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The aim of this study was to examine the effects of the Family-Based Health Behavior Development Program (FHEBIP) on obesity risk factors and body mass index (BMI) to prevent the increasing prevalence of overweight and obesity in children. The randomized controlled trial sample consisted of 96 fourth-grade primary school students and their mothers in Aksaray province. Data were collected using questionnaires and the Family Nutrition and Physical Activity Scale, and height and weight measurements were taken. Ethics committee and institutional approvals were obtained.
Obesity is an important public health problem due to the many chronic and non-chronic diseases it causes. It is not only seen in adults, but its prevalence is increasing in children. According to WHO 2018 statistical reports; While the prevalence of overweight (obesity) in children aged 5-19 was 4% in 1975, it increased to 18% in 2016. While 43 million children were obese in 2010, according to 2016 statistics, 340 million children and adolescents were overweight or obese in the world. One in every four children in European countries and one in every three children in the United States of America (USA) are obese.
In the studies conducted by the Ministry of Health, we see that the prevalence of obesity in children increases as the age groups change and the years increase. In order to prevent the increase in the prevalence of obesity, states globally offer various research and development (R&D) studies, incentives and support this with laws and regulations. Turkey, as one of these countries, closely follows the activities and takes part in the projects as a collaborator Although the causes of CBO are not fully known, it is known that many factors play a role in the development of CBO. Although the general mechanism is accepted as the energy intake being higher than the energy expenditure, there are factors that cause or support the development of obesity. Genetic factors, metabolism, hormones, psychological factors, sleep, screen time, socioeconomic level differences, unhealthy eating habits and physical inactivity, perinatal characteristics such as delivery method, birth weight and some environmental factors have been proven by studies to cause obesity. The vast majority of the causes of CBO are external factors (environmental factors) and excess energy intake, while a small portion is made up of biochemical factors such as genetic and endocrine causes. Studies on childhood overweight and obesity indicate four main environmental factors. These factors are nutrition, physical activity, screen time and sleep.
In addition to the many factors that cause obesity, there are also various health problems that obesity brings with it. Children with CSA, in particular, have a higher risk of early onset of chronic diseases such as cardiovascular diseases, diabetes and hypertension, and psychological distress such as anxiety, depression, social stigma and bullying. The variety of factors that cause CSA, the difference in obesity management according to developmental stages in children, basic differences in family factors, the high probability of those who are obese in childhood to become obese in adulthood, chronic diseases caused by CSA and the scarcity of randomized controlled trials (RCTs) in this area indicate that more research with high level of evidence is needed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| FHEBIP applied group | Experimental | The FHEBIP intervention group will be administered a Sociodemographic Information Form, Obesity Risk Factors Form, and FNPA Scale to measure maternal and child knowledge and obesity risk behaviors at pretest, interim, and posttest. The researcher will measure height and weight to calculate body mass index. Unlike the control group, the intervention group will receive motivational interviewing, family nutrition education, physical activity education, screen time education, and sleep education. Reminders and motivational messages appropriate to the educational content will be sent to the intervention group to maintain motivation during the interim and posttest intervals. |
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| Group not receiving FHEBIP | No Intervention | The FHEBIP control group will use the Inclusion Criteria form for the pretest, interim test, and posttest, along with a Sociodemographic Information Form, Obesity Risk Factors Form, and the FNPA Scale to measure maternal and child information and obesity risk behaviors. Children's height and weight will be measured, and their body mass index will be calculated. The control group will not receive any motivational interviews or training. No motivational or reminder messages will be sent during the interim and posttest intervals. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| FAMILY BASED HEALTH BEHAVIOR IMPROVEMENT PROGRAM (FHEBIP) | Behavioral | Unlike other behavior change programs, FHEBIP is designed with a focus on motivational interviewing and play. In addition to being family-based, it aims to increase family time, make that time more productive, and increase family control over the child. |
| Measure | Description | Time Frame |
|---|---|---|
| Body mass İndeks | Changes in Body Mass Index (BMI) will be considered the primary outcome measure. Data will be reported in BMI (kg/m²). | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| FNPA scale score | Changes in FNPA scale scores will be considered a secondary measurement outcome. The total scale score ranges from 20 to 80. As the total scale score approaches 80, obesity risk factor behaviors change in a positive direction. | The FHEBIP implementation period is 6 months. The interventions will be completed after the initial measurements are taken in 1 month. Interim measurements will be taken in the 3rd month, and final measurements will be taken in the 6th month. |
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Inclusion Criteria:
Exclusion Criteria:
Children with genetic disorders: Prader-Willi syndrome, Laurence-Moon-Biedl syndrome, Down syndrome, Cohen syndrome, Carpenter syndrome, Alstrom syndrome, Cowden syndrome, Turner syndrome, and other genetic diseases that cause obesity.
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| Name | Affiliation | Role |
|---|---|---|
| Dilek DAYANIR, ASSOCIATE PROFESSOR | NECMETTİNEU | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kılıçarslan Primary School, Selçuk Primary School, Emlak Kredi Primary School, Kamber Gülüzar Primary School and Hacı Mustafa Demir Primary School | Aksaray | Merkez | 68100 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Result | Yabancı N, Kısaç İ, Karakuş SŞ. The Effects of Mother's Nutritional Knowledge on Attitudes and Behaviors of Children About Nutrition. Procedia- Social and Behavioral Sciences, 2014;116:4477-81. | ||
| 31215768 | Result | Simon SL, Goetz AR, Meier M, Brinton J, Zion C, Stark LJ. Sleep duration and bedtime in preschool-age children with obesity: Relation to BMI and diet following a weight management intervention. Pediatr Obes. 2019 Nov;14(11):e12555. doi: 10.1111/ijpo.12555. Epub 2019 Jun 19. | |
| 24658411 |
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Laws in Türkiye do not allow the sharing of personal data.
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| ICF | No | No | Yes | Informed Consent Form | May 1, 2025 | Mar 31, 2026 |
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The Inclusion Criteria Form, Sociodemographic Information Form, Obesity Risk Factors Form, and the Family Nutrition and Physical Activity Screening Tool (FNPA) will be used to measure maternal and child information and obesity risk behaviors. As a pretest, mothers will be asked to complete the Sociodemographic Information Form, Obesity Risk Factors Form, and the FNPA Scale. The children's height and weight will be measured by the researcher, and their BMI will be calculated. Motivational interviewing and four training modules will be implemented as part of the FHEBIP (Family-Based Health Behavior Improvement Program), and the training will be completed in five weeks. No training will be provided between the interim and final measurements. Mothers will be supported with reminder messages and game suggestions. Mothers will complete the Obesity Risk Factors Form and the FNPA Scale, and the children's body mass index will be calculated (kg/m²).
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No masking.
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| FHEBIP (Family-Based Health Behavior Improvement Program) | Behavioral | Unlike other behavior change programs, FHEBIP is designed with a focus on motivational interviewing and play. In addition to being family-based, it aims to increase family time, make that time more productive, and increase family control over the child. |
|
| Result |
| Muthuri SK, Wachira LJ, Leblanc AG, Francis CE, Sampson M, Onywera VO, Tremblay MS. Temporal trends and correlates of physical activity, sedentary behaviour, and physical fitness among school-aged children in Sub-Saharan Africa: a systematic review. Int J Environ Res Public Health. 2014 Mar 20;11(3):3327-59. doi: 10.3390/ijerph110303327. |
| Result | Landgren K, Quaye AA, Hallström E, Tiberg I. Family-based prevention of overweight and obesity in children aged 2-6 years: a systematic review and narrative analysis of randomized controlled trials. CHILD AND ADOLESCENT OBESITY (CHAO), 2020;3(1):57-104. |
| 29224232 | Result | Foster C, Moore JB, Singletary CR, Skelton JA. Physical activity and family-based obesity treatment: a review of expert recommendations on physical activity in youth. Clin Obes. 2018 Feb;8(1):68-79. doi: 10.1111/cob.12230. Epub 2017 Dec 10. |
| 30515995 | Result | Bean MK, Thornton LM, Jeffers AJ, Gow RW, Mazzeo SE. Impact of motivational interviewing on engagement in a parent-exclusive paediatric obesity intervention: randomized controlled trial of NOURISH+MI. Pediatr Obes. 2019 Apr;14(4):e12484. doi: 10.1111/ijpo.12484. Epub 2018 Dec 4. |
| Result | Ahmad N, Shariff ZM, Mukhtar F, Lye MS. Malay ilkokul çocuklarının adipozitesini iyileştirmek için yüz yüze oturumları ve sosyal medyayı kullanan aile temelli müdahale: Malezya REDUCE programının randomize kontrollü bir saha denemesi. Beslenme J, 2018; 17(1): 1-13. |
| Result | World Health Organization (WHO). Obesity and overweight. Erişim: https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight Erişim tarihi:18.06.2022. |
| ICF_000.pdf |
| ID | Term |
|---|---|
| D063766 | Pediatric Obesity |
| ID | Term |
|---|---|
| D009765 | Obesity |
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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