Sports-health integration policy and childhood obesity: A difference-in-differences study
Abstract
Background: Childhood obesity has emerged as a major public health challenge, necessitating global effort to turn the tide. Jiangsu Province initiated the Sports-Health Integration Policy (SHIP) and selected different municipalities as the pilot and control sites. SHIP combined hospital collaboration with a digital platform for continuous physical fitness and health monitoring and early warning, supported by coordinated school–family–community engagement to advance sports-health integration. This study evaluated the impact of SHIP implementation on obesity-related outcomes among primary school children.
Methods: We used individual-level longitudinal data from a total of 600 students from multiple schools in the pilot city and another 600 students from the counterpart city, respectively. The primary outcomes included the obesity prevalence rates and BMI z-score. Body fat percentage was measured using bioelectrical impedance analysis. Secondary outcomes included self-reported dietary intake, physical activity, and sedentary lifestyle. A quasi-experimental difference-in-differences framework was used to estimate changes in study outcomes in association with the SHIP implementation.
Results: Compared with their counterparts, children in the SHIP implementation areas experienced greater reductions in overweight/obesity prevalence, BMI z-score, and body fat percentage. SHIP implementation also led to favourable changes in obesity-related lifestyles, including lower consumption of sugar-sweetened beverages, higher levels of moderate-to-vigorous physical activity, and shorter daily screen time.
Conclusions: These findings indicated the field effectiveness of the SHIP implementation warrants continuous investment for scale-up. This hybrid digital-assisted policy plays a promising role in childhood obesity prevention. Further randomized trials with specific school-based programs are encouraged to consolidate the public health gain from SHIP implementation.
Key messages: • This study demonstrates that the Sports-Health Integration Policy reduces obesity prevalence and promotes healthier lifestyle behaviors among children.
• SHIP’s hybrid digital-assisted model represents a effective population-level approach, providing evidence for its broader scale-up.
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BibTeX
@article{xue2026sportshealth,
title = {{Sports-health integration policy and childhood obesity: A difference-in-differences study}},
author = {H Xue and Y Wang and W Du},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.596},
url = {https://doi.org/10.1093/eurpub/ckag169.596},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Sports-health integration policy and childhood obesity: A difference-in-differences study
AU - H Xue
AU - Y Wang
AU - W Du
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.596
UR - https://doi.org/10.1093/eurpub/ckag169.596
AB - Background: Childhood obesity has emerged as a major public health challenge, necessitating global effort to turn the tide. Jiangsu Province initiated the Sports-Health Integration Policy (SHIP) and selected different municipalities as the pilot and control sites. SHIP combined hospital collaboration with a digital platform for continuous physical fitness and health monitoring and early warning, supported by coordinated school–family–community engagement to advance sports-health integration. This study evaluated the impact of SHIP implementation on obesity-related outcomes among primary school children. Methods: We used individual-level longitudinal data from a total of 600 students from multiple schools in the pilot city and another 600 students from the counterpart city, respectively. The primary outcomes included the obesity prevalence rates and BMI z-score. Body fat percentage was measured using bioelectrical impedance analysis. Secondary outcomes included self-reported dietary intake, physical activity, and sedentary lifestyle. A quasi-experimental difference-in-differences framework was used to estimate changes in study outcomes in association with the SHIP implementation. Results: Compared with their counterparts, children in the SHIP implementation areas experienced greater reductions in overweight/obesity prevalence, BMI z-score, and body fat percentage. SHIP implementation also led to favourable changes in obesity-related lifestyles, including lower consumption of sugar-sweetened beverages, higher levels of moderate-to-vigorous physical activity, and shorter daily screen time. Conclusions: These findings indicated the field effectiveness of the SHIP implementation warrants continuous investment for scale-up. This hybrid digital-assisted policy plays a promising role in childhood obesity prevention. Further randomized trials with specific school-based programs are encouraged to consolidate the public health gain from SHIP implementation. Key messages: • This study demonstrates that the Sports-Health Integration Policy reduces obesity prevalence and promotes healthier lifestyle behaviors among children. • SHIP’s hybrid digital-assisted model represents a effective population-level approach, providing evidence for its broader scale-up.
SN - 1101-1262
SN - 1464-360X
ER -