title: Effects of a Theory-Based Education Program to Prevent Overweightness in Primary School Children.
abstract: The effectiveness of the "Extra Fit!" (EF!) education program in promoting healthy diet and physical activity to prevent and reduce overweightness among primary school children aged 9 to 11 was evaluated. A randomized controlled design was carried out in 45 primary schools (n = 1112) in the Netherlands, 23 intervention and 22 control schools. The intervention schools received the education program for two successive school years in grades (U.S. system) 4, 5, and 6 (mean 7.6 h during 16 weeks per school per year). The control schools followed their usual curriculum. No positive effects of EF! were found with regard to behavior and anthropometric measures when follow-up measurements were compared to the baseline. However, from baseline to follow-up after one and two school years, the intervention group improved their knowledge score significantly compared to the control group. Moreover, an effect was observed for mean time spent inactively that increased more in the control group than in the intervention group. In conclusion, limited intervention effects were found for the intervention on knowledge and inactivity. To improve the effectiveness of education programs, we advise focusing on parental involvement, attractive lessons to enlarge the acceptability of the program, and multi-component environmental strategies.
authors.affiliation: Netherlands organization for applied scientific research (TNO), Division of Child Health, P.O. Box 3005, 2301 DA Leiden, The Netherlands. paul.kocken@tno.nl.|Leiden University Medical Center (LUMC), Department of Public Health and Primary Care, P.O. Box 9600, 2300 RC Leiden, The Netherlands. paul.kocken@tno.nl.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Kocken
authors.affiliation: Netherlands organization for applied scientific research (TNO), Division of Child Health, P.O. Box 3005, 2301 DA Leiden, The Netherlands. a.m.scholten@hhs.nl.|The Hague University of Applied Sciences, Nutrition and Dietetics, P.O. Box 13336, 2501 EH The Hague, The Netherlands. a.m.scholten@hhs.nl.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Scholten
authors.affiliation: Netherlands organization for applied scientific research (TNO), Division of Child Health, P.O. Box 3005, 2301 DA Leiden, The Netherlands. Ellen.Westhoff@radboudumc.nl.|Radboud Institute for Health Sciences, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Ellen.Westhoff@radboudumc.nl.
authors.forename: Ellen
authors.initials: E
authors.lastname: Westhoff
authors.affiliation: Netherlands organization for applied scientific research (TNO), Division of Child Health, P.O. Box 3005, 2301 DA Leiden, The Netherlands. brenda.dekok@gmail.com.
authors.forename: Brenda P H
authors.initials: BP
authors.lastname: De Kok
authors.affiliation: Netherlands organization for applied scientific research (TNO), Division of Child Health, P.O. Box 3005, 2301 DA Leiden, The Netherlands. emtaal@casema.nl.
authors.forename: Elisabeth M
authors.initials: EM
authors.lastname: Taal
authors.affiliation: Netherlands organization for applied scientific research (TNO), Division of Life Style, P.O. Box 3005, 2301 DA Leiden, The Netherlands. sandra.bausch@tno.nl.
authors.forename: R Alexandra
authors.initials: RA
authors.lastname: Goldbohm
mesh_terms: D002648:Child; D003479:Curriculum; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008297:Male; D009426:Netherlands; D050177:Overweight; D063766:Pediatric Obesity / Q000517:prevention & control*; D015397:Program Evaluation; D012574:Schools
keywords: RCT; behavioral determinants; education program; nutrition; overweight; physical activity; primary school children