Exploring the impact of lifestyle and physical fitness on childhood overweight and obesity prevention in schoolchildren: a quasi-experimental study assessing the effectiveness of a multimodal intervention in the province of Cádiz. The PREVIENE-CÁDIZ Study

Abstract

Childhood obesity is a growing public health concern worldwide, with significant implications for children's health and well-being. This International Doctoral Thesis aims to study the efficacy of a comprehensive intervention encompassing individual, school, and community-based approaches aimed at promoting healthy lifestyles and enhancing physical fitness to prevent overweight and obesity among 8 to 9-year-old schoolchildren of the province of Cadiz. The research encompasses three main studies conducted in the province of Cadiz, Spain, employing a quasi-experimental design with an intervention and control group.

The first study is a protocol study that describes the methodology of the PREVIENE-CÁDIZ research project, which is the project on which this doctoral thesis is based. The second study examines the association between lifestyle behaviours, physical fitness, and weight status among third-grade primary schoolchildren. The third study evaluates the effectiveness of a comprehensive intervention program in preventing childhood obesity among schoolchildren. Findings from the second study reveal an independent and combined association between lifestyle behaviours and physical fitness with children's weight status, highlighting the importance of promoting healthier lifestyles and improved physical fitness to combat childhood obesity. Moreover, despite promising findings in certain areas, the results of the third study suggested that the intervention produced moderate and at times variable effects in promoting healthier lifestyle behaviours among schoolchildren. While improvements were noted in the experimental group compared to the control group, these did not fully meet the initial expectations. This outcome underscores the need for further research and adjustments in implementation, such as the integration of specialised external personnel to support teachers, embedding the intervention into the school curriculum, and extending its duration throughout an entire academic year.

Moving forward, future research directions focus on refining the present intervention to increase the strength of effectiveness by addressing identified shortcomings. Longitudinal studies with extended follow-up periods are advocated to assess intervention sustainability and explore innovative intervention modalities, including digital health technologies and gamification, to enhance engagement and effectiveness among school-aged children. Furthermore, a multidisciplinary approach integrating insights from various domains such as public health, nutrition, and education is recommended to develop comprehensive and sustainable intervention strategies to address childhood obesity effectively.

This doctoral thesis contributes valuable insights into childhood obesity prevention and intervention strategies, paving the way for future research endeavours aimed at promoting the health and well-being of children worldwide.