Healthy living strategy for school-based weight control and childhood obesity prevention

Background: Childhood overweight and obesity are increasing public health concerns internationally, contributing to significant long-term health risks. School-based interventions integrating policy and behavioural strategies are needed to address this issue. Objectives: This study aimed to evaluate the effects of a school-based intervention informed by the Thailand Healthy Living Strategy (THLS) for weight control and obesity prevention among school-age children. Design: Cluster randomised controlled trial. Setting: Eight primary schools located in Northeastern Thailand. Methods: A total of 214 students were randomly assigned to intervention and control groups. The intervention consisted of five structured education sessions delivered over a 3-month period but also included policy development and parental engagement. Data were collected using a structured questionnaire at baseline (pretest) and at 1-month posttest following the intervention. Independent and paired t -tests were used to compare outcomes between and within groups. Results: At posttest, the intervention group showed significant improvements in self-efficacy (mean difference = 1.85, p = 0.03), outcome expectation (mean difference = 1.71, p = 0.03), and practice scores (mean difference = 8.40, p = 0.01). Between-group comparisons demonstrated significantly higher outcome expectations ( p < 0.001) and practice scores ( p < 0.001) in the intervention group compared to the control group. No significant differences were observed for knowledge between groups. Conclusions: The THLS-integrated school-based intervention improved self-efficacy, outcome expectations and obesity prevention practices among schoolchildren. These findings support the implementation of multi-component, school-based strategies involving policy, education, and family engagement to promote healthy lifestyles.