The global prevalence of overweight and obesity among children has increased rapidly in the recent decades, including in Malaysia. Thus, development of effective interventions to prevent childhood obesity in Malaysia is urgently needed. This paper describes the study design of a 12-week multi-component, school-based nutrition education programme aimed at managing childhood obesity. The objective of Juara Sihat™ is to determine the effectiveness of a nutrition education programme in improving anthropometric status, knowledge, attitude and practice (KAP) of nutrition, eating habits and physical activity level among overweight and obese children. This quasi-experimental study involves two primary schools in Kuala Lumpur with similar demographic characteristics. Eligibility criteria of research participants are overweight and obese children aged 9 to 11 years. The main components of the Juara Sihat™ intervention are nutrition education classes on healthy eating and active lifestyle; physical activity sessions; and active involvements of parents and teachers. The control school does not receive any interventions. The primary outcome is BMI-for-age z-score, while other outcomes include waist circumference, body fat percentage, KAP of nutrition score, dietary intake, physical activity level, sedentary behaviour and biochemical profile. Outcome measures will be assessed at three intervals: baseline, post-intervention 1 (3-month follow-up), and post-intervention 2 (6-month follow-up). The Juara Sihat™ programme represents a promising approach to examining the effectiveness of a school-based childhood obesity intervention with strong empowerment of Parents’ and Teachers’ Association (PTA). We anticipate that this study may provide insights towards the development of more effective strategies in formulating childhood obesity interventions.
Global prevalence of childhood overweight and obesity have increased drastically in the past years, including in Malaysia. School-based obesity intervention is important to promote healthy eating and behavioural change. Many obesity interventions have been conducted to combat childhood obesity; however, the sustainability of childhood obesity interventions are often overlooked. This study aimed to explore the factors that influenced sustainability of Juara Sihat intervention programme in Kuala Lumpur primary school. Face-to-face in-depth interviews were conducted with 26 children aged 12- 14 years old whom participated in the Juara Sihat intervention programme were purposively selected. Data was transcribed verbatim and analysed using thematic analysis. The main themes identified as motivators are (1) support from family, facilitators, school teachers, and friends; (2) physical activity and healthy eating practices after intervention; (3) self-awareness; (4) knowledge on food pyramid and healthy eating; and (5) home environment. While the barriers are (1) knowledge inconsistency; (2) own safety; (3) peers influence; (4) self-attitude; (5) boredom towards programme. The results showed that the main promoting factor for sustainability of Juara Sihat intervention programme is continued practice of physical activity and healthy eating, while the main barrier is knowledge inconsistency. Therefore, school-based obesity intervention programmes should consider these promoting and hindering factors that could influence the sustainability of intervention programmes. Future studies should consider those factors during program intervention planning especially when factors that influence implementation and sustainability are carefully considered and taken care of to ensure long-term success.