A mixed method study to determine the prevalence of childhood obesity and determinants of physical activity and gadgets use amongst school-going children (standard 1st to 10th) from an urban area located in central India

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Physical activity is critical for obesity prevention. Childhood Obesity is a proven risk factor for many noncommunicable diseases in adults. Environmental factors, habits, and cultural contexts have influenced the worldwide obesity epidemic. Obesity during childhood can have a comprehensive impact on a child’s overall health, affecting not only their physical well-being, but also their social and emotional development. It can influence confidence levels, social interactions, and even academic performance, leading to reduced quality of life. Aim This study aimed to determine the prevalence of obesity and examine the pattern of physical activity and gadget use among school-going children (1st -10th). Method This was a descriptive cross-sectional study with a mixed-method component that will be conducted in the urban field practice of a tertiary care hospital in central India among school-going children (std1st-std 10th). Quantitative data were collected by house-to-house surveys in systematically selected random households, while in-depth interviews were conducted among parents from randomly selected households. This study aimed to ascertain the frequency of obesity and physical activity patterns and examine parents’ opinions regarding technology use, exercise, and nutrition in their offspring. It will provide insights into the burden of childhood obesity along with appropriate strategies to plan based on the determinants and perceptions identified. 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F1000Research 2024, 13 :402 ( https://doi.org/10.12688/f1000research.147106.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol A mixed method study to determine the prevalence of childhood obesity and determinants of physical activity and gadgets use amongst school-going children (standard 1 st to 10 th ) from an urban area located in central India [version 1; peer review: awaiting peer review] Sayali umekar https://orcid.org/0009-0004-4650-7218 1 , Dr. Abhishek Joshi 2 Sayali umekar https://orcid.org/0009-0004-4650-7218 1 , Dr. Abhishek Joshi 2 PUBLISHED 26 Apr 2024 Author details Author details 1 School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, 442001, India 2 Department of Community Medicine, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, 442001, India Sayali umekar Roles: Conceptualization, Formal Analysis, Visualization, Writing – Review & Editing Dr. Abhishek Joshi Roles: Supervision, Validation, Writing – Original Draft Preparation OPEN PEER REVIEW REVIEWER STATUS AWAITING PEER REVIEW This article is included in the Datta Meghe Institute of Higher Education and Research collection. Abstract Introduction The word obesity comes from the Latin “obesus,” which means “pump” or “having eaten oneself fat.” Childhood obesity is a major problem in India. Physical activity is critical for obesity prevention. Childhood Obesity is a proven risk factor for many noncommunicable diseases in adults. Environmental factors, habits, and cultural contexts have influenced the worldwide obesity epidemic. Obesity during childhood can have a comprehensive impact on a child’s overall health, affecting not only their physical well-being, but also their social and emotional development. It can influence confidence levels, social interactions, and even academic performance, leading to reduced quality of life. Aim This study aimed to determine the prevalence of obesity and examine the pattern of physical activity and gadget use among school-going children (1st -10th). Method This was a descriptive cross-sectional study with a mixed-method component that will be conducted in the urban field practice of a tertiary care hospital in central India among school-going children (std1st-std 10th). Quantitative data were collected by house-to-house surveys in systematically selected random households, while in-depth interviews were conducted among parents from randomly selected households. This study aimed to ascertain the frequency of obesity and physical activity patterns and examine parents’ opinions regarding technology use, exercise, and nutrition in their offspring. It will provide insights into the burden of childhood obesity along with appropriate strategies to plan based on the determinants and perceptions identified. READ ALL READ LESS Keywords childhood obesity, physical activity, school-going children, mixed method study Corresponding Author(s) Sayali umekar ( [email protected] ) Close Corresponding author: Sayali umekar Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2024 umekar S and Joshi DA. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: umekar S and Joshi DA. A mixed method study to determine the prevalence of childhood obesity and determinants of physical activity and gadgets use amongst school-going children (standard 1 st to 10 th ) from an urban area located in central India [version 1; peer review: awaiting peer review] . F1000Research 2024, 13 :402 ( https://doi.org/10.12688/f1000research.147106.1 ) First published: 26 Apr 2024, 13 :402 ( https://doi.org/10.12688/f1000research.147106.1 ) Latest published: 26 Apr 2024, 13 :402 ( https://doi.org/10.12688/f1000research.147106.1 ) Introduction Childhood obesity is a significant public health concern. Obesity is a global problem that affects low- and middle-income countries. 1 Globally, more than 200 million school-aged children are overweight or obesity. 2 Approximately 18.3% of adolescent girls aged between 12 and 17 years in India are overweight or obese. 3 Approximately 39 million children below the age of five were identified as overweight or obese by 2020. 4 Overweight and obesity develop from unhealthy diets such as drinking cold drinks and eating fast food, missing meals, and eating too few vegetables and fruits. 5 , 6 Physical inactivity, sedentary lifestyle (bad sleeping habits, increased screen time), and improper nutrition are all behaviors that have a direct impact on children’s body weight. 2 , 5 Sedentary behaviors include activities such as using smartphones or tablets, watching television, playing video games, using a computer while in a vehicle, and reading or studying while at rest. 7 The prevalence of childhood obesity is increasing daily in many developing countries, and it is a serious concern in developed countries. 8 The prevalence of childhood and teenage obesity and overweight has significantly increased in India. Non-communicable diseases (NCDs) are associated with a number of risk factors such as smoking, high blood pressure, low fruit and vegetable diet, obesity, low physical activity, and increased cholesterol (WHO). 9 Engaging in physical activity is crucial for regular growth and development, serving as a key factor in averting childhood and adolescent overweight or obesity, while reducing health risks linked to excessive weight. 10 Physical activity is vital for reducing the likelihood of cardiovascular disease, type 2 diabetes, stroke, obesity, depression, dementia, and benign prostatic. India is undergoing economic and nutritional transformation, which is related to changes in food habits, decreased physical activity, and an increase in the number of cases of obesity and overweight. 11 , 12 The rise in fast-food establishments and sedentary behaviors, such as prolonged television viewing and increased computer gaming, has contributed to reduced physical activity levels. 13 , 14 Recently, there has been a significant rise in television watching among young children and teenagers. 1 , 15 There has been an increase in sedentary activity accompanied by a decline in physical exercise participation. Research indicates a correlation between the duration of children’s television viewing and their consumption of highly advertised products, such as sugary cereals, sweetened beverages, and salty snacks. Physical activity is directly associated with children’s healthy weight status, as it increases energy expenditure. 8 Rationale With the Socioeconomic Transition occurring in India, nutrition transition follows, which is connected with a shift in eating preferences, decreased physical activity due to the increasing influence of westernized lifestyle, and an increase in obesity prevalence. Evidence suggests that childhood obesity is a risk factor for Hypertension & Diabetes, obesity, and other non-communicable diseases, including various cancers, in adulthood. In addition, with changes in lifestyle and the advent of gadgets and technology, outdoor sports and physical activity are on decline as compared to outdoor sports and physical activity required appropriate for the age group. The goal of this study was to determine the prevalence of juvenile obesity, physical activity habits, and device usage (display time) among children in grades 1 through 10, as well as the viewpoints of their parents. The study findings will help us understand the current situation of childhood obesity and physical activity in study participants, as well as to sensitize and motivate parents for needful corrective measures and, finally, for healthcare professionals to make further interventions and strategies for prevention. Aim and objectives Aim To Determine the prevalence of childhood obesity and the pattern of physical activity among school-going children (1 st to 10 th std). Objectives 1) To Estimate the prevalence of childhood obesity among school-going children (std 1 st –10 th ) from an urban area in central India. 2) To assess the pattern of physical activity amongst study participants. 3) To Estimate the gadget use (screen time) amongst study participants. 4) To assess the perceptions of parents of school-going children regarding physical activity, dietary practices, and gadget use among their children. Methods 1) Study design: The study will be a Cross-sectional study with a Mixed method Component. 2) Study setting/place: The present study will be conducted in the urban field practice area of a tertiary care medical college hospital. 3) Study participant/population: School-going children from school (1 st to 10 th ) from urban field practice. Eligibility criteria Inclusion criteria: Parents whose children were willing to provide consent and engage in the study were included in the study’s inclusion criteria. Exclusion criteria: Children who are mentally or physically handicapped and seriously ill will be excluded from the study. 4) Sample size: N = Z 1 − α / 2 2 ∗ p ∗ ( 1 − p ) d 2 . Alpha ( α ) = 0.05 Estimated proportion ( p ) = 0.243 Estimated error ( d ) = 0.05 Estimated sample size = 283 5) Sampling method: A systematic random sampling method will be used to select households from the study area, and the interview technique will be used to collect data using a pre-tested semi-structured data collection tool. Variables Variables such as sociodemographic information, pattern of physical activity, obesity index, screen time, and intake of junk food. Key parameters Variables Data sources Data collection methods Demographic variable • Name • Age • Sex • Education • Religion Parents of study participants (Students from standard 1-10 th Std) Interview method using semi structured validated pretested Questionnaire in kobo online tool. Pattern of Physical activity • Walking/Running activity • Cycling • Exercise • Swimming activity • Any other Indices for obesity • Height • Weight • BMI • Hip and waist circumference • Abdominal circumference Screen time • TV • Laptop • Mobile • Tablet • Other Intake of junk food • Pizza • Burger • Chinese food • Chips • Soft drinks • Others Data collection procedure The study will be conducted using an interview technique with a semi-structured validated questionnaire using the kobo collection online tool. Data analysis plan Data collected will be entered and transferred to Microsoft Excel Spreadsheet from the Kobo toolbox to analyze the data, and the statistical product and service solution R-statistical software ( R: The R Project for Statistical Computing (r-project.org) ) will be utilized . The full analysis dataset will include all study participants with no missing values for all the parameters in the dataset. The study subjects will be participants who fulfill the inclusion and exclusion criteria. Primary variables: Physical activity. Secondary variables: Gadgets application and duration. All data will be summarized with baseline characteristics for demographic variables described by frequency and percentage for categorical data and with mean and standard deviation for continuous data. Outcome variables will be analyzed over continuous variables and summarized with the minimum, maximum, mean, standard deviation, standard error, and 95% CI for parametric data. Data for the continuous outcome variables were first tested using the Kolmogorov – Smirnov test at a 5% level of significance (P ≤ 0.05). If the data are rejected, they will be regarded as normal; otherwise, a nonparametric test will be employed to determine significance. ANOVA will be performed to determine the difference in significance at the 5% level (P = 0.05) for the comparison groups comprising various BMI categories. Non-normal data will be described by the mean, median, lower, and upper quartiles for nonparametric tests. It will be used to test significance using the Kruskal–Wallis test. Categorical variables will be summarized as frequency (N) and percentage values (%). Efficacy over the categorical variable will be analyzed using chi-square analysis to determine efficacy. All confounding variables were analyzed using a multivariate analysis. Discussion According to the World Health Organization (WHO), a lack of physical activity results in 1.9 million deaths globally, while being overweight or obese causes at least 2.6 million deaths. 16 Bhattad et al. (2023) conducted a school-based cross-sectional study on the prevalence of overweight and obesity in school-going children in Govt & Private schools in Latur District, Maharashtra. This study found that the prevalence rates of obesity and overweight were 5.0% and 9.8%, respectively. They concluded that boys were more obese and overweight than girls were. 17 Grace et al. (2021) conducted a case-control study in Chengelpet district, Tamil Nadu, of urban areas on obesity and physical activity among children in urban areas. This study involved school-going children aged 10–17 years and observed inadequate physical activity in 30.9% of controls and 73.6% of cases. There was also a regular habit of watching television while eating food in about 68.2% of controls and 83.6% of cases. Inadequate physical activity, sedentary behavior, and watching television while eating food were found to be associated with obesity. 18 Dabade et al. (2019) conducted a community-based cross-sectional study on the prevalence of overweight and obesity among school-going children in Satara District, Maharashtra. The research found that out of the 360 participants (185 boys and 175 girls), 12.97% of the male population and 9.14% of the female population were overweight or obese. A direct relationship was also observed between a history of obesity in the family, less sleeping time, and the working status of mothers with childhood obesity. 19 Kumari Veena Sinha (2019) conducted the study which was a cross-sectional community study in the Urban Health Training Centre’s Field Practice Area on the occurrence of obesity in Indian adolescent school-going children in urban areas. According to this study, among adolescents aged 10–19 years, 18.5% were overweight and 5.8% were obese. In addition, overweight and obesity were prevalent in 24.3% of the study population. 12 The incidence of overweight and obesity in school-age children in the Multan area was also the subject of a descriptive cross-sectional study by Khan S, Abbas A, et al. (2019). According to this study, approximately 10% and 5% of school-going children aged group (3 – 18 yrs) suffer from overweight and obese, respectively. This study found that fast food was directly associated with overweight and obesity, which was 36.5%, and also observed that children who were more physically active were not associated with overweight and obesity. Approximately 61.2% of children use television, mobile phones, and computers. 5 Saikia et al. (2016) conducted a school-based cross-sectional study on the prevalence of overweight and obesity and their relationship with physical activity in Dibrugarh town. The study observed that 20.4% and 10.3% of boys and 24.9% and 9.7% of girls were overweight and obese, respectively. The study also used the Global Physical Activity Questionnaire for physical activity where it has been seen that boys are more involved in activity than girls (68.7% and 58.1%). In sedentary activity, girls spend more hours than boys (18.2%) and (11.3%, respectively). 2 Rexlin et al. (2016) conducted a cross-sectional observational study on school-going children in Madurai. The children were recruited from two rural and two urban schools. The study observed that the prevalence rates of overweight and obesity were 16.8% and 9.3%, respectively. Mahajan et al. (2011) conducted a school-based cross-sectional study of all four regions of Puducherry. Children aged 6–12 years were involved. The study observed that the prevalence rates of obesity and overweight among children were 2.12% and 4.41%, respectively. Obesity and overweight were prevalent in 4.69% and 8.66% of the four regions, respectively. 20 Study data/tools The tool will be an online questionnaire accompanied by a consent form. The questionnaire will be created using a KoboToolbox . The questionnaire are closed ended and pre-tested. The question has been taken from the Global Physical Activity Questionnaire (GPAQ). 2 The questionnaire consisted of five parts. The first part will be socio-demographic data (name, age sex, religion), the second part will be a physical activity questionnaire (walking, exercise swimming, etc.), the third part will be a parameter of obesity detection like (height, weight, BMI, waist and hip circumference and), the fourth part will be screen time, and the fifth part will be intake of junk food. Bias: There may be Recall bias, Information bias, Social desirability bias. Ethics statement The study protocol was approved by the Institutional Ethics Committee, vide letter number DMIHER (DU)/IEC/2023/40, date of approval: 20/12/2023. Written Informed consent shall be taken prior to the study and also will explain study objectives to participants. While conducting interviews, privacy shall be maintained, and data shall be utilized only for academic purposes. Expected outcomes/results The study will generate evidence regarding the existing pattern of physical activity, use and duration of screen time, and prevalence of obesity among study participants along with perceptions of their parents and caregivers regarding the same. Implications of study 1) Determining obesity prevalence its determinants and perceptions shall also lead to sensitization of study participants & their parents 2) Evidence generated shall help plan intervention strategies at Family level and policy level for corrective measures. Limitation 1) The study only focuses on school going children from 1 st to 10 th std from defined area. 2) The study is conducted in urban area so its findings shall have limited external validity. Data availability statement No data associated with this article Extended data Figshare: STROBE Checklist for “A Mixed Method study to determine the prevalence of childhood obesity and determinants of physical activity and Gadgets use amongst school-going children (standard 1st to 10th) from an urban area located in central India”. http://doi.org/10.6084/m9.figshare.25347394.v1 . 21 Licence: CC BY 4.0 References 1. Sahoo K, Sahoo B, Choudhury A, et al. : Childhood obesity: causes and consequences. J. Family Med. Prim. Care. 2015 Apr 8; 4 : 187–192. PubMed Abstract | Publisher Full Text 2. Saikia D, Ahmed SJ, Saikia H, et al. : Overweight and obesity in early adolescents and its relation to dietary habit and physical activity: A study in Dibrugarh town. Clin. Epidemiol. Glob. Health. 2016 Jan 1; 4 : S22–S28. Publisher Full Text 3. Seema S, Rohilla KK, Kalyani VC, et al. : Prevalence and contributing factors for adolescent obesity in present era: Cross-sectional Study. J. Family Med. 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Wang S, Sun Q, Zhai L, et al. : The Prevalence of Depression and Anxiety Symptoms among Overweight/Obese and Non-Overweight/Non-Obese Children/Adolescents in China: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health. 2019 Feb; 16 (3): 340. PubMed Abstract | Publisher Full Text | Free Full Text 14. Shang X, Li Y, Liu A, et al. : Dietary Pattern and Its Association with the Prevalence of Obesity and Related Cardiometabolic Risk Factors among Chinese Children. PLoS One. 2012 Aug 14; 7 (8): e43183. PubMed Abstract | Publisher Full Text | Free Full Text 15. Bhadoria A, Kapil U: Television viewing and overweight and obesity amongst children. Biom. J. 2014; 37 (5): 337. 16. Dobbins M, Husson H, DeCorby K, et al. : School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst. Rev. 2013 Feb 28; 2013 (2): CD007651. PubMed Abstract | Publisher Full Text 17. Bhattad S, Bhattad S, Kendre V, et al. : Prevalence of overweight and obesity in school going children: A community based cross sectional study from Latur, Maharashtra. Int. J. Life Sci. Biotechnol. Pharma. Res. 2023 Jul-Sep; 12 (3): 107–111. 18. Angeline Grace G, Edward S, Gopalakrishnan S: A Case Control Study on Physical Activity and Obesity among Adolescent Children in an Urban Area of Tamilnadu. Nat. J. Community Med. 2021 Nov 30; 12 (11): 345–349. Publisher Full Text 19. Dabade S, Dabade K: Prevalence of overweight and obesity among school-going children of Satara district, Maharashtra. Natl. J. Physiol. Pharm. Pharmacol. 2019; 9 (3): 1. Publisher Full Text 20. Mahajan PB, Purty AJ, Singh Z, et al. : Study of Childhood Obesity Among School Children Aged 6 to 12 Years in Union Territory of Puducherry. Indian J. Community Med. 2011; 36 (1): 45–50. PubMed Abstract | Publisher Full Text | Free Full Text 21. Umekar S: STROBE Checklist for “A Mixed Method study to determine the prevalence of childhood obesity and determinants of physical activity and Gadgets use amongst school-going children (standard 1st to 10th) from an urban area located in central India.” figshare. Online resource. 2024. Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 26 Apr 2024 ADD YOUR COMMENT Comment Author details Author details 1 School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, 442001, India 2 Department of Community Medicine, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, 442001, India Sayali umekar Roles: Conceptualization, Formal Analysis, Visualization, Writing – Review & Editing Dr. Abhishek Joshi Roles: Supervision, Validation, Writing – Original Draft Preparation Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 26 Apr 2024, 13:402 https://doi.org/10.12688/f1000research.147106.1 Copyright © 2024 umekar S and Joshi DA. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article umekar S and Joshi DA. 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Register $(document).ready(function () { signIn.createSignInAsRow($("#sign-in-form-gfb-popup")); $(".target-field").each(function () { var uris = $(this).val().split("/"); if (uris.pop() === "login") { $(this).val(uris.toString().replace(",","/")); } }); });