Assess the Effectiveness of School-Based Interventions on Obesity-Related Behaviours among Children And Adolescents (5-19 Years Old) in Saudi Arabia: A Systematic Review

Abstract

Background: Childhood obesity poses a public health concern in Saudi Arabia. School-based interventions have been recommended to modify obesity-related behaviours in children and adolescents. Nevertheless, their effectiveness remains unclear, particularly in Saudi Arabia. Aim: This review examined the effectiveness of school-based interventions in positively changing obesity-related behaviour and/or BMI/BMI-Z in Saudi Arabia. The review also attempted to identify the characteristics of the intervention that contributed to its success. Methods: Six databases were searched: Medline (EBSCO host), PsycINFO (EBSCO host), SPORTDiscus (EBSCO host), Education Research Complete (EBSCO host), EMBASE, and Web of Science. Google Scholar was searched for unpublished studies, and reference lists were reviewed by hand. This review included all study designs from inception written in English, aimed at children or adolescents aged 5-19 in Saudi Arabia who received a school-based intervention and reported at least one obesity-related behaviour outcome and/or BMI/BMI-Z. Studies were assessed using the EPHPP quality assessment tool. Findings: Eight studies met the inclusion criteria and were incorporated into a narrative synthesis. 75% of the studies were performed on female participants and 50% on intermediate school students aged 12-15. About 63% of the studies focused on Saudi Arabia's Western region. The duration of the interventions varied from two days to six months. Various intervention approaches are employed in Saudi schools, including environmental modification, educational, behavioural, and sporing interventions. 63% of the interventions were theoretically based. Parents were included in 38% of the studies. Obesity-related behaviours were measured subjectively in most interventions. BMI/BMI-Z was measured using various reference charts. Five studies used multi-component approaches, with 60% achieving positive results. Three studies used single-component approaches, with 67% achieving positive results. Discussion: According to this review, 75% of Saudi Arabian school-based interventions improved obesity-related behaviours or BMI/BMI-Z. Therefore, Saudi Arabian schools could be a focal point for preventing obesity and promoting healthy behaviour. The effectiveness of multi-component interventions in Saudi schools is comparable to single-component interventions. It appears that duration is not a factor in the effectiveness of interventions targeted at the personal level. Also, this study indicated that interventions based on theoretical bases and involving parents are likely effective. Conclusion & Recommendations: This review indicates that most interventions implemented in Saudi schools have successfully modified children and adolescents' obesity-related behaviours and/or BMI/BMIZ. However, school-based interventions are limited in Saudi Arabia, with considerable heterogeneity. The strengths and limitations of the included interventions may have influenced the outcomes. Therefore, health promotion and prevention efforts should be improved methodologically and consider previous experiences when developing evidence-based interventions. In addition, long-term school-based interventions are necessary to evaluate the true impact of these interventions on childhood and adolescent obesity in Saudi Arabia. Implications for public health and health promotion: School-based interventions are suggested as a strategic approach to positively change obesity-related behaviours among children and adolescents. Schools are crucial to health promotion and can be especially beneficial in Saudi Arabia, given the high obesity rate. Investing in school-based interventions can help create a healthier generation of students equipped to make informed decisions and lead healthier lives.