Physical and Nutrition Education Intervention Improves Body Weight Status of Adolescents in Uasin Gishu County, Kenya: A Cluster-Randomized Controlled Trial

Abstract

The study aimed to establish the effect of a school-focused physical and nutrition education intervention on the weight status of adolescent students’ ages 15-18 years in Kenya. This was a Cluster-Randomized Controlled Trial conducted from August 2018 to March 2019, in which 4 schools were randomly placed into two study arms (control and intervention) at a ratio of 1:1. A total of 222 adolescent students were assigned to the 2 study groups (111 per arm) based on their schools’ study group. The Intervention group received physical and nutrition education sessions for a period of 8 weeks, while the control group received no intervention from the research team. The parents and students were both involved in this study which was conducted in parallel at different schools to avoid data contamination or mix of information. Data was collected at baseline, at 8 weeks and at 6 months post intervention. Study arms were similar in all baseline characteristics (demography, socio-economic and anthropometric indices). The intervention group had a significantly lower waist circumference at 8 weeks post intervention compared to the control group (T-test: 3.229; p =0.001), but the mean BMI for age Z scores were not significantly different at the same time period (T-test:-0.357; p=0.720), between the study groups. The intervention group had lower mean waist circumference and lower mean BMI for age Z scores in contrast to the control group, at 6 months post intervention. Significant changes in the mean scores of waist circumference (Difference in Difference (DID) of 1.16; p<0.001) and mean BMI for age z scores (DID of 0.66; p<0.001) were noted when baseline and end line mean scores were compared. This study has demonstrated that school focused physical and nutrition education can be effective in reducing weight status among adolescent students. Interventions that involve creating awareness among the parents for parental support are recommended in future.