
Title: Determination of school-based contextual factors and their associations with the prevalence of overweight and obese children
Author: Williams , Andrew James
Awarding Body: Exeter and Plymouth Peninsula Medical School
Current Institution: Exeter and Plymouth Peninsula Medical School
Date of Award: 2013
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The rising prevalence of overweight and obese children has seen a focus upon school-based interventions. However, little research has considered the impact of the school context on pupil weight status. The aim of this project was to identify whether primary schools have an impact upon pupil weight status, and subsequently explore which, if any, school-based contextual factors were associated with pupil weight status. Reviewing the relevant literature identified two gaps in the evidence related to primary school built environment and policy, and weight status, which were examined through systematic reviews. These reviews highlighted the paucity of literature on the school influence on pupil weight status, demonstrating the need for more research. Subsequently, the main component of the research was a repeated cross-sectional study using secondary data from the National Child Measurement Programme and additional sources. The reviews highlighted the need for studies to examine multiple contexts simultaneously, and although restricted to the school, sufficient data were available to examine the socio-demographic, built environment, physical activity, diet and ethos contexts of schools. The final data set comprised 62,554 participants, over 300 schools and 40 potential explanatory variables across five academic years (2006/07 - 2010/11). Both continuous and binary measures of weight status were assessed using national and international definitions and each academic year was analysed separately. Multilevel modelling allowed the estimation of how much of the variation in pupil weight status related to differences between schools and between-year groups within-schools, both of which were found to be small (intraclass correlation coefficient <0.03 (body mass index standard deviation score and overweight), -0.05 (obesity)). It was not possible to differentiate between schools. Primarily only two school-based contextual factors were statistically significant predictors in each academic year, mostly related to the socioeconomic status and ethos of the school; however these did not remain consistent across academic years. The small impact of schools, led to the consideration of whether the shared experience of attending school 'stabilised' children's growth.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available