title: An ecological and theoretical deconstruction of a school-based obesity prevention program in Mexico.
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.
authors.affiliation: Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Av. Universidad 655, Sta. Ma. Ahuacatitlán, Cuernavaca, Morelos, 62508, México. margarita.safdie@queensu.ca.|School of Kinesiology and Health Studies, Queen's University, 28 Division Street, Kingston, Ontario, Canada. margarita.safdie@queensu.ca.
authors.forename: Margarita
authors.initials: M
authors.lastname: Safdie
authors.affiliation: School of Population Health, University of South Australia, 160 Currie Street, GPO Box 2471, Adelaide, South Australia, 5000, Australia. margaret.Cargo@unisa.edu.au.
authors.forename: Margaret
authors.initials: M
authors.lastname: Cargo
authors.affiliation: Faculty of Nursing and IRSPUM, Université de Montréal, Station Centre-ville, PO Box 6128, H3C3J7, Montréal, Quebec, Canada. lucie.richard@umontreal.ca.
authors.forename: Lucie
authors.initials: L
authors.lastname: Richard
authors.affiliation: School of Kinesiology and Health Studies, Queen's University, 28 Division Street, Kingston, Ontario, Canada. lucie.levesque@queensu.ca.
authors.forename: Lucie
authors.initials: L
authors.lastname: Lévesque
mesh_terms: D002648:Child; D005247:Feeding Behavior; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008800:Mexico; D009043:Motor Activity; D009752:Nutritional Status; D009765:Obesity / Q000517:prevention & control*; D050177:Overweight / Q000517:prevention & control*; D015397:Program Evaluation; D012572:School Health Services; D012574:Schools; D066269:Social Theory
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