Effect of an Educational Intervention on Healthy Lifestyle in Iranian Children and Adolescents: The Iran-ending Childhood Obesity (IRAN-ECHO) Program

  • Zahra Abdollahi
  • Ali-Akbar Sayyari
  • Beheshteh Olang
  • Hassan Ziaodini
  • Hossein Fallah
  • Zahra Abasalti
  • Fereshteh Fozouni
  • Sakineh Jafari
  • Farhad Lashkarlouki
  • Mahnoush Sahebdel
  • Arash Siadati
  • Hamideh Aslani
  • Roya Riahi
  • Motahar Heidari-Beni
  • Roya Kelishadi
Keywords: Health behavior; Nutrition; Education; Knowledge; Attitude; Iran


Background: This study aimed at examining the effect of an educational program on children’s and adolescents’ knowledge of, attitude toward, and practice of healthy lifestyle habits.

Methods: This was a quasi-experimental nationwide intervention carried out as part of the Iran-Ending Childhood Obesity (IRAN-ECHO) program. Participants were selected from six cities of Iran. The sample size was calculated to be 1264 for each city. Knowledge of, attitude toward, and practice of healthy nutritional habits were measured at baseline and following the intervention. A physician and a dietitian provided recommendations on healthy diet, screen time, physical activity, and sleep time. Behavioral therapy was given when necessary.

Results: The prevalence of overweight or obesity was 7.6%. The frequency of students with desirable knowledge was significantly greater after the intervention compared with baseline (32.5% vs 24.8%, p = 0.02). The mean score for attitude toward obesity complications significantly increased from 73.09 to 74.78 (p = 0.03). There was also a significant increase in the mean score for the practice of low consumption of unhealthy snacks after the intervention (difference = 1.63, p = 0.03). The mean score for participation in mild physical activity increased from 50.67 to 65 after the intervention (p < 0.001). However, there were no significant changes in the number of students with desirable attitude and practice following the intervention (p> 0.05).

Conclusion: The study shows that an educational intervention based on WHO-ECHO recommendations can be useful for improving the knowledge of a healthy lifestyle in children and adolescents. Over time, it might lead to a positive attitude and behavior toward a healthier lifestyle. Continued professional education and implementation of guidelines for the prevention and management of early childhood overweight and obesity are suggested.