Association between overweight and obesity and school asset for physical activity

Abstract

Introduction: Obesity is a global public health concern which carries a heavy burden to society. School-based interventions tackling obesity during childhood and early adolescence were more successful than in later life. However, the asset for physical activity (PA) varies from school to school and it is unknown whether such variation plays a role. This study, therefore, aims to explore the relationship between overweight and obesity and school PA assets. Methods: Structured questionnaires based on previous literatures were sent to all primary and secondary school physical education (PE) teachers to survey their PA related attitude and experience and school PA environment. These items compiled three school PA asset index scores (teacher attitude, experience and school environment). Students’ individual height and weight data of the participating schools were then retrieved from the Student Health Service database of the local government, which covers majority of students in the region. Overweight and obesity were defined according to the International Obesity Task Force (IOTF) criteria. Results: The study utilised 215,538 student growth records and 1,174 teacher survey responses from 438 schools (45% of region total) in Hong Kong. Modelled with a multilevel logistic additive regression, we found that negative teacher attitude towards PA (OR = 1.22, p < 0.01) and poorer school PA environment (OR = 1.11, p < 0.01) associated with higher odds of overweight and obesity whereas PA teaching experience was a protective factor with OR = 0.86 (p < 0.01). Conclusion: Students’ overweight and obesity status were associated with school PA assets, including PE teachers’ attitude, experience and school environment. Further interventions should consider targeting these assets.