Effectiveness of a School-Centered Intervention for Myopia and Obesity Comorbidity in Children: A Cluster-Randomized Trial.
4 affiliations
- 1Institute of Child and Adolescent Health School of Public Health Peking University Beijing China.
- 2National Health Commission Key Laboratory of Reproductive Health Peking University Beijing China.
- 3Linyi University Linyi Shandong China.
- 4Stanford Prevention Research Center Palo Alto California USA.
Abstract
The rising comorbidity of myopia and overweight/obesity (OWOB) in children shares modifiable behavioral pathways, yet evidence for integrated prevention remains limited. We conducted a cluster-randomized, hybrid type I effectiveness-implementation trial in 36 pair-matched Beijing schools. Of 4991 enrolled students in Grades 1-4 and 7, 3426 (68.6%) completed the 12-month follow-up. The school-centered "22510SS" intervention targeted outdoor activity, screen time, diet, sleep, and health monitoring. No statistically significant between-group differences were observed in spherical equivalent or BMI change, or in the prevalence of myopia, OWOB, or their comorbidity. The intervention improved the overall behavior-improvement rate (39.7% vs. 33.7%; OR, 1.34; 95% CI, 1.00-1.80). In a prespecified analysis, students in Grades 1-4 showed slower myopia progression (OR, 0.46; 95% CI, 0.25-0.86); an exploratory analysis suggested benefits among children from less supportive family environments. Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) evaluation showed 100% fidelity for school-based activities, approximately 60% completion of family-facing health-tip dissemination, an incremental cost of ¥215.43 per participant, and a Program Sustainability Assessment Tool (PSAT) score of 6.10/7. The intervention was feasible and improved targeted behaviors but did not produce significant population-level clinical effects within 12 months. Stronger family engagement and longer follow-up may be needed. Trial Registration: NCT05275959.
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BibTeX
@article{li2026effectiveness,
title = {{Effectiveness of a School-Centered Intervention for Myopia and Obesity Comorbidity in Children: A Cluster-Randomized Trial.}},
author = {Jing Li and Di Shi and Yaqi Wang and Yihang Zhang and Jiajia Dang and Yunfei Liu and Jieyu Liu and Ziyue Chen and Xinxin Wang and Jieyun Song and Jun Ma and Randall S Stafford and Yanhui Dong and Yi Song},
journal = {MedComm},
year = {2026},
month = oct,
doi = {10.1002/mco2.71092},
url = {https://europepmc.org/article/MED/42928734},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effectiveness of a School-Centered Intervention for Myopia and Obesity Comorbidity in Children: A Cluster-Randomized Trial.
AU - Jing Li
AU - Di Shi
AU - Yaqi Wang
AU - Yihang Zhang
AU - Jiajia Dang
AU - Yunfei Liu
AU - Jieyu Liu
AU - Ziyue Chen
AU - Xinxin Wang
AU - Jieyun Song
AU - Jun Ma
AU - Randall S Stafford
AU - Yanhui Dong
AU - Yi Song
PY - 2026
DA - 2026/10/25
JO - MedComm
DO - 10.1002/mco2.71092
UR - https://europepmc.org/article/MED/42928734
AB - The rising comorbidity of myopia and overweight/obesity (OWOB) in children shares modifiable behavioral pathways, yet evidence for integrated prevention remains limited. We conducted a cluster-randomized, hybrid type I effectiveness-implementation trial in 36 pair-matched Beijing schools. Of 4991 enrolled students in Grades 1-4 and 7, 3426 (68.6%) completed the 12-month follow-up. The school-centered "22510SS" intervention targeted outdoor activity, screen time, diet, sleep, and health monitoring. No statistically significant between-group differences were observed in spherical equivalent or BMI change, or in the prevalence of myopia, OWOB, or their comorbidity. The intervention improved the overall behavior-improvement rate (39.7% vs. 33.7%; OR, 1.34; 95% CI, 1.00-1.80). In a prespecified analysis, students in Grades 1-4 showed slower myopia progression (OR, 0.46; 95% CI, 0.25-0.86); an exploratory analysis suggested benefits among children from less supportive family environments. Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) evaluation showed 100% fidelity for school-based activities, approximately 60% completion of family-facing health-tip dissemination, an incremental cost of ¥215.43 per participant, and a Program Sustainability Assessment Tool (PSAT) score of 6.10/7. The intervention was feasible and improved targeted behaviors but did not produce significant population-level clinical effects within 12 months. Stronger family engagement and longer follow-up may be needed. Trial Registration: NCT05275959.
SN - 2688-2663
ER -