Overweight and obesity among Grenadian adolescents: rural and urban differences in social determinants

OBJECTIVE: To examine the prevalence of overweight and obesity (OW/OB) among Grenadian adolescents and to determine associations with social determinants on urban and rural adolescents. DESIGN AND METHODS: A national sample of Form1 students (n = 689) aged 11 to 14 years, from all 23 secondary schools in Grenada were assessed as part of the Grenada School Nutrition Study (GSNS). Body Mass Index (BMI) was assessed using standard measures and standardized BMI percentile. Urban (n = 13) and rural (n = 10) schools were determined by location. Exposure to fast food outlets and shops which sold sugar sweetened beverages, candy, or highly processed foods was measured within a .75 km buffer surrounding each school and major transportation hub, between school and home. RESULTS: Overall, Grenadian adolescents had low rates of overweight (17.6%) and obesity (7.6%) compared to Grenadian adults. Girls, however, had nearly twice the rate of overweight compared to boys (i.e., 22.7% versus 12.2%). There were significant differences between rural and urban students for access to cars (40.7% versus 53.3%), computer access (61.6% versus 73.5%), and snacking after school (83.6% versus 90.5%) respectively. The rural school environment also had a lower mean density of snack shops (1.53 versus 3.39 shops/square km) and mean fast food outlet density (0 versus 1.17 outlets/square km). CONCLUSIONS: Grenadian adolescents demonstrate low rates of OW/OB compared to both Grenadian adults and their US counterparts. The low rates of OW/OB suggest Grenadian adolescents have not yet been affected by social determinants of the obesity epidemic.

The current prevalence and potential elimination of the soil transmitted helminth’s from Grenada

OBJECTIVE: This study formed part of a soil transmitted helminth elimination program in Grenada. The study assessed the prevalence of soil transmitted helminths (STH’s) in Grenadian primary school children. DESIGN AND METHODS: A longitudinal study was carried out on students attending 39 out of all 54 (72.2%) primary schools in Grenada, Carriacou and Petite Martinique between March 2013 and December 2014. The schools were randomly selected for inclusion in the study. Zinc Sulphate Floatation with centrifugation and Microscopy was used to assess the prevalence of STH’s in stool samples from Grenadian primary school children. RESULTS: The overall prevalence of STH was 1.3% (95% CI= 0.54-2.72). In 4 of the 8 parishes the prevalence was 0%. The highest prevalence was 3.9% (0.48-13.46) in St. Patrick. The STH identified were Ancylostoma duodenale, Ascaris lumbricoides and Trichuris trichuria. CONCLUSION: The prevalence of STH’s in the initial survey was 1.3%. This low prevalence indicates that the elimination program which utilizes a multi pronged approach including targeted chemotherapy and education may be feasible.

Individual and school-level influences on moderate and vigorous physical activity in Grenada adolescents

OBJECTIVE: The effect of school level policies on the physical activity of Grenadian children had not been studied. The present study tested the hypothesis that schools with physical activity (PA)-promoting policies would positively impact student’s levels of moderate and vigorous physical activity in Grenada. DESIGN AND METHODS: Multilevel analysis of a nationally representative sample of first year students (i.e. Form 1) (n = 138) from the twenty-three secondary schools in Grenada were assessed as part of the Grenada School Nutrition Study (GSNS). At the individual level physical activity was measured using Actigraph GT3X accelerometers. In addition to socio-demographic measures, height, weight and waist circumference (WC) were collected using standard anthropometric procedures. School-level measures were self-reported by school administrators. The school PA policy index included: student to teacher ratio in physical education (PE) classes, minutes of PE per week, number of PE facilities/equipment, having at least one policy to address PE participation, having ≥1 policy for access to sports teams or activities, having a school board or council to address PE policies. RESULTS: No school-level variables were significantly related to student Moderate and Vigorous Physical Activity (MVPA). Waist circumference was the only variable that significantly predicted MVPA in both boys (p=0.03) and girls (p=0.005). In girls, overweight/obesity was significantly associated with decreased MVPA (p=0.004). CONCLUSIONS: Contrary to findings in United States children, Grenada school-level policies and environments were not related to student’s physical activity levels. Further research was needed to understand the variation in physical activity levels by schools in both male and female Grenada students.

Short and long term knowledge of the transmission and prevention of soil transmitted helminths in primary schoolchildren assessed using Turning Point Technologies

OBJECTIVE: This study formed part of a soil transmitted helminth (STH) elimination program in Grenada. This study assessed the short and long term knowledge of primary school children on the transmission and prevention of STH using Turning Point Technologies. DESIGN AND METHODS: A longitudinal study was carried out on schoolchildren attending 39 out of all 54 (72.2%) primary schools from Grenada, Carriacou and Petite Martinique between March and November 2014. The schools were randomly selected for inclusion in the study. Turning Point Technology was used to assess the knowledge and administer the subsequent intervention to all students. The Pre, immediate-Post and long-term Post intervention (seven months later) data was analyzed using Chi Square. RESULTS: A total of 962 students participated in March 2014 and 805 students participated in October 2014. There was no significant (p< 0.05) inter school difference in the answering of questions. This displayed a ubiquitous knowledge transfer across the primary schools. There was a significant improvement in knowledge post turning point intervention, which was maintained at 7-months post-intervention. CONCLUSION: The advantages of using turning point technologies to impart this knowledge where class responses appear instantly, anonymously and can be used for immediate discussion were numerous. These include inter alia, active engaged participation.