Multilevel Analysis on the Socio-Cultural, Lifestyle Factors, and School Environment on the Risk of Overweight in Adolescents, Karanganyar District, Central Java
Abstract
Background: Basic Health Research (RISKESDAS) data in 2013 showed that the prevalence of overweight among adolescents aged 13-15 years was 10.8%. Karanganyar district is ranked fourth by the number of overweight adolescents cases in Central Java with prevalence of 8.2%. This study aimed to determine the asssociation between socio-cultural, lifestyle factors, and school environment on the risk of overweight in adolescents, Karanganyar District, Central Java, using social cognitive theory (SCT), PRECEDE-PROCEED model, and multilevel analysis.
Subjects and Method: This was an analytic observational study with cross-sectional design. The study was conducted at 25 junior high schools in Karanganyar district, Central Java, in December 2017. A sample of 200 junior high school students were selected for this study by stratified sampling and fixed disease sampling. The dependent variable was overweight. The independent variables were nutritional intake, snacking habits, physical activity, self efficacy, paternal BMI, maternal BMI, peer group influence, and school environment. Body weight data was measured by digital scale. Contextual effect of school environment was measured by the number of snack sellers at school. Other data were collected by questionnaire and analyzed by multilevel analysis.
Results: High nutritional intake (b= 1.56, SE = 0.73, p= 0.032), high snacking habits (b= 1.27, SE = 0.70; p= 0.069), paternal BMI ≥23 (b= 1.60; SE= 0.79; p= 0.042 ), maternal BMI ≥23 (b= 2.29; SE = 0.76; p = 0.002), parent income ≥minimum regional wage (b= 2.17; SE= 0.76; p= 0.004), and strong peer group influence (b= 2.22; SE = 0.65; p= 0.001) increased the risk of overweight in adolescents. High self-efficacy (b= -3.61, SE= 0.75, p <0.001) and high physical activity (b= -2.92; SE= 0.80; p <0.001) decreased the risk of overweight in adolescents. Intraclass correlation= 9.92% indicating considerable contextual effect of school environment.
Conclusion: Nutritional intake, snack habits, paternal BMI, maternal BMI, family income, and peer influence increase the risk of overweight in adolescent. Self-efficacy and high physical activity decrease the risk of overweight in adolescent. School environment has a considerable contextual effect on overweight in adolescents.
Keyword: overweight, social cultural factor, adolescents, school environment
Correspondence: Aris Widiyanto. School of Health Sciences Mambaul Ulum, Jl. Ring Road Utara, Tawangsari, Mojosongo, Jebres, Surakarta, Central Java. Email: widiyanto.aris99@gmail.com. Mobile: 081329209095.
Journal of Epidemiology and Public Health (2018), 3(1): 94-104
https://doi.org/10.26911/jepublichealth.2018.03.01.08
References
Baker CW, Little TD, Brownell KD (2003). Predicting adolescent eating and activity behaviors: the role of social norms and personal agency. Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 22(2): 189–98.
Banwell C, Hinde S, Dixon J, Sibthorpe B (2005). Reflections on expert consensus: a case study of the social trends contributing to obesity. European Journal of Public Health, 15(6): 564–568. Available at: http://www.ncbi.nlm.nih.gov/pubmed/16141305.
Barlow SE, Expert Committee (2007). Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report. Pediatrics, 120(4): S164–S192. Available at: http://www.ncbi.nlm.nih.gov/pubmed/1855651.
Baroogh NS, Pashaeipour SH, Rezaeipour A, Kazemnejad A (2005). The quality of mid meal Nutrition of Adolescent between 12‑18 years promise. J Nurs Midwifery Faculty Tehran Univ Med Sci, 12: 21-9.
Bowman SA et al. (2004). Effects of fastfood consumption on energy intake and diet quality among children in a national household survey. Pediatrics, 113(1): 112–8. Available at: http://www.ncbi.nlm.nih.gov/pubmed/14702458.
Burg J (2008). Determinants of healthy eating: motivation, abilities and environmental opportunities. Family Practice, 25(1): i50–i55. Available at: http://www.ncbi.nlm.nih.gov/pubmed/18826991.
Davison KK, Birch LL (2002). Obesigenic families: parents’ physicalactivity and dietary intake patterns predict girls’ risk of overweight.Int J Obes Relat Metab Disord. 26:1186-93.
de la Haye K et al.(2011). Homophily and Contagion as Explanations for Weight Similarities Among Adolescent Fri-ends. Journal of Adolescent Health, 49(4): 421–427. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21939874.
Dowda M, Ainsworth BE, Addy CL, Saunders R, Riner W (2001). Environ mental influences, physical activity, and weight status in 8 to 16 year olds. Arch Pediatr Adolesc Med, 155: 711–717.
Goran MI, Treuth MS (2001). Energy expenditure, physical activity, and obesity in children. Pediatr Clin North Am, 48: 931–953.
Gordon Larsen P, Nelson MC, Page P, Popkin BM (2006). Inequality in the built environment underlies key health disparities in physical activity and obesity. Pediatrics, 117: 417– 424.
Hosseinnejad M, Azizadehfoorouzei M, Mohammadalizadeh S, Haghdoust A (2008). Assessment of the self efficacy role in prediction of nutritional behavior of girls students. J Shahid Sadoughi Univ Med Sci Health Serv, 16: 49‑56.
Janssen I, Katzmarzyk PT, Srinivasan SR, Chen W, Malina RM, Bouchard C, Berenson GS (2005). Combined influence of body mass index and waist circumference on coronary artery disease risk factors among children and adolescents. Pediatrics, 115(6): 1623–1630.
Jimenez Pavon D, Kelly J, Reilly JJ. (2011). Physical Activity, Fitness, and Fatness in Children and Adolescents. Dalam: Moreno LA, Pigeot I, Ahrens W, Editor. Epidemiology of Obesity in Children and Adolescents: Prevalence and Etiology. New York: Springer; 347.
Lumeng JC, Hillman KH (2007). Eating in larger groups increases food consumption. Archives of disease in childhood, 92(5): 384–7. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17301111.
Menezes IHCF, Neutzling MB, Taddei JAAC (2009). Risk factors for overweight and obesity in adolescents of a Brazilianuniversity: a case control study. Nutr Hosp.24:17-24.
Nie P, Sousa Poza A, He X (2015). Peer effects on childhood and adolescent obesity in China. China Economic Review, 35: 47–69. Available at: http://www.sciencedirect.com/science/article/pii/S1043951X15000826.
Ogden CL, et al. (2010). Prevalence of High Body Mass Index in US Children and Adolescents, 2007-2008. JAMA, 303(3): 242. Available at: http://www.ncbi.nlm.nih.gov/pubmed/20071470.
Pate RR, Davis MG, Robinson TN, et al (2006). Promoting physical activity in children and youth: a leadership role for schools: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Physical Activity Committee) in collaboration with the Councils on Cardiovascular Disease in the Young and Cardiovascular Nursing. Circulation, 114: 1214 –1224.
Péneau S, et al.(2009). Influence of environmental factors on food intake and choice of beverage during meals in teenagers: a laboratory study. British Journal of Nutrition, 102(12): 1854. Available at: http://www.ncbi.nlm.nih.gov/pubmed/19682398.
Rezaiepour A, Yousefi F, Mahmoodi M, Shakeri M (2006). The relationship of nutritional behaviors and physical Activities of adolescent girls with their perception of parental lifestyle. J Nurs Midwifery Faculty Tehran Univ Med Sci,13:17‑25.
Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS (2015). Childhood Obesity: Causes And Consequences. Journal Family Med Prim Care, 4(2): 187–192.
Salvy SJ (2012). Influence of Peers and Friends on Children’s and Adolescents. Eating and Activity Behaviors. , 106(3):369–378. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372499/pdf/nihms371600.pdf.Soetardjo S (2011). Gizi Seimbang Dalam Daur Kehidupan. Jakarta: PT. Gramedia Pustaka Utama.
Stettler N, Signer TM, Suter PM (2004). Electronic games and environmental factors associated with childhood obesity in Switzerland. Obes Res, 12: 896 –903.
Trogdon JG, Nonnemaker J, Pais J (2008). Peer effects in adolescent overweight. Journal of Health Economics, 27(5): 1388–1399. Available at: http://linkinghub.elsevier.com/retrieve/pii/S0167629608000477.
Tudor Locke C, Ainsworth BE, Popkin BM (2001). Active commuting to school: an overlooked source of childrens’ physical activity? Sports Med, 31: 309 –313.
Valente TW, et al (2009). Adolescent Affiliations and Adiposity: A Social Network Analysis of Friendships and Obesity. Journal of Adolescent Health, 45(2): 202–204. Available at: http://www.ncbi.nlm.nih.gov/pubmed/19628148.
______ (2017c). Physical activity. Diakses dari http://www.who.int/topics/physical_activity/en/ pada 27 September 2017.
WHO (2004a). Global Strategy on Diet, Physical Activity and Health. Geneva, Switzerland: World Health Organization. Diakses dari www.who.int/dietphysicalactivity/en.
Winkleby MA, Cubbin C (2004). Changing patterns in health behaviors and risk factors related to chronic diseases, 1990‑2000. Am J Health Promot, 19: 19‑27.
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Published
2018-01-24
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Vol. 3 No. 1 (2018)
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