The effectiveness of the health promoting school intervention model in reducing overweight and obesity among school children in indonesia: a mixed-methods protocol study

Background : Childhood obesity is a growing public health concern in Indonesia, with potential long-term health consequences. Despite various interventions, the prevalence of overweight and obesity among school-aged children continues to rise. This study aims to develop, implement, and evaluate a comprehensive school-based intervention to reduce overweight and obesity in Indonesian school children through improved health literacy, nutrition education, and physical activity promotion. Methods : This mixed-methods study will employ a three-phase design: pre-intervention, intervention, and post-intervention. The study will be conducted in three districts of South Sulawesi, Indonesia: Makassar, Gowa, and Maros. The intervention, based on Bandura's Social Cognitive Theory, will include capacity building for teachers, canteen workers, and school principals; implementation of health promoting schools; and parental engagement. Quantitative data will be collected through anthropometric measurements, questionnaires assessing knowledge, self-efficacy, and health literacy. Qualitative data will be gathered through focus group discussions with key stakeholders. The effectiveness of the intervention will be evaluated using various statistical analyses, including ANOVA, t-tests, and ANCOVA, while qualitative data will undergo thematic analysis. Results : We anticipate that this intervention will lead to significant reductions in BMI, improvements in health literacy, increased knowledge about nutrition and physical activity, and enhanced self-efficacy among participating school children. Conclusion : By integrating nutrition education, physical activity promotion, and the Health Promoting School model, this research aims to provide valuable insights for developing effective strategies to combat childhood obesity. The findings are expected to inform health and education policies in Indonesia and contribute to the global effort in addressing childhood obesity. Trial registration : Current Controlled Trial NCT06601348