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Randomized Controlled Trial
. 2014 Aug 10:11:103.
doi: 10.1186/s12966-014-0103-2.

An ecological and theoretical deconstruction of a school-based obesity prevention program in Mexico

Margarita Safdie  1   2 , Margaret Cargo  3 , Lucie Richard  4 , Lucie Lévesque  5
Affiliations
Randomized Controlled Trial

An ecological and theoretical deconstruction of a school-based obesity prevention program in Mexico

Margarita Safdie et al. Int J Behav Nutr Phys Act. .

Abstract

Background: Ecological intervention programs are recommended to prevent overweight and obesity in children. The National Institute of Public Health (INSP) in Mexico implemented a successful ecological intervention program to promote healthy lifestyle behaviors in school age children. This study assessed the integration of ecological principles and Social Cognitive Theory (SCT) constructs in this effective school-based obesity prevention program implemented in 15 elementary schools in Mexico City.

Methods: Two coders applied the Intervention Analysis Procedure (IAP) to "map" the program's integration of ecological principles. A checklist gauged the use of SCT theory in program activities.

Results: Thirty-two distinct intervention strategies were implemented in one setting (i.e., school) to engage four different target-groups (students, parents, school representatives, government) across two domains (Nutrition and Physical Activity). Overall, 47.5% of the strategies targeted the school infrastructure and/or personnel; 37.5% of strategies targeted a key political actor, the Public Education Secretariat while fewer strategies targeted parents (12.5%) and children (3%). More strategies were implemented in the Nutrition domain (69%) than Physical Activity (31%). The most frequently used SCT construct within both intervention domains was Reciprocal Determinism (e.g., where changes to the environment influence changes in behavior and these behavioral changes influence further changes to the environment); no significant differences were observed in the use of SCT constructs across domains.

Conclusions: Findings provide insight into a promising combination of strategies and theoretical constructs that can be used to implement a school-based obesity prevention program. Strategies emphasized school-level infrastructure/personnel change and strong political engagement and were most commonly underpinned by Reciprocal Determinism for both Nutrition and Physical Activity.

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Figures

Figure 1
Figure 1
Social Cognitive Theory construct use within the Nutrition and Physical Activity (PA) intervention domains.
See this image and copyright information in PMC

References

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