Školsko okruženje kao prediktor prekomjerne tjelesne mase i debljine u djece drugih i trećih razreda osnovne škole u Hrvatskoj

doctoral thesis

• Title (english): School environment as a predictor of overweight and obesity in second- and third-grade children in Croatia
• Author: Maja Lang Morović
• Mentor: Sanja Musić Milanović (mentor)
• Committee member: Marjeta Majer (predsjednik povjerenstva)
• Committee member: Orjena Žaja (član povjerenstva)
• Committee member: Antoinette Kaić-Rak (član povjerenstva)
• Committee member: Danijela Štimac (član povjerenstva)
• Committee member: Mirjana Kujundžić Tiljak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Medical Statistics, Epidemiology and Medical Informatics); Zagreb
• Defense date and country: 2024-09-04, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Epidemiology
• Universal decimal classification (UDC): 614 - Public health and hygiene. Accident prevention

Abstract

UVOD: Debljina u dječjoj dobi poseban je javnozdravstveni problem zbog negativnog utjecaja na cjeloživotno zdravlje. Cilj doktorskog rada bio je istražiti povezanost školskih okruženja u kojima je djeci dostupna pravilna prehrana i koja im pruža mogućnost bavljenja tjelesnom aktivnošću s učestalošću prekomjerne tjelesne mase i debljine u djece drugih i trećih razreda osnovnih škola u Republici Hrvatskoj.
UZORAK I METODE: Doktorski rad dio je istraživanja Childhood Obesity Surevillance Initiative. Istraživanje je provedeno u 182 druga i 182 treća razreda iz 164 osnovne škole Republike Hrvatske.
REZULTATI: Na nacionalnoj razini nije utvrđena povezanost između proučavanih odrednica mogućnosti za pravilnu prehranu u školama s prosječnim udjelima prekomjerne tjelesne mase i debljine u djece. U Kontinentalnoj regiji utvrđena je povezanost postojanja trgovine ili kafića unutar škole s prosječnim udjelom djece s prekomjernom tjelesnom masom po školi (F(5,80)=5,794, p<0,001, R2=0,266), uz kontrolu utjecaja razvijenosti jedinice lokalne samouprave i socioekonomskih obilježja majke. Na nacionalnoj razini i u Kontinentalnoj regiji utvrđene su statistički značajne povezanosti prosječnog udjela djece s debljinom u školi i ukupne mogućnosti sudjelovanja u tjelesnim aktivnostima u školi. Ove povezanosti potvrđene su i nakon kontroliranja razvijenosti jedinice lokalne samouprave i socioekonomskih odrednica majki; nacionalno (F (6,139) = 3,630, p = 0,002, R2 = 0,135) i u Kontinentalnoj regiji (F (6,139) = 3,630, p = 0,002, R2 = 0,135). U Kontinentalnoj regiji su, uz kontrolu mogućeg utjecaja socioekonomskih varijabli, postojanje vanjskog školskog igrališta (B = - 18,130, 95% IP [- 28,793; - 7,467]) i provedbe nastave Tjelesne i zdravstvene kulture 135 minuta tjedno (B = - 10,316, 95% IP [- 18,896; - 1,737]) utvrđeni statistički značajni prediktori prosječnog broja djece s debljinom po školi.
ZAKLJUČAK: Sukladno dobivenim rezultatima, neophodno je javnozdravstveno djelovanje da bi se pozitivno utjecalo na razvoj zdravih navika i smanjenje učestalosti prekomjerne mase i debljine u djece.

Abstract (english)

INTRODUCTION: Childhood obesity is a particular public health issue due to its negative impact on lifelong health. The aim of this doctoral dissertation was to investigate the association between school environments that provide children with access to proper nutrition and opportunities for physical activity, and the prevalence of overweight and obesity in second and third grade children in elementary schools in the Republic of Croatia.
SAMPLE AND METHODS: The doctoral dissertation is part of the Childhood Obesity Surveillance Initiative research. The study was conducted in 182 second grades and 182 third grades from 164 elementary schools in the Republic of Croatia.
RESULTS: At the national level, no association was found between the studied determinants of proper nutrition availability in schools and the average rates of overweight and obesity in children. In the Continental region, an association was found between the presence of a store or café within the school and the average rate of overweight children per school (F (5,80) = 5.794, p < 0.001, R2 = 0.266), controlling for the impact of local government unit development and mothers' socioeconomic characteristics. At both the national level and in the Continental region, statistically significant associations were found between the average rate of obese children in schools and the total opportunities for physical activity in schools. These associations were confirmed even after controlling for the development of local government units and mothers' socioeconomic determinants; nationally (F (6,139) = 3.630, p = 0.002, R2 = 0.135) and in the Continental region (F (6,139) = 3.630, p = 0.002, R2 = 0.135). In the Continental region, after controlling for the possible impact of socioeconomic variables, the existence of an outdoor school playground (B = - 18.130, 95% CI [- 28.793; - 7.467]) and conducting Physical and Health Education classes for 135 minutes per week (B = - 10.316, 95% CI [- 18.896; - 1.737]) were identified as statistically significant predictors of the average number of obese children per school.
CONCLUSION: According to the obtained results, public health action is necessary to positively influence the development of healthy habits and reduce the prevalence of overweight and obesity in children.Obesity is a growing public health problem worldwide. Its consequences have a negative effect on all aspects of an individual's health, including physical, mental and social health.

• Keywords: školsko okruženje; debljina u dječjoj dobi; rizični čimbenici; tjelesna aktivnost; pravilna prehrana; promicanje zdravlja
• Keywords (english): school environment; childhood obesity; risk factors; physical activity; proper nutrition; health promotion
• Language: croatian
• URN:NBN: urn:nbn:hr:105:896209
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 139 str.
• File origin: Born digital
• Access conditions: Open access
• Public note: Disertacija je izrađena u Hrvatskom zavodu za javno zdravstvo kao rezultat istraživanja koje je dio znanstveno-istraživačkog projekta Svjetske zdravstvene organizacije „Childhood Obesity Surveillance Initiative“ (COSI), čija je voditeljica izv.prof.dr.sc. Sanja Musić Milanović.
• Created on: 2024-10-01 08:23:48