| Objectives To analyze the influencing factors of overweight and obesity in primary school students by quantitative research,and to explore the cognition of overweight and obesity of students in schools and parents by qualitative research.Combining the results of quantitative and qualitative research.Based on social cognition theory and referring to domestic and foreign intervention models,a school-student-family integrated comprehensive intervention model for pupils’ obesity was constructed and a preliminary intervention plan was formed so as to provide reference for pupils’ obesity interventions.Methods A combination methods of quantitative and qualitative research was used to construct intervention models.A cluster random sampling method was used to select grade1-4 pupils of a primary school in Tangshan City,and a combination of questionnaire survey and physical examination was used to investigate and collect subject’s general information,diet and physical activity,as well as height and weight data.A total of 2242 students in grade1-4 were analyzed using the spss23.0 software package.The univariate analysis of overweight and obesity of primary pupils was performed by Chis-quare test,and multivariate unconditional logistic regression analysis was used to make certain the risk factors of overweight and obesity in primary school students.Qualitative research selected 2 school leaders responsible for student health,3 physical education teachers in each grade,7 class teachers,and 5 parents as qualitative interviews’ subjects.Personal in-depth interviews were conducted with school leaders,and group interviews were conducted in teachers and parents.After the interview,the interview results were summarized and sorted according to the framework analysis method.Combining the results of quantitative research with qualitative research,summarize,and a comprehensive intervention model for pupils obesity was establish.Results Quantitative research results: 1 The overweight rate of grade 1-4 primary school students in this survey was 16.8%,and the obesity rate was 30.1%.2 Univariate analysis showed that boys’ overweight rates(17.6%)and obesity rates(35.4%)were higher than girls’ overweight rates(15.8%)and obesity rates(24.3%),and the difference had statistically significant(P<0.05).Birth weight was related to overweight and obesity in primary school students(P<0.05).Family history of hypertension has an association with overweight and obesity in primary school students(P<0.05),the overweight rate(18.3%)and obesity rate in primary school students with family history of hypertension(39.1%)were higher than the overweight rate(16.6%)and obesity rate(29.1%)of elementary school students without a family history of hypertension(P<0.05).With the weight of the father or mother increasement,the overweight rate and obesity rate of elementary school students were gradually increasing(trend chis-quare Test,P<0.05).The education level of the father or mother had a statistically significant difference in the effect of overweight and obesity of pupils(P<0.05).The overweight and obesity rates of pupils with sleep time less than 9 hours were higher than that of primary pupils with sleep time more than 9 hours(P<0.05).Snoring and holding breath had an effect on overweight and obesity in elementary school students(P<0.05).3 Taking the elementary school students’ personal demographic factors,behavior and lifestyles as well as parent family factors as independent variables,and BMI classification(normal,overweight,obesity)as the dependent variable,a multivariate unconditional logistic regression analysis was performed.The results showed that the overweight of boys was 1.485 times that of girls(OR95%CI: 1.181～1.866),and the risk of boy’s obesity was 1.939 times that of girls(OR95%CI: 1.595～2.357).Age was related to overweight in primary school students.The overweight and obese of fathers had a different risks of overweight for primary school students,the odds ratio was 1.471 times(OR95%CI:1.127～1.920)and 1.982 times(OR95%CI: 1.433～2.742)of families with normal father weight.The risk of obesity in primary school students in families with obese mothers was1.571 times(OR95%CI: 1.101～2.241)of families with normal mothers’ weight.The risk of obesity of primary school students with sleep time less than 9 hours is 1.734 times that of students with sleep time more than 10 hours(OR95%CI: 1.042～2.885).The risk of obesity in students with snoring during sleep was 1.951 times that of students without snoring(OR95%CI: 1.512～2.517).Tthe risk of obesity for students who made moderate-intensity exercise less than 1 hour per day was 1.348 times that of students who exercise for more than 1 hour(OR95%CI: 1.088～1.801).The risk of obesity for students with high birth weight was 1.949 times that of normal-weight students(OR95%CI: 1.324～2.870).Parental overweight and obesity was one of risk factors of students obesity,OR 95% CI was 2.256(1.773～2.869),3.927(2.970～5.191),1.488(1.191～1.860),and 1.830(1.354～2.471) respectively.Quanlitative research results showed that in 4 group interviews,parents had poor cognition on obesity in primary school students,and believed that It was not important and harmless for their children to be obesity.5 The head teacher and physical education teacher had a harmful congnition for obesity in elementary school students,but still lacked relevant knowledge.In terms of student diet,parents were relatively lack of heathy diet knowledge for their children,and have fewer restrictions on student food choices and food intake.6 Students cannot bring snacks into the classroom,but few students and parents can comply with this rule.7 In terms of physical activities,parents have not enough awareness for students’ physical activities and were afraid of their children to be injured.Due to parents’ reasons,physical education teachers dare not make excessive demands on students in physical education classes,resulting in less activity.In-depth interviews with 8 individuals,the school has carried some professional guidance on students’ diet,sports activities,and personal living habits,and hopes to provide professional guidance to students and parents through intervention activities.The school was willing to provide various platforms.Conclusions 1 The unchangeable factors that affect overweight and obesity in primary school students are gender,age,and the father’s weight and the birth weight.The changeable factors that affect overweight and obesity in primary school students are sleep time,sleep problems-snoring.2 Parents have poor awareness of students’ overweight and obesity,lack of professional knowledge,and professional guidance.School teachers have a certain students’ health perceptions,but they give less guidance to students due to parents’ reasons.The school can provide various platforms to support the healthy growth of students by healthy guidance of diet and sleep.3 Based on quantitative and qualitative research results,and social cognition theory,a school-student-family integrated obesity intervention model with sleep,sports,and diet as the intervention content has been initially established in primary school students.Figure1;Table11;Reference 121... |
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