The Effectiveness of a School-Based Health Education Intervention in Changing Screen-Based and Physical Activities in Croatian Young Adolescents

Author(s):

Josip Burusic(submitting)Denis Baric(presenting)Mia Karabegović(presenting)Cilic Burusic Lidija

Conference:

ECER 2015

Network:

08. Research on Health Education

Format:

Paper

Session Information

08 SES 05 A, Physical Activity in Schools - Evaluation Challenges

Paper Session

Time:

2015-09-09

11:00-12:30

Room:

108.Oktatóterem [C]

Chair:

Monica Carlsson

Contribution

The percentage of adolescents aged 15 who reported being overweight or obese in Croatia, and certain Southern European countries, was around 15% in the 2009/2010 period (OECD, 2012). These results are somewhat alarming, since excessive weight can bring about serious negative health outcomes in adulthood, such as cardiovascular diseases (Baker, Olsen & Sorensen, 2007). Although sometimes overlooked because of the life-threatening aspect of physical consequences, psychological issues related to obesity should also be taken into account. For instance, being obese or overweight has been proven to have a detrimental effect on the development of self-esteem, and lead to poorer mental health later on (Wang, Wild, Kipp, Kuhle, & Veugelers, 2008).

One possible way of avoiding these negative outcomes lies in school-based prevention programs focusing on instructing children how to embrace a healthier, more active lifestyle. A bulk of previous research has discovered negative correlations between the excessive use of television and physical activity (Chen, Liou, & Wu, 2008; Koezuka, Koo, Allison, Adlaf, Dwyer, Faulkner, & Goodman, 2006). Apart from the threat of obesity and excessive weight, more time spent watching television has been linked to attentional problems (Landhuis, Poulton, Welch, & Hancox, 2007) while certain results have also shown a connection with adolescent smoking(Gidwani, Sobol, DeJong, Perrin, & Gortmaker, 2002). Similar results surfaced about computer use and playing videogames (Koezuka et al., 2006; Vandewater, Shim, & Caplovitz, 2004), though some of the studies seemed to show gender-related outcomes, in the direction of only girls' computer use being statistically significant in predicting obesity (Kautiainen, Koivusilta, Lintonen, Virtanen, & Rimpela, 2005).

Since children spend a substantial amount of time at school at this age, it seems as a good environment to educate them on the risks pertaining to the excessive use of television and computers in their free time, as well as promoting the benefits of a more physically active lifestyle. Several papers have addressed this by evaluating health-promoting interventions in school-aged children.

Our study sought to investigate whether a more general educational program, which addressed the benefits of physical activities and promoted a healthy lifestyle among other issues, would bring about the desired changes in students' habits. Firstly, we evaluated the relationship between physical exercise and mediause in a sample of older students and then used a quasi-experimental design to ascertain whether the students included in the experimental condition changed their habits regarding time spent on exercise and screen-based activities after the intervention, as opposed to the control group who did not receive any instructions on the matter.

Method

A quasi-experimental design was used to compare the results of students before and after they participated in a health education program, as well as those in the control group who did not receive any information. The health-education program evaluated in this study took place during the five months in a form of lectures, class exercises and class project activities. We sought to investigate whether this kind of an intervention is likely to promote physical activity, as opposed to spending more time on screen-based activities, i.e. watching television, playing video games and spending time on the computer. The questions we address include the following: What is the relationship between physical activity and screen-based activities in older school-aged children? Can school-based, advice only programs which promote healthy lifestyle choices influence students' habits regarding media overuse and encourage physical activity? The participants in this quasi-experimental research project were children in the fifth grade of the Croatian elementary school system, aged 10 to 11. The sample encompassed schools from both urban and rural areas, eight schools in the experimental and eight in the control condition, for the total of sixteen schools which participated in the study. 858 students completed the questionnaires, 377 of them male and 476 female. Television, computer and video game time were measured using students' self-assessment in both the inital and the follow-up questionnaire and physical activity was also measured using self-assessment of physical activities in the last month.

Expected Outcomes

Results showed weakly effects, where no major difference between the pre- and post-intervention reports of time spent on screen-based activities and physical exercise where found. Furthermore, the time students spent exercising was not correlated to the time they spent on sedentary behaviors. Our results show that this kind of an intervention does not significantly alter students' health-related behaviors, that is, the time they spend on screen-based activities and physical exercise. Although negative, this is consistent with previous findings of studies which employed a school-based, curriculum-only approach to changing students' health behaviour. Salmon et al. (2007) analyzed five interventions of a similar kind which focused on promoting physical activity and targeted children aged 4-12 years, out of which only the Know Your Body program (Marcus et al., 1987) proved to be successful, though it is important to note that a subsequent replication of the same program was not effective (Bush et al., 1989). We conclude that more focused interventions are needed for the desired behavioral changes to occur, as well as the inclusion of certain behavior treatment methods apart from the advice-only approach.

References

Baker, J. L., Olsen, L. W., & Sørensen, T. I. (2007). Childhood body-mass index and the risk of coronary heart disease in adulthood. New England journal of medicine, 357(23), 2329-2337. Budd, G.M, & Volpe, S.L. (2006). School-Based Obesity Prevention: Research, Challenges, and Recommendations. Journal of School Health 76(10), 485-495. Bush, P. J., Zuckerman, A. E., Theiss, P. K., Taggart, V. S., HOROWITZ, C., Sheridan, M. J., & Walter, H. J. (1989). Cardiovascular risk factor prevention in black schoolchildren: twoyear results of the “Know Your Body” program.American Journal of Epidemiology, 129(3),466-482. Chen, M., Liou, Y., Wu J. (2008). The Relationship Between TV/Computer Time and Adolescents' Health-Promoting Behavior: A Secondary Data Analysis. Journal of Nursing Research 16(1), 75-84. Gidwani, P. P., Sobol, A., DeJong, W., Perrin, J. M., & Gortmaker, S. L. (2002). Television viewing and initiation of smoking among youth. Pediatrics, 110(3), 505-508. Jenvey, V. B. (2007). The relationship between television viewing and obesity in young children: a review of existing explanations.Early Child Development and Care, 177(8), 809-820. Landhuis, C. E., Poulton, R., Welch, D., & Hancox, R. J. (2007). Does childhood television viewing lead to attention problems in adolescence? Results from a prospective longitudinal study. Pediatrics, 120(3), 532-537. Marcus, A. C., Channing Wheeler, R., Cullen, J. W., & Crane, L. A. (1987). Quasiexperimental evaluation of the Los Angeles Know Your Body program: knowledge, beliefs, and self-reported behaviors. Preventive medicine, 16(6), 803-815. Melkevik, O., Torsheim, T., Iannotti, R. J., & Wold, B. (2010). Is spending time in screenbased sedentary behaviors associated with less physical activity: a cross national investigation. International Journal of Behavioral Nutrition and Physical Activity, 7(1), 1-10. OECD (2012), “Overweight and obesity among children”, in Health at a Glance: Europe 2012, OECD Publishing. Robinson, T. N. (1999). Reducing children's television viewing to prevent obesity: a randomized controlled trial. Jama, 282(16), 1561-1567. Salmon, J., Booth, M. L., Phongsavan, P., Murphy, N., & Timperio, A. (2007). Promoting physical activity participation among children and adolescents. Epidemiologic Reviews, 29, 144-59. Vandewater, E. A., Shim, M. S., & Caplovitz, A. G. (2004). Linking obesity and activity level with children's television and video game use. Journal of adolescence, 27(1), 71-85. Wang, F., Wild, T. C., Kipp, W., Kuhle, S., & Veugelers, P. J. (2009). The influence of childhood obesity on the development of self-esteem. Health Rep, 20(2), 21-27.

Author Information

Josip Burusic (submitting)

Ivo Pilar Institute of Social Sciences, Croatia

Denis Baric (presenting)

University of Zagreb

Catholic Faculty of Theology

Zagreb

Mia Karabegović (presenting)

Central European University

Cognitive Science

Budapest

Cilic Burusic Lidija

SUVAG Polyclinic for the Rehabilitation of Listening and Speech

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