Asset Assessment for Obesity Control among Middle School Students: a Qualitative Study

Abstract

Background Adolescence is a high-risk period for obesity, and it is crucial and urgent to implement obesity control among adolescents. However, existing interventions commonly face challenges in sustainability and scalability. Asset assessment to identify and leverage existing community assets and strengths is essential to facilitate and maintain the implementation of these programs. Objective To assess assets for obesity control among middle school students, and to identify the advantages and deficiencies in the current policy, physical, social, and information environments, along with suggestions for improvements. Methods From 2023 to January 2024, purposive sampling method was adopted, face-to-face one-by-one interviews were conducted with 11 staff members involved in obesity control for middle school students from the Center for Disease Control and Prevention, Education Bureau, and three middle schools in a major city in East China. Additionally, eight parents and their children from each of the three schools were invited to participate in focus group discussions, with 6 groups and 8 participants per group. Thematic analysis was applied to analyze the interview data. Results This study found that the advantages in obesity control for middle school students primarily included policies and conditions ensured for obesity surveillance, nutritional school lunch and physical activity, along with media for health communication. The main deficiencies were the lack of specific policies for efficient obesity control, insufficient physical and social assets to support healthy eating and physical activity, and the quality and intensity of information assets supporting to facilitate changes in knowledge, attitude, and behaviors. In response to these challenges, participants suggested the implementation of both rigid regulations and flexible incentives, improvement of asset accessibility, encouragement of multi-stakeholder cooperation, and strengthening of health communication. Integrating existing assets and suggestions for improvement has formed an asset assessment checklist, corresponding to 10 assets from the policy environment, 8 from the physical environment, 20 from the social environment, and 12 from the information environment. Conclusion Several assets exist for obesity control among middle school students and identifies areas for improvement. Subsequent efforts in obesity control for middle school students should be made on promoting intervention strategies to better align with the context based on the asset assessment checklist to diagnose the current status of assets, thus enhancing the efficacy and sustainability of the program.

Keywords

• obesity|obesity management|universal precautions|asset assessment|adolescent|interview