The Effect of School Environment on Overweight/Obesity among Private School Adolescents in Addis Ababa, Ethiopia: 2016
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Date
2016-06
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Addis Ababa University
Abstract
Introduction: Obesity was formally recognized as a global epidemic in 1997 by World Health Organization (WHO). It has more has more has more has more than doubled in children and quadrupled than doubled in children and quadrupled than doubled in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. adolescents in the past 30 years. In our country, among adolescents, high magnitudes have been shown especially in private schools (10-23%). Though there are studies that have showen the magnitude and individual level determinants, little is known about environmental-level determinants especially school environment and particularly adequacy of space in schools. School environment could affect largely since adolescents spend majority of their time in schools.
Objectives: The study was aimed at comparing the magnitude of overweight and obesity among adolescents in private schools with and without adequate space for physical activity and exploring other environmental and individual-level determinants among private school adolescents in Addis Ababa, Ethiopia.
Methods: School based comparative cross-sectional study was conducted among adolescents 10-19 years old. A total of 20 private schools were included in the study in which 10 were with adequate space and the rest 10 without adequate space for physical activity. A three stage random sampling technique was used to select the study participants. Adolescents were interviewed using pre-tested structured questionnaire. Weight and height measurements were done using standardized weighing scales and measuring boards respectively. Body Mass Index (BMI) for age Z-score was compared to WHO 2007 growth reference standards using WHO Anthro plus version 1.0.4 software. Data were entered and cleaned using EpiData 3.1 and all statistical tests were done using STATA version 12.1 software. Descriptive statistical tests, bivariate and multivariate logistic regression analysis were done to identify factors associated with overweight and obesity.
Results: Out of the sampled adolescents, 1277 respondents participated in the study with response rate of 99.3%. The overall magnitude of overweight & obesity among the study participants was 17.0% which was significantly higher in schools without adequate space for physical activity (19.4% versus 14.6%) with p-value of 0.01. In the bivariate analysis, adolescents in schools without adequate space for physical activity
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had 1.86 times higher odds of being in lower physical activity level and 1.41 times higher odds of being overweight/obese with p-value of 0.001 and 0.041 respectively. The partial correlation between adequacy of space and overweight/obesity accounting for the explanatory power of physical activity was also significant with partial correlation coefficient 0.06 and p-value 0.0341. Those in the middle wealth quintile, low Physical activity, traveling with private car from home to school, irregular breakfast consumption and ≤ 3 meals per day also had increased odds of being overweight / obese in the multivariate analysis.
Conclusions: The findings of the study gave insight on the effect of inadequate space in schools as an important contributor to physical inactivity and a higher burden of overweight and obesity. Low physical activity and traveling with private car were also found to be significant factors associated with overweight and obesity among private school adolescents.
Recommendations: Based on the the results of this study, it is important that officals responsible for urban development and licensing of private schools consider availability of a reasonably adequate space for schools and work with relevant regulatory bodies to ensure implementation according to the guidelines.
School officials should design their schools in a way having adequate space for physical activity. Lastly the school community and the general public should promote adolescents to be physically active and walk to schools.
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Overweight/Obesity