@article{aa777048935c4c049da5aaeda5e08c92,
title = "Nutrition and physical activity related school environment/policy factors and child obesity in China: a nationally representative study of 8573 students in 110 middle schools",
abstract = "Background: Obesity is a serious threat to global health. School is a key setting for obesity intervention. Research on school risk factors for child obesity is limited in developing countries. Objectives: To examine regional variations in obesity and school environments/policies and their associations among students in China. Methods: Analyses were based on the first nationally representative sample of 8573 9th graders in 110 middle schools from 28 regions across China. Multilevel models tested associations between school factors and child self-reported weight outcomes and by school urbanicity setting (urban, rural). Results: Overweight/obesity rate is higher among boys and in urban areas. Schools in rural areas, or less developed regions, promote longer on-campus life, as is indicated by the presence of school cafeterias, night study sessions and longer class hours. Multilevel models show that (i) school cafeterias (OR = 2.53, 95% CI = 1.35–4.75) and internet bars close to school (OR = 1.63, 95% CI = 1.15–2.30) are associated with increased overweight/obesity risk in rural areas, especially for boys; (ii) school night study sessions are associated with lower overweight/obesity risk (OR = 0.69, 95% CI = 0.50–0.96) in rural areas. Conclusions: China has large regional disparities in school environment/policies related to nutrition and physical activity. Some school factors are associated with students' weight status, which vary across gender and areas. Future school-based interventions should attend to diverse regional contexts.",
keywords = "Child obesity, China, school environment, school policy",
author = "M. Li and H. Xue and M. Wen and W. Wang and Y. Wang",
note = "Funding Information: The present study is funded by the U.S. National Institute of Health (NIH, U54 HD070725). The U54 project (U54 HD070725) is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the Office of the Director, National Institutes of Health (OD). The data collection was funded by the Renmin University of China. The content of the paper is solely the responsibility of the authors and does not necessarily represent the official views of the funders. We thank all of the study participants and school personnel who participated in the data collection. The content of the paper is solely the responsibility of the authors and does not necessarily represent the official views of the funders. None of the authors has been paid to write this article by a pharmaceutical company or other agency. Youfa Wang initially conceived the research idea, directed the study, secured research funding and provided administrative support. Miao Li designed the study, performed data management and analysis and drafted the manuscript. Hong Xue, Weidong Wang and Ming Wen advised on study design, contributed to data interpretation and critically revised the manuscript. Weidong Wang directed the field data collection. All coauthors read and approved the final manuscript. Funding Information: The present study is funded by the U.S. National Institute of Health (NIH, U54 HD070725). The U54 project (U54 HD070725) is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the Office of the Director, National Institutes of Health (OD). The data collection was funded by the Renmin University of China. The content of the paper is solely the responsibility of the authors and does not necessarily represent the official views of the funders. We thank all of the study participants and school personnel who participated in the data collection. Publisher Copyright: {\textcopyright} 2016 World Obesity Federation",
year = "2017",
month = dec,
doi = "10.1111/ijpo.12169",
language = "English (US)",
volume = "12",
pages = "485--493",
journal = "Pediatric Obesity",
issn = "2047-6302",
publisher = "Wiley-Blackwell for the International Association for the Study of Obesity",
number = "6",
}