Abstract

Objectives: Child obesity, a major risk factor of non-communicable diseases such as diabetes or heart diseases, has become a major health issue in Indonesia, especially in the wake of economic growth. Nevertheless, child obesity prevention programs and relevant information is limited. Our study aimed to investigate child obesity status, lifestyle behaviours (LSBs) and their predictors, and their structures, in order to develop a model to discuss a collaborative healthy weight development program for schoolchildren in urban Indonesia. There were two objectives of our study: (1) In order to investigate schoolchildren's obesity status, LSBs, and their predictors and (2) In order to examine relationships among schoolchildren's obesity status, LSBs, and their predictors in urban Indonesia.

Methods: The design was a cross-sectional study using physical measurement tools and an 82 item selfdeveloped questionnaire based on interviews for 9 to 11 year old school children in 2015. Sampling included 5 schools resulting in 594 eligible students with 579 (97.5%) responding. Collected data were analyzed by descriptive statistics and a structural equation modeling. The Research Ethics Committee of St. Luke's International University (Approval Number 15-036) approved our study.

Results: Physical measurement classified participants 40% as obese or overweight and 35% as underweight. Descriptive statistics revealed limited behaviours and environments in access to snacks, physical activity (PA), weight-monitoring, obesity education, and support. The models by type of schools and by sex (CFI=0.88-0.91) indicated; boys' trouble sleeping (β=-0.18), private schoolchildren's frequency of junk and outside foods (β=-0.18 and -0.19) predicted Body Mass Index. Safe-PA environment (β=0.17-0.48) and family support (β=0.36-0.59) predicted PA LSBs. For girls, PA-peer presence predicted PA LSBs (β=0.88).

Conclusion: These findings could help developing the effective obesity-prevention programs such as healthy dietary environment, safe-PA-environment, PA-peer-group support for girls, family-involved dietary-PA interventions in urban Indonesia.

Keywords: Child; Obesity; Body weight; Lifestyle; Indonesia