Journal of Youth and Adolescence

, Volume 40, Issue 3, pp 361–372 | Cite as

A Multi-Level Examination of the Association Between Older Social Models in the School Environment and Overweight and Obesity Among Younger Students

Empirical Research

Abstract

Few studies have examined how school characteristics are associated with obesity. The purpose of this study was to examine the student- and school-level characteristics associated with being overweight and obese among 12,049 students in grades 9 and 10 (junior students) attending 76 secondary schools in Ontario, Canada. The sample was 49.2% female and the average age was 14.7 years. Overall, 15.0% of the sample was considered overweight and 6.3% of the sample was considered obese. Multi-level regression analysis revealed significant between-school random variation for the likelihood of a junior student (grade 9 or 10) being overweight or obese. For each 1% increase in the prevalence of obese senior students (grade 11 and 12) at a school, the odds of a junior student at that school being overweight or obese increased significantly. Important student-level characteristics included physical activity, screen time sedentary behaviour (e.g., watching television), participation in varsity sports and gender. Future research should evaluate if the optimal population level impact for school-based obesity prevention programming might be achieved by targeting the schools that are putting students at the greatest risk.

Keywords

Obesity Body mass index (BMI) Physical activity Sedentary behaviour Youth Multi-level model 

Notes

Acknowledgments

Data used in this analysis were drawn from the SHAPES-Ontario project, funded by the Ontario Ministry of Health and Long-Term Care/Ministry of Health Promotion and by Cancer Care Ontario (grant awarded to S. Leatherdale and S. Manske). The project was conducted by the Population Health Research Group at the University of Waterloo, with in-kind contributions from participating Public Health units. The concept for the SHAPES data collection and feedback system was developed by the Canadian Cancer Society’s Centre for Behavioural Research and Program Evaluation. Additional support for S. Papadakis on this project was provided from a Learning Opportunities Grant through the Interdisciplinary Capacity Enhancement (ICE) team of Dr. Paul McDonald (PI) at the University of Waterloo funded by the Canadian Tobacco Control Research Initiative (CTCRI). Dr. Leatherdale is a Cancer Care Ontario Research Chair in Population Studies. This manuscript (or corresponding data) have not been published elsewhere or are under consideration for publication elsewhere and none of the authors have any conflicts of interest to report related to this work.

References

  1. American Dietetic Association. (2006). Position of the American Dietetic Association: Individual-, family-, school-, and community-based interventions for pediatric overweight. Journal of the American Dietetic Association, 106, 925–945.CrossRefGoogle Scholar
  2. Anderson, P. M., & Butcher, K. E. (2006). Childhood obesity: Trends and potential causes. Future Child, 16, 19–45.CrossRefPubMedGoogle Scholar
  3. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
  4. Beets, M. W., & Pitetti, K. H. (2005). Contribution of physical education and sport to health-related fitness in high school students. Journal of School Health, 75, 25–30.CrossRefPubMedGoogle Scholar
  5. Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.Google Scholar
  6. Burgeson, C. R., Wechsler, H., Brener, N. D., Young, J. C., & Spain, C. G. (2000). Physical education and activity: Results from the School Health Policies and Programs Study 2000. Journal of School Health, 71, 279–293.CrossRefGoogle Scholar
  7. Cameron, R., Brown, K. S., et al. (1999). Effectiveness of a social influences smoking prevention program as a function of provider type, training method, and school risk. American Journal of Public Health, 89, 1827–1831.CrossRefPubMedGoogle Scholar
  8. Centers for Disease Control and Prevention. (2004). Surveillance summaries, May 21, 2004. Morbidity and Mortality Weekly Reports 53, SS-2.Google Scholar
  9. Centers for Disease Control and Prevention. (2006). BMI—body mass index: About BMI for children and teens.Google Scholar
  10. Colditz, G., DeJong, W., Hunter, D., Trichopoulos, D., & Willett, W. (1996). Harvard report on cancer prevention. Volume 1: Causes of human cancer. Cancer Causes and Control, 7, S3–S58.CrossRefGoogle Scholar
  11. Coleman, K. J., Tiller, C. L., et al. (2005). Prevention of the epidemic increase in child risk of overweight in low-income schools: The El Paso coordinated approach to child health. Archives of Pediatric and Adolescent Medicine, 159, 217–224.CrossRefGoogle Scholar
  12. Dietz, W. H. (1998). Health consequences of obesity in youth: Childhood predictors of adult disease. Pediatrics, 101, 518–525.PubMedGoogle Scholar
  13. Faulkner, G., & Goodman, J. (2007). Participation in high school physical education—Ontario, Canada, 1999–2005. Morbidity and Mortality Weekly Reports, 26, 52–54.Google Scholar
  14. Flegal, K. M., Graubard, B. I., Williamson, D. F., & Gail, M. H. (2005). Excess deaths associated with underweight, overweight, and obesity. Journal of the American Medical Association, 293, 1861–1867.CrossRefPubMedGoogle Scholar
  15. Flegal, K. M., Tabak, C. J., & Ogden, C. L. (2006). Overweight in children: Definitions and interpretation. Health Education Research, 21, 755–760.CrossRefPubMedGoogle Scholar
  16. Forshee, R. A., Anderson, P. A., & Storey, M. L. (2004). The role of beverage consumption, physical activity, sedentary behavior, and demographics on body mass index of adolescents. International Journal of Food Sciences and Nutrition, 55, 463–478.CrossRefPubMedGoogle Scholar
  17. Irving, H. M., Adlaf, E. M., Allison, K. R., Paglia, A., Dwyer, J. J., & Goodman, J. (2003). Trends in vigorous physical activity participation among Ontario adolescents. Canadian Journal of Public Health, 94, 272–274.Google Scholar
  18. Janssen, I., Katzmarzyk, P. T., et al. (2005). Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns. Obesity Reviews, 6, 123–132.CrossRefPubMedGoogle Scholar
  19. Johnston, L. D., Delva, J., & O’Malley, P. M. (2007). Sports participation and physical education in American secondary schools: Current levels and racial/ethnic and socioeconomic disparities. American Journal of Preventive Medicine, 33, s195–s208.CrossRefPubMedGoogle Scholar
  20. Leatherdale, S. T., Cameron, R., Brown, K. S., Jolin, M., & Kroeker, C. (2006a). The influence of friends, family and older peers on smoking among elementary school students: Low risk students in high risk schools. Preventive Medicine, 42, 218–222.CrossRefPubMedGoogle Scholar
  21. Leatherdale, S. T., & Manske, S. (2005). The relationship between student smoking in the school environment and smoking onset in elementary school students. Cancer Epidemiology, Biomarkers and Prevention, 14, 1762–1765.CrossRefPubMedGoogle Scholar
  22. Leatherdale, S. T., Manske, S., & Kroeker, C. (2006b). Sex differences in how senior student’s influence junior student smoking behaviour. Addictive Behaviors, 31, 1308–1318.CrossRefPubMedGoogle Scholar
  23. Leatherdale, S. T., Manske, S., Wong, S., & Cameron, R. (2009). Integrating research, policy and practice in school-based physical activity prevention programming: The school health action, planning and evaluation system (SHAPES) physical activity module. Health Promotion Practice, 10, 254–261.CrossRefPubMedGoogle Scholar
  24. Leatherdale, S. T., McDonald, P. W., Cameron, R., & Brown, K. S. (2005). A multi-level analysis examining the relationship between social influences for smoking and smoking onset. American Journal of Health Behavior, 29, 520–530.PubMedGoogle Scholar
  25. Leatherdale, S. T., & Wong, S. L. (2008). Modifiable characteristics associated with sedentary behaviours among youth. International Journal of Pediatric Obesity, 3, 93–101.CrossRefPubMedGoogle Scholar
  26. Lowry, R., Wechsler, H., Galuska, D. A., Fulton, J. E., & Kann, L. (2002). Television viewing and its association with overweight, sedentary lifestyle, and insufficient consumption of fruits and vegetables among US high school students: Differences by race, ethnicity, and gender. Journal of School Health, 72, 413–421.CrossRefPubMedGoogle Scholar
  27. Marshall, S. J., Biddle, S. J., Gorely, T., Cameron, N., & Murdey, I. (2004). Relationships between media use, body fatness, and physical activity in children and youth: A meta-analysis. International Journal of Obesity Related Metabolic Disorders, 28, 1238–1246.CrossRefGoogle Scholar
  28. Marshall, S. J., Gorely, T., & Biddle, S. J. H. (2006). A descriptive epidemiology of screen-based media use in youth: A review and critique. Journal of Adolescence, 29, 333–349.CrossRefPubMedGoogle Scholar
  29. McMurray, R. G., Ring, K. B., et al. (2004). Comparison of two approaches to structured physical activity surveys for adolescents. Medicine and Science in Sports and Exercise, 36, 2135–2143.PubMedGoogle Scholar
  30. Murnaghan, D. A., Leatherdale, S. T., Sihvonen, M., & Kekki, P. A. (2008). A multilevel analysis examining the association between school-based smoking policies, prevention programs and youth smoking behavior: Evaluating a provincial tobacco control strategy. Health Education Research, 23, 1016–1028.CrossRefPubMedGoogle Scholar
  31. O’Malley, P. M., Johnston, L. D., Delva, J., Bachman, J. G., & Schulenberg, J. E. (2007). Variation in obesity among American secondary school students by school and school characteristics. American Journal of Preventive Medicine, 33, S187–S194.CrossRefPubMedGoogle Scholar
  32. Ogden, C. L., Flegal, K. M., et al. (2002). Prevalence and trends in overweight among US children and adolescents, 1999–2000. Journal of the American Medical Association, 288, 1728–1732.CrossRefPubMedGoogle Scholar
  33. Potter, B. K., Pederson, L. L., Chan, S. S. H., Aubut, J. L., & Koval, J. J. (2004). Does a relationship exist between body weight, concerns about weight, and smoking among adolescents? An integration of the literature with an emphasis on gender. Nicotine & Tobacco Research, 6, 397–425.CrossRefGoogle Scholar
  34. Rasbash, J., Browne, W., Healy, M., Cameron, B., & Chalton, C. (2005). MLwiN version 2.02. Multilevel Models Project: Institute of Education.Google Scholar
  35. Serdula, M. K., Ivery, D., Coates, R. J., Freedman, D. S., Williamson, D. F., & Byers, T. (1993). Do obese children become obese adults? A review of the literature. Preventive Medicine, 22, 167–177.CrossRefPubMedGoogle Scholar
  36. Shields, M. (2006). Overweight and obesity among children and youth. Health Reports, 17, 27–42.PubMedGoogle Scholar
  37. Singh, A. S., Paw, M. J., Brug, J., & van Mechelen, W. (2007). Short-term effects of school-based weight gain prevention among adolescents. Archives of Pediatric and Adolescent Medicine, 161, 565–571.CrossRefGoogle Scholar
  38. Storey, M. L., Forshee, R. A., Weaver, A. R., & Sansalone, W. R. (2003). Demographic and lifestyle factors associated with body mass index among children and adolescents. International Journal of Food Sciences and Nutrition, 54, 491–503.CrossRefPubMedGoogle Scholar
  39. Tomeo, C. A., Field, A. E., Berkey, C. S., Colditz, G. A., & Frazier, A. L. (1999). Weight concerns, weight control behaviors, and smoking initiation. Pediatrics, 104, 918–924.CrossRefPubMedGoogle Scholar
  40. United States Department of Health and Human Services. (2001). The surgeon general’s call to action to prevent and decrease overweight and obesity. Rockville, MD: USDHHS, Public Health Services, Office of the Surgeon General.Google Scholar
  41. Veugelers, P. J., & Fitzgerald, A. L. (2005a). Prevalence of and risk factors for childhood overweight and obesity. Canadian Medical Association Journal, 13, 607–613.CrossRefGoogle Scholar
  42. Veugelers, P. J., & Fitzgerald, A. L. (2005b). Effectiveness of school programs in preventing childhood obesity: A multilevel comparison. American Journal of Public Health, 95, 432–435.CrossRefPubMedGoogle Scholar
  43. Wong, S. L., & Leatherdale, S. T. (2009). Association between sedentary behaviour, physical activity, and obesity: Inactivity among active kids. Preventing Chronic Diseases, 6, 1–13.Google Scholar
  44. Wong, S. L., Leatherdale, S. T., & Manske, S. (2006). Reliability and validity of a school-based physical activity questionnaire. Medicine and Science in Sports and Exercise, 38, 1593–1600.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of Population Studies and SurveillanceCancer Care OntarioTorontoCanada
  2. 2.Department of Health Studies and GerontologyUniversity of WaterlooWaterlooCanada
  3. 3.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada

Personalised recommendations