Participatory Intervention to Improve Nutrition and Physical Activity in Schoolchildren From Acatlán de Juárez, Jalisco
Condition: Sedentary Behavior; Adipose Tissue; Child Obesity
MeSH terms: Pediatric Obesity
Study type: Interventional

Summary: 
      This is a community project carried out jointly by the Technological Institute of Higher
      Studies of the West (ITESO), the University Center of Tonalá of the University of Guadalajara
      (CUTonalá) and the University Center of Health Sciences of the University of Guadalajara (
      CUCS) with advice from the National Institute of Public Health (INSP), financed by the
      Tresmontes Lucchetti company and endorsed by the Jalisco Association of Nutritionists, AC
      (AJANUT). This project follows the provisions of the "National Strategy for the Prevention
      and Control of Overweight, Obesity and Diabetes" signed by the executive branch of the
      Federal Government. In particular, this project is inserted within the Public Health
      Strategy, in the strategic axis of Health Promotion and educational communication (while
      still having an impact on the axes of Epidemiological Surveillance and Prevention). In
      addition, it follows the agreement in which the general guidelines for the expenditure and
      distribution of food and beverages prepared and processed in the schools of the National
      Educational System were obtained, proposed by the Ministries of Health and Public Education.
      The aforementioned referrals are intended to protect and improve the health of Mexican
      children.
    

Detailed description: 
      The project is a community trial that will last three years, which includes an intervention
      group and a control group of three schools each. Acatlán de Juárez has a total of 11
      elementary schools.

      The strategies will be implemented in collaboration with the authorities of the Acatlán de
      Juárez community, the school authorities, ITESO staff, CUTonalá, CUCS, and AJANUT. Key actors
      from both the school and community levels will be involved through the study to adapt the
      strategies socially and culturally to promote community project ownership. An initial study
      of the viability of the project and the current conditions of food and physical activity in
      school facilities will be carried out, as well as the perception of the community. The
      research team will design the contents and materials of the intervention taking into account
      the opinions and suggestions of the community and the results of the initial study. The
      schools of the control group will be chosen from the municipality of Villa Corona, Jalisco,
      which is similar to Acatlán de Juárez.

      The strategies proposed for intervention by the research team, which will be agreed with the
      community, including the following:

        -  Surveillance in compliance with the regulation of the sale of food in school buildings,
           according to official guidelines

        -  Sensitization of children, parents, teachers (especially those in charge of the physical
           education class) and personnel in charge of the food supply (school cooperative), to
           improve acceptance and commitment to the regulation of the sale of food

        -  Training for the preparation of hygienic and healthy food for the personnel in charge of
           food sale

        -  Promotion of the consumption of simple water and healthy foods

        -  Rescue and promotion of the consumption of regional foods

        -  Reconditioning of the infrastructure for the consumption of simple water, free and
           healthy food, and the realization of physical activity

        -  Organization of events and support in the coordination of groups that promote physical
           activity at the community level

        -  Optimization of physical education classes at school sites

        -  Implementation of health promotion and care actions in the school context

        -  Development of skills in the school community for health care and generation of healthy
           school environments

        -  Creation and strengthening of health and nutrition committees in schools, with the
           participation of directors, teachers and parents to generate necessary and permanent
           conditions that favor healthy environments

      To achieve a greater rapprochement with the population, qualitative instruments will also be
      implemented before the intervention, such as focus groups and in-depth interviews, which
      allow the identification of barriers and possible solutions to improve eating habits and
      promote physical activity in the population. Likewise, during the intermediate and final
      measurement phases, similar qualitative strategies will be applied to rescue successes and
      points for improvement of the intervention.

      During the implementation of the strategies, meticulous monitoring of the localities will be
      carried out to identify significant changes that may affect the eating habits and physical
      activity in either of the two groups (intervention and control).
    

Intervention name(s): Participatory intervention
Intervention type(s): Behavioral
Intervention description(s): Surveillance in compliance with the regulation of the sale of food in school buildings, according to official guidelines Training for the preparation of hygienic and healthy food for the personnel in charge of food sale Promotion of the consumption of simple water and healthy foods Reconditioning of the infrastructure for the consumption of simple water, free and healthy food, and the realization of physical activity Organization of events and support in the coordination of groups that promote physical activity at the community level Optimization of physical education classes at school sites Implementation of health promotion and care actions in the school context Development of skills in the school community for health care and generation of healthy school environments Creation and strengthening of health and nutrition committees in schools, with the participation of directors, teachers and parents to generate necessary and permanent conditions that favor healthy environments
Other intervention name(s): Healthy diet; Physical activity; Nutrition literacy
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: Monitoring and evaluation of the impact of the intervention will be carried out through a community trial. There will be three schools in each study group (intervention and control). There will be three measurement periods: a baseline in the 2015-2016 school year, an intermediate measurement in the 2016-2017 school year, and a final measurement in the 2017-2018 school year. The measurement periods will have an estimated duration of two months.
In the measurement periods, the body composition of the children from 1st to 4th grade will be obtained, and they will be followed up for two years; The dynamics of water and food consumption, physical activity, functional physical capacities, as well as availability and accessibility of food in schools will be identified. In addition, from a sub-sample of the study subjects, questionnaires on the frequency of food consumption, additional anthropometric measurements, and venous blood will be obtained to determine glucose and blood lipid levels.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Child Obesity; Exercise; Healthy Eating; Anthropometry