Luận văn prevalence of overweight and obesity and associated factors among adolescentc aged 15 to 19 years old in phonghong districh, vientiane province, lao pdr in 2019

MINISTRY OF HEALTH UNIVERSITY OF HEALTH SCIENCES, FACULTY OF PUBLIC HEALTH AND MINISTRY OF EDUCATION AND TRAINING - MINISTRY OF HEALTH HANOI UNIVERSITY OF PUBLIC HEALTH SOMPHONE SOUKHAVONG PREVALENCE OF OVERWEIGHT AND OBESITY AND ASSOCIATED FACTORS AMONG ADOLESCENTS AGED 15 TO 19 YEARS OLD IN PHONHONG DISTRICT, VIENTIANE PROVINCE, LAO PDR 2019 MASTER OF PUBLIC HEALTH CODE: 8720701 HANOI, 2020 MINISTRY OF HEALTH UNIVERSITY OF HEALTH SCIENCES, FACULTY OF PUBLIC HEALTH AND MINISTRY OF EDUCATION AND TRAINING - MINISTRY OF HEALTH HANOI UNIVERSITY OF PUBLIC HEALTH SOMPHONE SOUKHAVONG PREVALENCE OF OVERWEIGHT AND OBESITY AND ASSOCIATED FACTORS AMONG ADOLESCENTS AGED 15 TO 19 YEARS OLD IN PHONHONG DISTRICT, VIENTIANE PROVINCE, LAO PDR 2019 MASTER OF PUBLIC HEALTH CODE: 8720701 SUPERVISORS: DR CHANDAVONE PHOXAY ASSOC PROF LE THI THANH HUONG DIRECTOR, NUTRITION CENTER HEAD, FACULTY OF ENVIRONMENTAL AND MINISTRY OF HEALTH, LAO PDR OCCUPATIONAL HEALTH HANOI UNIVERSITY OF PUBLIC HEALTH HANOI, 2020 i ACKNOWLEDGEMENTS This independent study would not have been possible without the help and support of many people I am very thankful to the Ministry of Health of the Lao PDR and the LEARN project for funding my studies at the University of Health Sciences and the LaoTHPI in Laos and at the Hanoi University of Public Health in Vietnam Dr Sengchanh Kounnavong, Director of Lao-TPHI and all her staff are also gratefully acknowledged for allowing me to study at the University of Health Sciences in Laos and at the Hanoi University of Public Health in Vietnam I am also thank to my thesis advisors Dr Chandavone Phoxay, Director of the Nutrition Center, Ministry of Health and Assoc Prof Le Thi Thanh Huong, Head of the Faculty of Environmental and Occupational Health, Hanoi University of Public Health, who steered me in the right direction whenever they thought I needed it I would also like to acknowledge the valuable comments and encouragement from the examination chair of my Independent Study Committee and also wish to thank the external members of the committee I am most grateful to the directors of the Vientiane Provincial Health Department as well as to the facilitators, heads of villages and the research team in Phonhong District, Vientiane Province, who kindly agreed to help and participate in this research This study could not have been completed without their generous assistance I am grateful as well to all the lecturers, teachers and staff of the UHS, LaoTPHI and HUPH for their continuous assistance and helpful advice I would like to thank Dr Somphou Outensackda, Miss Ammala Phommachack and my classmates for their kindness during the period of my studies at UHS and HUPH Finally, I would like to thank my family for their love, understanding, support, and encouragement during the time I was studying in Laos and Vietnam Mrs Somphone SOUKHAVONG ii ABBREVIATIONS BMI Body Mass Index GSHS Global School Based Health Survey Lao-TPHI Lao Tropical and Public Health Institute LSIS Lao Social Indicators Survey MOES Ministry of Education and Sports MOH Ministry of Health NCD Non-Communicable Disease NIDDK National Institute of Diabetes and Digestive and Kidney Diseases NIOPH National Institute of Public Health UNICEF United Nations Children‟s Fund UNFPA United Nations Fund for Population Assistance WHO World Health Oganization iii CONTENTS ACKNOWLEDGEMENTS i ABBREVIATIONS ii LIST OF TABLES v SUMMARY vi INTRODUCTION RESEARCH OBJECTIVES CHAPTER REVIEW OF LITERATURE 1.1 Concept of overweight and obesity 1.2 Concept of adolescents 1.3 Causes of overweight and obesity 1.4 Consequences of overweight and obesity 1.5 Classification and assessment of overweight and obesity 1.6 Overweight and obesity situation among adolescents 1.6.1 Overweight and obesity situation among adolescents at global level 1.6.2 Overweight and obesity situation among adolescents in Laos 1.6.3 Overweight and obesity situation among adolescents in Vientiane Province 10 1.7 Factors associated with overweight and obesity among adolescents 10 1.7.1 Individual factors 10 1.7.2 Family factors 13 1.7.3 Eating habits among adolescents 16 1.7.4 Physical activities among adolescents 17 1.8 Conceptual Framework 18 1.9 Study setting 19 CHAPTER 20 METHODOLOGY 20 2.1 Study population 20 2.2 Study site and duration of data collection 20 2.3 Study design 20 iv 2.4 Sample size 21 2.5 Sampling method 21 2.6 Data collection 22 2.7 Variables of the study 24 2.8 Assessment criteria 26 2.9 Data analysis 27 2.10 Ethical considerations 28 CHAPTER 29 RESULTS 29 3.1 Demographic characteristics 29 3.2 Overweight and obesity statuses among adolescents 31 3.3 Factors associated with overweight and obesity statuses among adolescents 32 3.4 Multiple logistic regression analysis of the factors associated with overweight and obesity 52 CHAPTER 55 DISCUSSION 55 CONCLUSION 67 RECOMMENDATIONS 68 REFERENCES 69 ANNEXES 75 Annex 1: Table of definition and measurement of variables in the study 75 Annex 2: Table 3.6 Frequency of eating particular food items of adolescent (n=403) 78 Annex 3: Questionnaires 81 Annex 4: BMI for age growth charts for boys and girls 5-19 years old 90 Annex 5: Certificate of approval 92 Annex 6: Participant Information Sheet 94 Annex 7: Informed Consent Form 96 Annex 8: Thesis comment 97 Annex 9: Minutes of explanation after thesis defence 104 v LIST OF TABLES Table 3.1 Demographic characteristics of adolescent aged 15-19 years old 30 Table 3.2 Overweight and obesity statuses of adolescents aged 15-19 years old 31 Table 3.3 Overweight and obesity statuses by gender among adolescents aged 15-19 years old 31 Table 3.4 Overweight and obesity statuses by age among adolescents aged 15-19 years old 32 Table 3.5 Family factors contributing to occurrence of overweight and obesity statuses of adolescents 33 Table 3.6 Frequency of eating particular food items of adolescents aged 15-19 years old 36 Table 3.7 Eating habits among adolescents aged 15-19 years old 37 Table 3.8 Physical activity and sedentary behavior among adolescents 38 Table 3.9 Association between individual factors and adolescents‟ overweight and obesity statuses 42 Table 3.10 Association between family factors and overweight and obesity statuses among adolescents aged 15-19 years old 44 Table 3.11 Association between eating habits of adolescents and their overweight and obesity statuses 48 Table 3.12 Association between physical activities of adolescents and their overweight and obesity statuses 49 Table 3.13 Multiple logistic regression analysis of the factors associated with overweight 53 Table 3.14 Multiple logistic regression analysis of the factors associated with obesity 54 vi SUMMARY Overweight and obesity in adolescents is increasing worldwide Malnutrition has become a challenge to public health in developing countries Childhood obesity increases the risk of chronic disease in adulthood Information about childhood overweight and obesity, however, is scarce in Laos The researcher was therefore keen to explore the prevalence of overweight and obesity and their associated factors among adolescents aged 15 to 19 years in Phonhong District, Vientiane Province, Lao PDR in 2019 A cross-sectional descriptive study was conducted in Phonhong District from 20th August to 10th September, 2019 using a cluster sampling method with 403 adolescents aged 15 to19 A face to face interview technique and anthropometric measurements were used to collect data, with the help of six well trained research assistants Overweight and obesity were determined when BMI for age = 23.0 – 24.9 kg/m2 and BMI for age ≥ 25 kg/m2, respectively Data were processed and entered into the EpiData software and exported into the STATA application for data analysis Univariate and multivariate logistic regressions were carried out to identify the factors associated with overweight and obesity Sixty-one percent of those studied were women, and the prevalence of overweight and obesity were 13% and 11% respectively High monthly family income and family eating outside the home or eating fast food were statistically significant in overweight among adolescents, with (AOR=4.9, p-value