AUTHOR=Almughamisi Manal , O'Keeffe Majella , Harding Seeromanie 

TITLE=Adolescent Obesity Prevention in Saudi Arabia: Co-identifying Actionable Priorities for Interventions

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.863765

DOI=10.3389/fpubh.2022.863765

ISSN=2296-2565

ABSTRACT=Childhood obesity is a serious issue in the Kingdom of Saudi Arabia, but there is no known community intervention. This aim of this study was to use a participatory approach to obtain the perspectives of students, school staff and Ministry of Education (MoE) representatives and parents on important and feasible intervention opportunities for school-based obesity prevention for adolescent girls.
Method: The study was conducted in two intermediate schools for girls (13-15 years old) in Jeddah. Group concept mapping, a six-step mixed method, was conducted with 19 adults which included staff from the MoE and schools, school canteen suppliers and mothers. Adults generated statements in response to two prompts (P); P1 ‘The factors influencing adolescent obesity in Saudi are...’ and P2 ‘The content of school-based programmes should focus on...’. Photovoice-enhanced concept mapping was used in the students’ workshops to capture adolescent perspectives on what influences their dietary and physical activity habits. Stakeholders, sorted the statements into themes and rated each statement for relative importance and feasibility. 

Result: Adults generated 35 statements in response to P1 and identified five themes that influenced adolescent obesity including ‘Home Environment’, ‘Lifestyle’, ‘School Environment, ‘Community’, ‘Biology’. They generated 42 statements in relation to P2 and identified four themes including ‘Ministry of Education Support’, ‘School Environment, ‘Public health programmes’ and ‘Wider environmental influences’. Students generated 42 statements from 39 pictures. They identified five themes that influenced their dietary and physical activity habits - ‘Role of Government’, ‘School Environment,’ Home environment’, ‘Retail Environment’ and ‘Cultural Practices’. Both groups identified several common important and feasible actions with a strong emphasis on improving the school environment, in particular food provision, with MoE support. Exemplar corresponding statements from adults were ‘Offer healthy foods in the canteen’ and ’Remove chocolate’  and from students were ‘Offer fruit and vegetables in the canteen’ and ‘Remove chocolates from the canteen’.After further consultations, stakeholders agreed on improving access to healthy foods in the canteen. 
 Students, school and Ministry of Education staff, and mother jointly agreed that a canteen-based intervention was important and feasible to improve dietary habits and thus help to prevent obesity among adolescent girls.