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. 2022 Dec 1;20(12):2936-2985.
doi: 10.11124/JBIES-21-00233.

School-based obesity prevention programs in rural communities: a scoping review

Crystal S Lim  1   2 , Jennifer Robinson  2   3 , Elizabeth Hinton  2   3   4 , Xiaoshan Z Gordy  5 , Abigail Gamble  6 , Caroline Compretta  7 , Megan E Holmes  8 , Martha Ravola  9
Affiliations

School-based obesity prevention programs in rural communities: a scoping review

Crystal S Lim et al. JBI Evid Synth. .

Abstract

Objective: The objective of this review was to examine existing literature and conceptually map the evidence for school-based obesity prevention programs implemented in rural communities, as well as identify current gaps in the literature.

Introduction: Pediatric obesity is a significant public health condition worldwide. Rural residency places children at increased risk of obesity. Schools have been identified as an avenue for obesity prevention in rural communities.

Inclusion criteria: We considered citations focused on children (5 to 18 years of age) enrolled in a rural educational setting. We included obesity prevention programs delivered in rural schools that focused on nutrition or dietary changes, physical activity or exercise, decreasing screen time, or combined nutrition and physical activity that aimed to prevent childhood obesity. We included all quantitative, qualitative, and mixed methods research designs, as well as text and opinion data.

Methods: A search was conducted of published and unpublished studies in English from 1990 through April 2020 using PubMed, CINAHL Complete, ERIC, Embase, Scopus, Academic Search Premier, Cochrane Register of Controlled Trials, and ClinicalTrials.gov. Gray literature was also searched. After title and abstract review, potentially relevant citations were retrieved in full text. The full texts were assessed in detail against the inclusion criteria by 2 independent reviewers. Included citations were reviewed and data extracted by 2 independent reviewers and captured on a spreadsheet targeting the review objectives.

Results: Of the 105 studies selected for full-text review, 72 (68.6%) were included in the final study. Most of the studies (n = 50) were published between 2010 and 2019 and were conducted in the United States (n = 57). Most studies included children in rural elementary or middle schools (n = 57) and targeted obesity prevention (n = 67). Teachers implemented the programs in half of the studies (n = 36). Most studies included a combination of physical activity and nutrition components (n = 43). Other studies focused solely on nutrition (n = 9) or physical activity (n = 9), targeted obesity prevention policies (n = 9), or other components (n = 8). Programs ranged in length from weeks to years. Overall, weight-related, physical activity-specific, and nutrition-specific outcomes were most commonly examined in the included citations.

Conclusions: Obesity prevention programs that focused on a combination of physical activity and nutrition were the most common. Multiple outcomes were examined, but most programs included weight-specific and health behavior-specific outcomes. The length and intensity of rural school-based obesity prevention programs varied. More research examining scientific rigor and specific outcomes of rural school-based obesity prevention programs is needed.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1:
Figure 1:
Search results and source selection and inclusion process
See this image and copyright information in PMC

References

    1. Bauman A, Rutter H, Baur L. Too little, too slowly: International perspectives on childhood obesity. Public Health Res Pract 2019;29(1):1–5. - PubMed
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Appendix II: Studies ineligible following full-text review

    1. Adom T, De Villiers A, Puoane T, Kengne AP. School-based interventions targeting nutrition and physical activity, and body weight status of African children: a systematic review. Nutrients. 2019;12(1). - PMC - PubMed

    2. Reason for exclusion: ineligible context – included both rural and urban settings

    1. Baker K, Hagedorn RL, Hendricks T, Clegg EN, Joseph L, McGowan M, et al. Katalyst: development of a fifth-grade novel approach to health and science experiential learning. Sci Act. 2018;55(3–4):127–39. - PMC - PubMed

    2. Reason for exclusion: ineligible concept – no outcomes reported

    1. Hosseini H, Yilmaz A. Using telehealth to address pediatric obesity in rural Pennsylvania. Hosp Top. 2019;97(3):107–18. - PubMed

    2. Reason for exclusion: ineligible concept – no outcomes reported

    1. Lyders S Evaluation of a daily activity program for early school-age children in a rural setting. 2019.

    2. Reason for exclusion: ineligible population – adults

    1. Marchetti D, Fraticelli F, Polcini F, Fulcheri M, Mohn AA, Vitacolonna E. A school educational intervention based on a serious game to promote a healthy lifestyle. Mediterranean J Clin Psychol. 2018;6(3):1–16.

    2. Reason for exclusion: ineligible context – both rural and urban settings

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