Ecological Factors Affecting Obesity Among Middle School Students in South Korea

• Published in: The Journal of school health Vol. 89; no. 3; pp. 181 - 190
• Main Authors: Kim, Suhee, Kim, Gwang Suk
• Format: Journal Article
• Language: English
• Published: Malden, USA Wiley Periodicals, Inc 01-03-2019; Wiley-Blackwell; American School Health Association; Blackwell Publishing Ltd
• Subjects: Access to Computers; Adolescent; Analysis; Body Weight; Childhood obesity; Community; Community Relations; Correlation; Cross-Sectional Studies; Curricula; Diet; Eating Habits; Ecological Factors; ecological model; Ecology; Educational Environment; Environmental health; Environmental Influences; Female; Habits; Health aspects; Health Education; Health status; Humans; Junior high school students; Male; Middle and junior high school students; Middle School Students; Middle schools; Multilevel analysis; Nursing; Obesity; Obesity in children; Pediatric Obesity - epidemiology; Pediatric Obesity - etiology; Peer Relationship; Personal computers; Physical Activities; Physical activity; Prevention; Prevention programs; Republic of Korea - epidemiology; Risk Factors; Role; School Nurses; Schools; Social Environment; Social interactions; Social support; Sports complexes; Sports facilities; Students - psychology; Students - statistics & numerical data; Team Sports; Teenagers; Republic of Korea; South Korea; multilevel analysis; adolescent; ecological model; obesity
• ISSN: 0022-4391; 1746-1561
• DOI: 10.1111/josh.12727

ABSTRACT
BACKGROUND
Despite the environment being recognized as playing an important role in health, little is known about the influence of school and community factors on student health. This study aimed to identify the ecological factors influencing obesity among middle school students, including intrapersonal, interpersonal, school, and community factors.
METHODS
The study sample consisted of 2069 students from 50 middle schools, with individual‐level data. School and community‐level data were collected using a school nurse survey and official materials from the National and Civic Statistics. These data were merged and used for a series of multilevel logistic regression analyses.
RESULTS
There were significant variations in the students' overweight/obesity status, by ecological factors. Individual dietary habits, peer social support for physical activity, health education in the regular curriculum, the number of personal computer rooms per 100,000 individuals, and the area of public sports facilities per 100,000 individuals were significantly associated with student obesity.
CONCLUSIONS
To be more effective, overweight/obesity prevention efforts for middle school students should focus not only on individual factors, but also on school and community factors.