Participanten
The Endorse study is performed by the Department of Public Health at the Erasmus Medical Centre Rotterdam, in collaboration with the Public Health Services of the city of Rotterdam www.ggdrotterdam.nl.

 

Periode
September 2004 - August 2008

Sponsor(s)
This study is financially supported by The Netherlands Organisation for Health Research and Development (ZonMw).

 

Doelen
Background: The prevalence of obesity and overweight is rising in the Netherlands as well as worldwide, importantly among children and adolescents. Weight gain is caused by a positive energy balance, i.e. energy intake (diet) exceeds energy output (physical activity). Long-term successful treatment of obesity is rare and more emphasis should be given to prevention of weight gain. Children and adolescents are probably the most important target group for prevention of overweight since overweight is often initiated early in life and tracks into adulthood. For successful prevention, a combination of changes in both diet and physical activity behaviours, seems most promising. In order to encourage changes in energy balance behaviours, however, it is necessary to have insight into the determinants of these behaviours.

 

Most research into health behaviour determinants has focused on proximal, mostly cognitive factors. However, for overweight, and even more so for overweight in children, so-called obesogenic environmental factors, such as excess availability of tasty, low priced, high calorie foods and low and decreasing opportunities and necessity for physical activity, are expected to be important determinants of energy balance behaviours. Such social and physical environmental factors are expected to be more important than cognitive factors in explaining energy balance behaviours especially among children since they often have less autonomy and behaviour control than adults, also as far as diet and physical activity are concerned. However, no systematic research into overweight-inducing environmental factors for children and younger adolescents has been conducted in the Netherlands and instruments to do so are largely lacking.

 

Study goals: The present study aims at the identification of specific overweight inducing risk behaviours and to study observed as well as perceived school, neighbourhood and family environmental determinants of these behaviours in 12 to 15-year-olds.

 

Methoden
A first exploratory phase will consist of literature research, a Delphi study among experts, and qualitative research among children, parents, and teachers will result in a broad inventory of specified potential weight gain inducing behaviours and their potential environmental determinants.

 

This exploratory phase will inform the second phase of the research which will involve the development of questionnaires and observation checklists that assess the obesogenic factors identified in the exploratory phase.

 

These quantitative tools will be pre-tested and subsequently used in the third phase of the research. In this final phase, we will use an existing research infrastructure of the Public Health Services of the city of Rotterdam (The Rotterdam’s Youth Monitor) to survey 1200 students in the first high school and lower vocational school levels, their parents and their teachers on potential personal, social environmental and perceived physical environmental factors that may predict weight-gain inducing behaviours among the students.

 

The data collected through this questionnaire will be enriched with anthropometrics (height, weight, waist circumference) from the children obtained in routine health checks, data from the existing neighbourhood geographic information system in Rotterdam and with data from systematic observations in the school and neighbourhood environment.

 

The project will result in specific change objectives for prevention of overweight interventions in younger adolescents and thus will inform planned prevention interventions.

 

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