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EDITORIALS: Richard L Atkinson and Susan A Nitzke School based programmes on obesity BMJ 2001; 323: 1018-1019 [Full text]

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Lack of evaluation studies of the effect of preventive interventions can be harmful to health

P A Wiegersma   (17 November 2001)

Lack of evaluation studies of the effect of preventive interventions can be harmful to health 17 November 2001
P A Wiegersma, senior lecturer University Groningen, Dept. Social Medicine Send response to journal: Re: Lack of evaluation studies of the effect of preventive interventions can be harmful to health	Editor – With interest I read the article ‘school based programmes on obesity’.1 The conclusion, that the school based intervention caused knowledge about nutrition to increase but has no positive influence on behaviour or pertinent health outcomes, is in line with what we found in a study we carried out among schoolchildren and male conscripts in The Netherlands.2 In this study, we evaluated the effect of (frequent) well child visits, and open consultation hours on various forms of health related behaviour, including eating habits. Another health outcome evaluated was the prevalence of obesity in male conscripts. The Odds Ratio for obesity in male conscripts showed an adverse effect of a greater number of well child visits (OR=2.46, 95% CI=1.74-3.46) and the availability of open consultation hours (OR=1.97, 95% CI=1.72-2.25), whereas eating habits were not significantly influenced by either of these interventions. These findings, as well as those described in the editorial, emphasise the importance of rigorous evaluating any preventive health programme before (general) implementation is even considered. If pushed, many health promotion and public health professionals will agree to this. However, in everyday practice an evaluation of the way the intervention was implemented and the degree of acceptance by both professionals and persons targeted generally suffices. This is clearly illustrated by the way in which in The Netherlands child health care is (to be) implemented: although over the years there has been increasing evidence of the inefficiency and ineffectiveness of especially well child visits, this time consuming and in some respect even detrimental intervention is still carried out widely on grounds hardly scientific in nature. There is even a possibility that in the near future this activity will be entered in the renewed Collective Preventive Health Care Act as one of the core activities of youth health care. 1. Atkinson RL, Nitzke SA. School based programmes on obesity. Increase knowledge about nutrition but do not change eating habits by much. BMJ 2001;323:1018-9. 2. Wiegersma PA, Hofman A, Zielhuis GA. Prevention of unhealthy behaviour by youth health care. J Public Hlth Med, 2000;22:386-92.