Faculty of Medicine

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Author: search.filters.author.Wallace, Silver Lorraine

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    FAMILY SOCIOECONOMIC DIFFERENCES AMONG CHILDREN LIVING WITH OVERWEIGHT AND OBESITY IN NORTH MACEDONIA
    (Institute of Public Health of the Republic of North Macedonia, 2024-12)
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    Wallace, Silver Lorraine
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    Mihajlova, Katerina
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    Dimitrievska, Ljubica
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    Globally, the prevalence of overweight and obesity is increasing among children and adolescents. Halting the rise in obesity is a significant challenge because of the complex interplay of factors and influences. We aimed to explore the role of family socioeconomic status (SES) indicators in relation to overweight and obesity prevalence rates among primary school children in North Macedonia. Materials and methods: Data were collected on a nationally representative sample of children and their parent(s)/caregiver(s) participating in the 6th round of World Health Organization (WHO)-European Childhood Obesity Surveillance Initiative (COSI) in North Macedonia. Every child had their height and weight objectively measured and their family sociodemographic and SES data were obtained through a self-reported record form by their parent(s)/caregiver(s). According to COSI reporting, responses on three SES indicators (parental educational attainment, parental employment status and family-perceived wealth) were categorized in levels for data analysis. Overweight and obesity rates were estimated based on 2007 WHO growth references. Pearson’s χ2-tests, corrected with the Rao-Scott method, were used to test differences in overweight and obesity across various subgroups. Results: The sample consisted of primarily native-born children (97.3%) and parents (mothers - 96.2%; fathers - 97.6%), living in urban areas (66.9%), in two-parent families (84.9%) and spoke Macedonian at home (59.8%). The majority of children lived in families with low to medium SES level. Prevalence of overweight was 30.5% [95% CI: 28.5-32.7], whilst of obesity 14.1% [95% CI: 12.3-16.0]. There were no significant differences observed across family SES indicators in overweight or obesity rates. Conclusion: Our findings contribute towards reporting on family SES among children living with overweight and obesity to better understand and address potential obesity risk factors. Future research should focus on exploring family SES within the long-term context of children’s health-related behaviours.
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    DEFINING THE PHYSICAL ACTIVITY ENVIRONMENT IN PRIMARY SCHOOLS ACROSS NORTH MACEDONIA: COSI STUDY
    (Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2025-06)
    Mihajlova, Katerina
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    Wallace, Silver Lorraine
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    Encouraging children to engage in physical activity (PA) is crucial for their overall development. The school environment can play a significant role in shaping children‘s PA habits, which in turn can positively impact their overall health and wellbeing. The aim of this study was to describe characteristics of the PA environment in primary schools across North Macedonia using data from the World Health Organization’s European Childhood Obesity Surveillance Initiative (COSI)—6th round. Materials and Methods: A primary school representative (n=111) responded to questions regarding the PA environment, which included questions about having outdoor and indoor playgrounds and gymnasiums, using of outdoor playgrounds outside of the school hours and during unfavorable weather conditions and organizing PA in and outside of the school hours. Descriptive statistics were conducted to depict the PA environment in primary schools across North Macedonia. Results: Most primary schools had an outdoor playground (94.6%), provided ≥2 hours per week of physical education lessons (89.2%), and had an indoor gymnasium (83.8%). However, smaller primary schools (≤29 pupils) were significantly less likely to have an indoor gymnasium. Approximately half of the primary schools (48.5%) offered organized sport/physical activities ≥1 time per week outside of school hours. Outside of school hours, most primary schools permitted the use of outdoor play areas (77.1%). Conclusion: In conclusion, while the overall PA environments were positive, all Macedonian primary schools did not possess adequate recreational facilities and space for students to be engaged in regular PA. Thus, there is a pressing need for collaborative efforts among schools, local and national authorities to address this issue effectively, aiming to combat childhood obesity and promote increased PA among young students
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    Parental perceptions on their child's weight status in North Macedonia
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2024-07)
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    Wallace, Silver Lorraine
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    Mihajlova, Katerina
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    Introduction: Obesity is a growing crisis, with onset in early childhood. Therefore, understanding the complexity of the family interplay is an important step. Aim: The purpose of this study was to explore parental perceptions of their child’s weight among a nationally representative sample of children living in North Macedonia. Materials and Methods: From October to December 2022, a cross-sectional study was conducted including children and their parents/caregivers who were living in North Macedonia. The study was a part of the 6thround of the WHO Childhood Obesity Surveillance Initiative (COSI). Parental perceptions were assessed through record forms and compared in relation to objectively measured weight status using anthropometric standardized procedures. WHO 2007 cut-off definitions on overweight/obesity were used. Wald χ2-tests were usedto explore relations between objectively measured weight status (i.e., body mass index -BMI) and parental perceptions of their child’s weight status. Statistical significance was set at p<0.05 a priori. Results: The sample was composed of 2613 school children with equal male to female representation and majority living in urban areas, whilst 31.8% of the children were living with overweight (including obesity). Parents underestimated their child’s weight status, especially regarding children with overweight and obesity. Conclusion: To the best of our knowledge, this is the first study in North Macedonia to explore parental perceptions of school children’s weight status and compare accuracy with objective measured children’s weight status. Our study further compliments previous evidence of parental underestimation of children living with overweight and obesity, which is a crucial factor in understanding and addressing childhood obesity
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    Characterizing food, diary and beverage availability in primary schools premises in North Macedonia COSI-Study
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2024-07)
    Mihajlova, Katerina
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    Wallace, Silver Lorraine
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    Introduction: Childhood obesity remains a global public health challenge. As part of the World Health Organization's (WHO) Childhood Obesity Surveillance Initiative (COSI), North Macedonia participates in each data collection round to monitor primary school nutritional environments across the country. School nutrition environment characteristic exploration is necessary for managing and tracking childhood obesity and associated risk factors over time. Aim: Using WHO COSI-6thround data, the aim of this study was to depict availability of select foods, dairy and beverages in a nationally representative sample of primary schools across North Macedonia. Material and methods: Data were drawn from the WHOCOSI-6thround conducted in North Macedonia in 2022. A designated official (n=111) at the respective primary school reported availability of the following: (1) food (fruits, vegetables, ice cream, sweet snacks, and savory snacks), (2) dairy (milk, yogurt, and/or ayran), (3) beverages without added sugar (water, tea, and fruit juices), and (4) beverages with added sugar (non-carbonated fruit juices, carbonated drinks, hot drinks [e.g., cocoa], and flavored milk).Additionally, the designated school official reported whether their primary school had a canteen and/or shop/cafeteria where foods or beverages could be purchased. Results: Across primary schools in North Macedonia, availability of healthy options(i.e., fruits and vegetables)was lower as compared to energy-dense selections (i.e., sweet and savory snacks). Overall, 18.3% of schools offered dairy products (including milk, yogurt, and ayran).Water was the most commonly available (69.0%) beverage. No significant differences emerged in availability of food, dairy, beverages without added sugar or beverages with added sugar across primary school enrollment (small versus large). Less than one-fifth of primary schools had a canteen (17.4%) and/or shop/cafeteria (14.4%) where foods or beverages could be purchased. Conclusion: In conclusion, access to food, dairy, and beverages for primary school children in North Macedonia was limited.