Intervention effects and long-term changes in physical activity and cardiometabolic outcomes among children at risk of noncommunicable diseases in South Africa: a cluster-randomized controlled trial and follow-up analysis
IntroductionRisk factors for noncommunicable diseases such as insufficient physical activity (PA), overweight or hypertension are becoming increasingly predominant among children globally. While school-based interventions are promising preventive strategies, evidence of their long-term effectiveness...
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| Format: | Article |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1199381/full |
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| author | Patricia Arnaiz Harald Seelig Markus Gerber Larissa Adams Jan Degen Danielle Dolley Nandi Joubert Nandi Joubert Nandi Joubert Madeleine Nienaber Siphesihle Nqweniso Peter Steinmann Peter Steinmann Jürg Utzinger Jürg Utzinger Rosa du Randt Cheryl Walter Uwe Pühse Ivan Müller |
| author_facet | Patricia Arnaiz Harald Seelig Markus Gerber Larissa Adams Jan Degen Danielle Dolley Nandi Joubert Nandi Joubert Nandi Joubert Madeleine Nienaber Siphesihle Nqweniso Peter Steinmann Peter Steinmann Jürg Utzinger Jürg Utzinger Rosa du Randt Cheryl Walter Uwe Pühse Ivan Müller |
| author_sort | Patricia Arnaiz |
| collection | DOAJ |
| description | IntroductionRisk factors for noncommunicable diseases such as insufficient physical activity (PA), overweight or hypertension are becoming increasingly predominant among children globally. While school-based interventions are promising preventive strategies, evidence of their long-term effectiveness, especially among vulnerable populations, is scarce. We aim to assess the short-term effects of the physical and health KaziKidz intervention on cardiometabolic risk factors and the long-term, pre-and post-COVID-19 pandemic changes thereof in high-risk children from marginalized communities.MethodsThe intervention was tested in a cluster-randomized controlled trial between January and October 2019 in eight primary schools near Gqeberha, South Africa. Children with overweight, elevated blood pressure, pre-diabetes, and/or borderline dyslipidemia were identified and re-assessed 2 years post-intervention. Study outcomes included accelerometry-measured PA (MVPA), body mass index (BMI), mean arterial pressure (MAP), glucose (HbA1c), and lipid levels (TC to HDL ratio). We conducted mixed regression analyses to assess intervention effects by cardiometabolic risk profile, and Wilcoxon signed-rank tests to evaluate longitudinal changes in the high-risk subpopulation.ResultsWe found a significant intervention effect on MVPA during school hours for physically inactive children, and among active as well as inactive girls. In contrast, the intervention lowered HbA1c and TC to HDL ratio only in children with glucose or lipid values within the norm, respectively. At follow-up, the intervention effects were not maintained in at-risk children, who showed a decline in MVPA, and an increase in BMI-for-age, MAP, HbA1c and TC to HDL ratio.ConclusionWe conclude that schools are key settings in which to promote PA and improve health; however, structural changes are necessary to ensure that effective interventions reach marginalized school populations and achieve sustainable impact. |
| first_indexed | 2024-03-13T09:28:07Z |
| format | Article |
| id | doaj.art-5538739453284bee9292e1a8fdb9d2da |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-13T09:28:07Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-5538739453284bee9292e1a8fdb9d2da2023-05-26T04:41:40ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-05-011110.3389/fpubh.2023.11993811199381Intervention effects and long-term changes in physical activity and cardiometabolic outcomes among children at risk of noncommunicable diseases in South Africa: a cluster-randomized controlled trial and follow-up analysisPatricia Arnaiz0Harald Seelig1Markus Gerber2Larissa Adams3Jan Degen4Danielle Dolley5Nandi Joubert6Nandi Joubert7Nandi Joubert8Madeleine Nienaber9Siphesihle Nqweniso10Peter Steinmann11Peter Steinmann12Jürg Utzinger13Jürg Utzinger14Rosa du Randt15Cheryl Walter16Uwe Pühse17Ivan Müller18Department of Sport, Exercise and Health, University of Basel, Basel, SwitzerlandDepartment of Sport, Exercise and Health, University of Basel, Basel, SwitzerlandDepartment of Sport, Exercise and Health, University of Basel, Basel, SwitzerlandDepartment of Human Movement Science, Nelson Mandela University, Gqeberha, South AfricaDepartment of Sport, Exercise and Health, University of Basel, Basel, SwitzerlandDepartment of Human Movement Science, Nelson Mandela University, Gqeberha, South AfricaDepartment of Sport, Exercise and Health, University of Basel, Basel, SwitzerlandSwiss Tropical and Public Health Institute, Allschwil, SwitzerlandUniversity of Basel, Basel, SwitzerlandDepartment of Human Movement Science, Nelson Mandela University, Gqeberha, South AfricaDepartment of Human Movement Science, Nelson Mandela University, Gqeberha, South AfricaSwiss Tropical and Public Health Institute, Allschwil, SwitzerlandUniversity of Basel, Basel, SwitzerlandSwiss Tropical and Public Health Institute, Allschwil, SwitzerlandUniversity of Basel, Basel, SwitzerlandDepartment of Human Movement Science, Nelson Mandela University, Gqeberha, South AfricaDepartment of Human Movement Science, Nelson Mandela University, Gqeberha, South AfricaDepartment of Sport, Exercise and Health, University of Basel, Basel, SwitzerlandDepartment of Sport, Exercise and Health, University of Basel, Basel, SwitzerlandIntroductionRisk factors for noncommunicable diseases such as insufficient physical activity (PA), overweight or hypertension are becoming increasingly predominant among children globally. While school-based interventions are promising preventive strategies, evidence of their long-term effectiveness, especially among vulnerable populations, is scarce. We aim to assess the short-term effects of the physical and health KaziKidz intervention on cardiometabolic risk factors and the long-term, pre-and post-COVID-19 pandemic changes thereof in high-risk children from marginalized communities.MethodsThe intervention was tested in a cluster-randomized controlled trial between January and October 2019 in eight primary schools near Gqeberha, South Africa. Children with overweight, elevated blood pressure, pre-diabetes, and/or borderline dyslipidemia were identified and re-assessed 2 years post-intervention. Study outcomes included accelerometry-measured PA (MVPA), body mass index (BMI), mean arterial pressure (MAP), glucose (HbA1c), and lipid levels (TC to HDL ratio). We conducted mixed regression analyses to assess intervention effects by cardiometabolic risk profile, and Wilcoxon signed-rank tests to evaluate longitudinal changes in the high-risk subpopulation.ResultsWe found a significant intervention effect on MVPA during school hours for physically inactive children, and among active as well as inactive girls. In contrast, the intervention lowered HbA1c and TC to HDL ratio only in children with glucose or lipid values within the norm, respectively. At follow-up, the intervention effects were not maintained in at-risk children, who showed a decline in MVPA, and an increase in BMI-for-age, MAP, HbA1c and TC to HDL ratio.ConclusionWe conclude that schools are key settings in which to promote PA and improve health; however, structural changes are necessary to ensure that effective interventions reach marginalized school populations and achieve sustainable impact.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1199381/fullphysical activityhealth promotionschool-basednoncommunicable diseaseseffectivenesssustainability |
| spellingShingle | Patricia Arnaiz Harald Seelig Markus Gerber Larissa Adams Jan Degen Danielle Dolley Nandi Joubert Nandi Joubert Nandi Joubert Madeleine Nienaber Siphesihle Nqweniso Peter Steinmann Peter Steinmann Jürg Utzinger Jürg Utzinger Rosa du Randt Cheryl Walter Uwe Pühse Ivan Müller Intervention effects and long-term changes in physical activity and cardiometabolic outcomes among children at risk of noncommunicable diseases in South Africa: a cluster-randomized controlled trial and follow-up analysis Frontiers in Public Health physical activity health promotion school-based noncommunicable diseases effectiveness sustainability |
| title | Intervention effects and long-term changes in physical activity and cardiometabolic outcomes among children at risk of noncommunicable diseases in South Africa: a cluster-randomized controlled trial and follow-up analysis |
| title_full | Intervention effects and long-term changes in physical activity and cardiometabolic outcomes among children at risk of noncommunicable diseases in South Africa: a cluster-randomized controlled trial and follow-up analysis |
| title_fullStr | Intervention effects and long-term changes in physical activity and cardiometabolic outcomes among children at risk of noncommunicable diseases in South Africa: a cluster-randomized controlled trial and follow-up analysis |
| title_full_unstemmed | Intervention effects and long-term changes in physical activity and cardiometabolic outcomes among children at risk of noncommunicable diseases in South Africa: a cluster-randomized controlled trial and follow-up analysis |
| title_short | Intervention effects and long-term changes in physical activity and cardiometabolic outcomes among children at risk of noncommunicable diseases in South Africa: a cluster-randomized controlled trial and follow-up analysis |
| title_sort | intervention effects and long term changes in physical activity and cardiometabolic outcomes among children at risk of noncommunicable diseases in south africa a cluster randomized controlled trial and follow up analysis |
| topic | physical activity health promotion school-based noncommunicable diseases effectiveness sustainability |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1199381/full |
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