The prevalence of obesity in children is increasing rapidly, Among children aged 5-12 years, 18.8% have severe overweight, comprising 10.8% who are obese and 8.8% who are over. The development of effective and sustainable intervention strategies to prevent childhood obesity in Indonesia is becoming increasingly important, particularly given the limited implementation of health-promoting schools in the country.
The first Phase using qualitative exploration was a needs assessment will be using of social cognitive theory. The second Phase will be the development model intervention modification of the health promotion school WHO and "Health School". The third Phase is the quantitative stage using a Cluster Randomised Controlled Trial to analyse differences and test the effectiveness of the HPS model. This study will be conducted in 8 primary schools located in Makassar, South Sulawesi. School in Makassar city and schools from outside Makassar city, randomly selected for the trial. Then the selected schools are randomly divided into school for nutrition education and physical activity. Intervention, while school each for comprehensive intervention. The study will be target students in Grades 4 and 5 of primary school. Assessments for the primary objective (BMI Z score), and secondary objectives (change in knowledge, self-efficacy, and health literacy) in thirds study arm. The subsequent phase will assess the efficacy of the intervention in terms of reductions in BMI Z scores, improvements in knowledge, self-efficacy and health literacy. Concurrently, the exploration of parental and teacher knowledge and insights regarding health promotion in schools and its potential in reducing overweight and obesity in children will be conducted.
Male and female gender
Children aged 9-12 years old (at the time of baseline data collection)
All fourth and fifth grade students/children
Children who are willing as respondents and ready to follow the intervention until completion and willing to fill in the informed consent.
Children with clinical conditions / health disorders such as heart disease etc.)
Children who did not take the pretest
Children who left or moved schools
Children who did not complete the intervention
Single group
Nutrition education, physical activity intervention, and health promoting school model trials
Other interventionA nutrition education and physical activity intervention, combining a pilot health promoting school model that includes health education and recreational enhancement with the curriculum of a government-designated healthy school, was designed to reduce childhood overweight and obesity. The programme was implemented over 6 months. This program has been widely conducted in several countries, but there are still many differences from previous studies, especially in terms of strengthening qualitative studies in the first stage, then in the intervention stage using a Cluster Randomised Controlled Trial design. Another advantage of this study is the combination of intervention and health promoting school. In Indonesia, there are few intervention studies in reducing overweight and obesity in children, some only focus on descriptive studies such as nutritional knowledge, physical activity measures using questionnaires to determine the relationship or measure BMI.
BMI Z-score
Where weight will be measured using a body composition meter (Seca 804) to 0.1 kg, and height measured with a stadiometer to 0.1 cm. BMI (kg/m2) will be converted to the Weight and height measurements will be taken twice to obtain accuracy and correct averages. Body mass index (BMI) for age Z score, according in 2007 WHO Growth Standards for children, will be used to classify the risk of being overweight with a Z SD score of 1, overweight with a Z SD score 1, and overweight: BMI Z-score ≤ 3, obesity BMI Z- score ≥ 3.
Children knowledge, Self-efficacy, and Health Literacy
Children knowledge, the ability to give appropriate answers to questions about nutrition, physical activity, causes of overweight and obesity and how to prevent them. The measuring instrument uses a questionnaire, a ratio measuring scale, the measurement result is determined from the total score set, the correct answer score is given 1) if it is wrong 0). Self-efficacy, a person belief in their ability to perform a behaviour, the behaviour is obesity prevention, measured using a 3-point Likert scale, namely 1) agree, 2) disagree, and 3) disagree. Answer score for favourable questions: Agree: 3) Undecided: 2) Disagree:1) Unfavourable question answer score: Agree: 1) Undecided: 2) Disagree: 3). Health literacy, the ability of children, orangutans and schools to apply and use information, health promoting school approach measurement tool, in-depth interview and questionnaire distribution.
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