| Summary: | Childhood obesity has been a major public health concern in Malaysia and other
developed countries for years. Focus of the present study was to evaluate the effectiveness
of developed intervention known as Interactive Multimedia-based Nutrition Education
Package (IMNEP) targeting on overweight and obese children in Kota Bharu, Kelantan.
This study had two phases; development of the IMNEP and impact of the IMNEP. Phase
I describes how the IMNEP developed and its contents. The IMNEP were then evaluated
among school children (n=50), review panels (n=10) and parents (n=8). In Phase II, 4-arm
cluster randomized school-based trial was conducted among primary schools in Kota
Bharu. Fourteen participated schools were randomly assigned into one of four groups:
three intervention groups (CPI: children, parents intervention; COI: children only
intervention and POI: parents only intervention) or a control group (COC: children only
control). Intervention groups were exposed to animated explanatory videos, an education
video game entitled My Healthy Eating and active gaming exercises by using XBOX 360
over a 12-week and another 12-week without intervention. In Phase I, majority of the
respondents gave positive responses and they felt that this IMNEP was interesting and
engaging in terms of variety topics included, graphics, contents, animations and purposes as new medium in teaching nutrition for children and parents. Some modifications has
been made and come out with the final version of the IMNEP. Of the 139 respondents
recruited at baseline during Phase II, 121 (87.1%) of respondents completed the 12-week
of IMNEP and 112 (80.6%) completed overall 24-week of intervention study. Initially,
the percentage of obesity (83.5%) was higher than those overweight (16.5%). However,
after 12 weeks, the results showed reduction in the percentage of overweight and obese,
significant reduction in body weight (CPI), body mass index (BMI) (CPI, POI), fat mass
(POI), waist (POI) and hip (COI, POI) circumferences among those in the intervention
groups. Significant increments of nutrition knowledge (CPI, POI) and practice (CPI),
vitamin A intake (CPI, COI) as well as higher number of those physically active especially
based on described best activities (COI) and Total PAQ-C score (POI) were also shown
among intervention groups. By using RMANOVA test, the respondents in intervention
groups keep experiencing significant increments of nutrition knowledge (COI, POI),
vitamin A intake (CPI, COI) and continued to be physically active (COI, POI) seen in
Total PAQ-C from baseline to week 24. Eating habits for milks, fruits and vegetables
groups remain unchanged. In this cohort, the IMNEP was found to be beneficial in
effectively increased nutrition knowledge and physical activity outcomes but not in
selected food groups and nutrient intakes outcomes. Positive results in anthropometric
measurements were also achieved in intervention groups. Targeting both parents and
children in childhood obesity prevention interventions are crucial because parents’
involvement has powerful effects on a child’s perception and behaviours towards food
and physical activity.
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