A school-based comprehensive lifestyle intervention among chinese kids against obesity (CLICK-Obesity): Rationale, design and methodology of a randomized controlled trial in Nanjing city, China

摘要

Background: The prevalence of childhood obesity among adolescents has been rapidly rising in Mainland China inrecent decades, especially in urban and rich areas. There is an urgent need to develop effective interventions toprevent childhood obesity. Limited data regarding adolescent overweight prevention in China are available. Thus,we developed a school-based intervention with the aim of reducing excess body weight in children. This reportdescribed the study design.Methods/design: We designed a cluster randomized controlled trial in 8 randomly selected urban primary schoolsbetween May 2010 and December 2013. Each school was randomly assigned to either the intervention or controlgroup (four schools in each group). Participants were the 4th graders in each participating school. The multi-componentprogram was implemented within the intervention group, while students in the control group followed their usualhealth and physical education curriculum with no additional intervention program. The intervention consisted of fourcomponents: a) classroom curriculum, (including physical education and healthy diet education), b) school environmentsupport, c) family involvement, and d) fun programs/events. The primary study outcome was body composition, andsecondary outcomes were behaviour and behavioural determinants.Discussion: The intervention was designed with due consideration of Chinese cultural and familial tradition, socialconvention, and current primary education and exam system in Mainland China. We did our best to gain good supportfrom educational authorities, school administrators, teachers and parents, and to integrate intervention componentsinto schools’ regular academic programs. The results of and lesson learned from this study will help guide futureschool-based childhood obesity prevention programs in Mainland China.