Ecological system theory and school-age obesity in Thailand: a participation action research for implications to practice.

Objective: Developing an appropriate context-based school-age obesity prevention programme, understanding the root causes of obesity in real-life situations is vital. The objectives of this study were to explore the risk factors of school-age obesity based on Ecological System Theory (EST) and develop mutual problem-solving guidelines for school-age obesity prevention.

Methods: Participation Action Research (PAR) was used as the study design. The data collection employed focus group discussions, in-depth interviews, participant's observations, together with the procedures of Appreciation, Influence, and Control (AIC) with 55 school key informants.

Results: Risk factors supported by EST at all level included high-calorie intake; sedentary lifestyles; perceptions of 'Chubby are cute'; indulgent parenting, including limited exercise area in school. PAR process guarantees the sustained context-based prevention guidelines.

Conclusions: The results could be used as a policy-driven for school-based participation and environmental support in order to promote health-promoting school.