis of the obesity-related KAP of early and middle adolescence children showed that gender,grade,residence,father's education,family relationship,parenting style,academic performance,BMI group and number of closed friends were the main influencing factors.The better the family relationship,the better the academic performance,the higher the education level of the father,living in urban,authoritative parenting style,and girls,the higher KAP scores(all P<0.05).The mean scores of the QOL were 140.65±18.86 and four dimensions were:physiological dimension(29.72±5.25),psychological dimension(38.73±7.12),social dimension(50.55±8.44),and adolescent dimension(21.43±3.70).Different BMI groups had statistically significant differences in quality of life,physiological dimension,sleep status,social dimension,appearance experience,puberty feeling and puberty cognition,and the scores of the normal group were higher than those of the overweight and obese groups(all P<0.05).General Linear Model analysis of the QOL scores showed that gender,grade,residence,parents educational level,family economic status,family relationships,parenting style,academic performance,learning pressure,whether family members suffer from chronic diseases,sleep time,number of closed friends,BMI were the main factors influencing the quality of life and each dimension.2.Evaluation id interventionBefore intervention,the proportions of BMI in the intervention group were normal(81.7%),overweight(13.5%)and obese(4.8%),respectively.The proportions of BMI after intervention were normal(83.1%),overweight(12.5%)and obese(4.4%),respectively.The difference was statistically significant(~2=1314.92,P<0.000).Controling the influence of baseline,the results showed that the growth value of the KAP of the intervention school were higher than those of the control school(F=4.31,3.91 and 4.23,all P<0.05).Compared with the control group in different gender and grade,the growth of KAP was higher than that of the control group.Single factor repeated measurement anova was used to compare the changes of QOL and factors in each dimension before and after the intervention,the results showed that the intervention was effective in improving QOL,psychological dimension,negative emotion and aggressive emotion(F=4.75,8.51,6.95,5.35,all P<0.05).ConclusionThe current situation of overweight and obesity in early and middle adolescence children is not optimistic.Different comprehensive intervention plans and targeted health education should be developed for different genders and school groups.The better mental health status of overweight and obese children in school,family and society can improve their quality of life. |
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