A tutto GAS “Gioco, Amici, Salute” project. Effect of a school-based physical activity programme on health and fitness in 9-12 year olds children for the prevention of obesity.

The research project aims to demonstrate the effect of a school-based physical activity program based on an ecological approach. The indicators used are related to the physical fitness, to the anthropometric characteristics, academic achievement and lifestyle of children attending the last years of primary school and the first year of secondary school of I grade. The preliminary bibliographic survey has highlighted the state of knowledge about the prevalence of childhood obesity, the relationship among obesity, motor performance, academic achievement and the effectiveness of programs for the prevention and treatment of this phenomenon in the school. The evidences of scientific literature assign to the physical inactivity and overweight / obesity in children a significant role in the increase in diseases (WHO, 2000; CDC, 2003). The ecological approach and increment physical activity are considered as effective ways that have yet to be transformed into good practice demonstrated in various scholastic contexts (DL Katz, 2009; Jennifer L Foltz, 2012). The research was conducted in three comprehensive schools in the city of Verona, in the Veneto region. The schools involved are part of the 1st district (IC 20 S. Michele Extra, IC 21 Madonna di Campagna) and the 7th district (IC 18 Veronetta - Port San Pancrazio). Participants: We involved the 682 students attending at 4 or 5 class of primary school and 1 class of secondary school of I level in the three comprehensive institutes involved. The families who have given informed consent to participate in the project were 189, 126 completed the questionnaire but they have not given the consent to participation and 315 families have not given any response. The research aims to examine in detail the following objectives: 1.Identify the anthropometric characteristics and lifestyle of the population involved. 2.Analyze the effect of the program, during six months, on the anthropometric parameters BMI, sum of skinfolds, waist circumference and hip ratio / life. 3.Evaluate the possible improvement of the aerobic fitness and motor skills of strength, resistance strength, flexibility and balance. 4.Determine the influence of the physical activity program on some psychological parameters in relation to the motor self-efficacy and motivation towards physical activity. 5.Study the correlation among different anthropometric parameters, physical capacities and behaviors related to lifestyle. 6.Analyze the possible relationships among academic performance, physical capacities and body weight 7.Evaluate the effect of the program on the lifestyle at follow-up (6 months after the post-training) 8.Study the effect of the program in children of normal weight and overweight The various analyzes were addressed to 189 students (9-12 years old) and their parents who have declared an intention to participate in the project and they were randomly assigned to the Intervention Group (IG - 107 children) and the control group ( CG - 82 children). The protocol of the program, included the following activities for children and parents: Additional activities for students: -Two extracurricular sessions of physical activity per week, during 60 minutes each session, in addition to the time of physical education provided by the ministry. The main contents of the proposed activities were exercises, games and sports, that aimed to improve the physical capacities (balance, strength, speed, flexibility) of children. Motor activities were also aimed to enhance the pleasure and enjoyment to encourage the participation of the children in physical activity during the period of the program and also to motivate them to maintain an active lifestyle in the future. -Three training sessions on lifestyle (physical activity practice and healthy eating). Activities for parents: -Three meetings of counseling service separated from children, about the strategies to increase the active lifestyle in their children. Education topic of the materials presented in three sessions were: -Presentation the objects and the evaluation model of the project and the different phases of its, during 6 months. -Benefits of Eating Well and Being Physically Active for the growth and the prevention of childhood obesity. -Presentation of examples to became “more active”, in different moment of the day (games and activities to do alone or with parents or friends) -Presentation of instruments to evaluate the change in physical activity and to increase the motivation in the physical activity (for example: pedometer, diary of physical activity..). The materials and methods for assessment include the use of different instruments: Initial questionnaire to investigate the willingness of families to participate in the project, to know demographic characteristics (age, nationality, level of education), anthropometric parameters (weight and height) of behaviors related to lifestyle (amount of physical activity) of students and their parents. -Measurement of BMI with the threshold values, according to Cole (Cole 2000) -Measurement of skinfolds, waist circumference and the waist/hip ratio (Manual by Lohman, 1994) -Motor test for the evaluation of motor development: six minute walking test (Li Yi Au, 2006; Morinder 2008) Flamingo balance test, hand-grip test, sit and reach test, log jump test stand, sit-up test (taken from the battery of tests EUROFIT engines, Council of Europe, 1988). -Questionnaire for the assessment of the amount of physical activity for week (PAQ-C; Crocker, 2004). -Questionnaire for the assessment of motivation towards physical activity (PASCQ; Marcus 2003). -Questionnaire for the assessment of motor self-efficacy (PPA sub-scales; Bortoli, 2006). -Questionnaire for the evaluation of enjoyment of physical activity (PACES; Carraro 2008). -The year-end scholastic report with grades in all scholastic subjects and conduct. The data analysis show a negative relationship between body weight and the physical capacities of balance, strength and endurance, but also between body weight and scholastic performance, in some school subjects like Italian, English, Art, Physical Education, Math. Instead the overweight is not correlated to motivation, enjoyment toward of physical activity practice and the amount of physical activity. Even more important result is the demonstration of the effectiveness of the school-based physical activity programme on several factors related to health and fitness in children. The final data confirm that the anthropometric parameters investigated are all improved for the group that participated to the activities and in particular the body mass index (BMI) improves more in overweight / obese children compared to normal-weight children. After six months of intervention, the normal-weight and overweight children show positive changes in all physical abilities, physical self-perception and the enjoyment of physical activity. The participation at the program also show an improvement of the active lifestyle, showing an increase of the the amount of physical activity practice and motivation towards physical activity. A further aim of the research is to investigate the maintenance of the positive effect due to the program, after the end of the same. In this regard, the results show that after six months from the end of the project occurred a partial reduction in the levels of physical activity and motivation towards physical activity, but they were still higher than those initials. This leads us to think that in order to effectively flight physical inactivity and overweight in school, you should avoid limited and occasional interventions preferring organic interventions and long-term programs.