Prevention of Further Weight Gain

¶ … Prevention of further weight gain in overweight school children, a pilot study' by Anna Melin and Ragnhild Arvidsson Lenner

The overarching aim of this study was to evaluate and describe a weight control treatment method for school nurses for use in school care centres. The need for such studies is directly related to the obesity epidemic affecting children in many industrialized countries, including Sweden (Segelken 2005).

Key findings of the study. Based on their results of their study, Melin and Lenner suggest that it is possible to prevent additional weight gain in school children with existing weight problems through a heightened awareness of the problem, the types of foods consumed by the children and their typical day-to-day activities. To be truly effective, though, the researchers emphasize that any intervention by school nursing staff must be part of a larger multidisciplinary approach that includes a dietitian and healthcare team. The need for discretion in administering such an intervention program was also highlighted by these researchers (Melin & Lenner 2008).

Assessment

Design. This was an ambitious longitudinal study that took place over the course of a year. A team of 15 nurses working at various school care centres who were trained for the study interviewed subjects using standardized questionnaires and provided dietary and lifestyle advice. Parents, children and nurses were subsequently interviewed using an open question format concerning their experiences and views about the intervention.

Sampling. Although the authors do not specify what type of sampling approach they used, they report that the population sample for the study consisted of 20 families who were determined to have an overweigh child as defined by Swedish body mass index standards as well as 19 overweight children used as a control group; the families were recruited from 13 primary schools in Halmstad County, Sweden.

Reliability and Validity. The researchers used standardized questionnaires with untested reliability and validity levels and did not conduct a pilot test to evaluate these issues. According to Chandler and Lyon, "Reliability refers to the consistency and stability of a score from a measurement scale. Validity refers to the establishment of evidence that the measurement is actually measuring the intended construct. Measures can be reliable without being valid, but cannot be valid without being reliable" (2001, p. 102). Therefore, there is a need to establish reliability and validity levels for the methods used by these researchers.

Data analysis. The analysis of the data included the following:

1. Calculation of body mass indexes (BMI) calculated from measured weight and height at baseline and again one year following enrollment in the intervention program, which is a standard approach to determining overweight and obesity levels (Singh 2004; Klesgas, Klem & Klesges 1999);

2. A comparison of growth changes in the intervention and control groups;

3. The mean number of dietary advice provided; and,

4. The relation between change in BMI z-score, life-style and number of visits at school care centres among intervened children.