title: A national school-based health lifestyles interventions among Chinese children and adolescents against obesity: rationale, design and methodology of a randomized controlled trial in China.
abstract: BACKGROUND
  The prevalence of obesity among children and adolescents has been rapidly rising in Mainland China in recent decades, both in urban and rural areas. There is an urgent need to develop effective interventions to prevent childhood obesity. Limited rigid data regarding children and adolescent overweight prevention in China are available. A national random controlled school-based obesity intervention program was developed in the mainland of China.
  
  
  METHODS
  The study was designed as a national multi-centered cluster randomized controlled trial involving more than 70,000 children and adolescents aged 7-18 years from 7 provinces in China. In each center, about 12-16 primary and secondary schools, with totally at least 10000 participants were randomly selected (Primary: Secondary = 1:1). All of the selected schools were randomly allocated to either intervention or control group (Intervention: Control = 1:1).The multi-components school-based and family-involved scheme was conducted within the intervention group for 9 month, while students in the control group followed their usual health practice. The intervention consisted of four components: a) Create supportive school and family environment, b) Health lifestyles education and related compulsory physical activities, c) Instruct and promote school physical education, d) Self-monitor obesity related behaviors. Four types of outcomes including anthropometric, behavioral, blood chemical and physical fitness were measured to assess the effectiveness of the intervention program.
  
  
  CONCLUSIONS
  This is the first and largest multi-centered school-based obesity intervention program with the consideration of geographical and social-demographic characteristics of the rapidly increased obesity prevalence of Chinese children and adolescent. The intervention is based on Social Cognitive Theory and Social-Ecological Model of Health, and follows a stepwise approach guided by PRECEDE-PROCEED (P-P) Model and Intervention Map. The results of and lesson learned from this study will help guide future school-based national childhood obesity prevention programs in Mainland China.
  
  
  BACKGROUND
  January 22, 2015;
  
  
  BACKGROUND
  NCT02343588.
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China. chenyj68@mail.sysu.edu.cn.
authors.forename: Yajun
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China. 980434761@qq.com.
authors.forename: Lu
authors.initials: L
authors.lastname: Ma
authors.affiliation: Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China. yinghuama@bjmu.edu.cn.
authors.forename: Yinghua
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China. whjun1@bjmu.edu.cn.
authors.forename: Haijun
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Central South University, Changsha, China. jiayouluo@126.com.
authors.forename: Jiayou
authors.initials: J
authors.lastname: Luo
authors.affiliation: School of Public Health, Tianjin Medical University, Tianjin, China. zhangxin@tijmu.edu.cn.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Shanghai Municipal Center for Disease Control and Prevention & Shanghai Institutes of Preventive Medicine, Shanghai, China. luochunyan@scdc.sh.cn.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Luo
authors.affiliation: Chongqing Medical University, Chongqing, China. wangh111111@aliyun.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Ningxia Medical University, Ningxia, China. zhpgj@163.com.
authors.forename: Haiping
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Liaoning Health Supervision Bureau, Shenyang, China. pandehong163@163.com.
authors.forename: Dehong
authors.initials: D
authors.lastname: Pan
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China. zhuyn3@mail.sysu.edu.cn.
authors.forename: Yanna
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China. caili1127@foxmail.com.
authors.forename: Li
authors.initials: L
authors.lastname: Cai
authors.affiliation: Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China. harveyzou2002@bjmu.edu.cn.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Zou
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China. yangwhan@mail.sysu.edu.cn.
authors.forename: Wenhan
authors.initials: W
authors.lastname: Yang
authors.affiliation: Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China. majunt@bjmu.edu.cn.
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China. jingjin@mail.sysu.edu.cn.
authors.forename: Jin
authors.initials: J
authors.lastname: Jing
mesh_terms: D000293:Adolescent; D002648:Child; D002681:China; D005260:Female; D006266:Health Education; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008297:Male; D063766:Pediatric Obesity / Q000517:prevention & control*; D012107:Research Design; D040242:Risk Reduction Behavior; D012574:Schools