2.1. Study Design and Participants
obesity, adiposity
OBESITY, ADIPOSITY
The participants in this study were from a cluster randomized controlled trial named Diet, Exercise and Cardiovascular Health-Children (DECIDE-Children) conducted in 3 socioeconomically distinct regions from the eastern (Beijing), central (Changzhi, in Shanxi Province), and western (Urumqi, in Xinjiang Province) parts of China from September 2018 to June 2019. There were 705 grade 4 students (about 10 years old in the Chinese school system) from 12 intervention schools and 687 from 12 control schools. Children of this age have the ability to complete questionnaires. Based on the socio-ecological model, dietary and exercise interventions for children were carried out in the intervention group at the school, family and individual levels. For the school level, we developed school obesity prevention policies including physical education sessions, healthy food environment, and health education sessions for teachers and children. For the individual level, we promoted children’s physical exercise at school and at home and recommended for them not to eat fried food, snacks, fast food, etc. For the family level, we conducted health education sessions for parents. In addition, an application on the mobile phone of the parents (named Eat Wisely and Move Happily) was used to conduct the regular monitoring and feedback of children’s diet and exercise behaviors and adiposity indicators, and promote the family involvement in the childhood-obesity intervention. Details of sampling and interventions can be found in previously published articles [