Effect of educational intervention on healthy lifestyle in Iranian children and adolescents: The IRAN-Ending Childhood Obesity (IRAN-ECHO) Program

Introduction: Overweight and obesity during childhood and adolescence are increasing as public health problem. This study aimed at examining the effect of the education program on children and adolescents’ knowledge, attitudes and behavior in relation to healthy lifestyle. Methods: This study was performed as a quasi-experimental national survey as part of the IRAN-Ending Childhood Obesity (IRAN-ECHO) program. Participants were selected from six cities of Iran. The sample size was calculated as 1264 for each city. Nutrition-related knowledge, attitudes and behavior were measured at pre- and post-intervention surveys. Physician and dietitian provided recommendations on healthy dietary, reducing screen time, increasing physical activity, and sufficient sleep time, as well as behavioral therapy when necessary. Results: The prevalence of excess weight (overweight/obesity) was 7.6%. The frequency of desirable knowledge after intervention (32.5%) is significantly higher than before intervention (24.8%) (p-value=0.02). The mean score of attitude about obesity complications was significantly increased from 73.09 to 74.78 after intervention (p-value < 0.05). There was significant increase in mean score of practice in relation to low consumption of unhealthy snacks after intervention compared to the baseline (difference = 1.63, pvalue= 0.03). The mean score of mild physical activity increased from 50.67 to 65 after intervention (p-value< 0.001). There was no significant differences between the desirable total attitude and total practice before and after the intervention (p-value > 0.05). Conclusion: The survey highlights educational intervention based on WHO-ECHO recommendations can beuseful for improvement the knowledge related to healthy lifestyle in children and adolescents; over time it might lead to change in attitude and in turn in improving their practice. Continued professional education and development, and implementation of guidelines for the prevention and management of early childhood overweight and obesity are suggested.

Keywords:

Health behavior , Nutrition , Education , Knowledge , Attitude , Practice , Iran