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多组分干预对低人类发展指数地区巴西青少年生活方式因素的影响:一项整群随机对照试验。

Effect of a Multicomponent Intervention on Lifestyle Factors among Brazilian Adolescents from Low Human Development Index Areas: A Cluster-Randomized Controlled Trial.

机构信息

Federal Institute of Education, Science and Technology of Ceara, 63870-000 Boa Viagem, Brazil.

Post-graduate Program in Collective Health, Ceara State University, 60741-000 Fortaleza, Brazil.

出版信息

Int J Environ Res Public Health. 2019 Jan 18;16(2):267. doi: 10.3390/ijerph16020267.

Abstract

Promoting healthy lifestyle factors (e.g., physical activity, healthy eating, less screen time) among young people is a relevant and challenging step toward reducing non-communicable diseases. This study aimed to evaluate the effect of a multicomponent intervention on lifestyle factors among adolescents from schools in low Human Development Index (HDI < 0.500) areas. The program was conducted with 548 adolescents aged 11⁻18 years old in the intervention group and 537 in the control group. The four-month intervention included strategies focused on training teachers, new opportunities for physical activity in the school environment, and health education strategies for the school community (including parents). Moderate- to-vigorous physical activity level (≥420 min/week), TV watching and computer use/gaming (<2 h/day), daily consumption of fruit juice, fruit, vegetables, soft drinks, savory foods and sweets, and current alcohol and tobacco use were measured before and after intervention. McNemar's test and logistic regression (odds ratio [OR] and a 95% confidence interval [95% CI]) were used, considering < 0.05. In the intervention schools, a significant increase occurred in the number of adolescents who met physical activity guidelines (5.3%; 95% CI = 0.8; 9.8) and who reported using computer for <2 h a day (8.6%; 95% CI = 3.8; 13.4) after intervention. No changes were observed in the control schools. At the end of the intervention, adolescents from intervention schools were more likely to practice physical activity at recommended levels (OR = 1.44; 95% CI = 1.00; 2.08) than adolescents from control schools. No significant change was observed for the other lifestyle factors. In conclusion, this multicomponent intervention was effective in promoting physical activity among adolescents from vulnerable areas. However, other lifestyle factors showed no significant change after intervention. This study is registered at Clinicaltrials.gov NCT02439827.

摘要

促进年轻人的健康生活方式因素(例如,身体活动、健康饮食、减少屏幕时间)是减少非传染性疾病的一个相关且具有挑战性的步骤。本研究旨在评估一项多成分干预措施对来自人类发展指数(HDI < 0.500)较低地区学校青少年生活方式因素的影响。该方案在干预组中对 548 名 11⁻18 岁的青少年和对照组中的 537 名青少年进行了研究。为期四个月的干预措施包括侧重于培训教师、在学校环境中提供新的身体活动机会以及为学校社区(包括家长)提供健康教育策略的策略。在干预前后测量了中等到剧烈的身体活动水平(≥420 分钟/周)、看电视和使用电脑/玩游戏(<2 小时/天)、每天摄入果汁、水果、蔬菜、软饮料、咸味食品和甜食以及当前饮酒和吸烟的情况。采用 McNemar 检验和逻辑回归(比值比 [OR]和 95%置信区间 [95%CI]),考虑 < 0.05。在干预学校,符合身体活动指南的青少年人数(5.3%;95%CI = 0.8;9.8)和报告每天使用电脑时间<2 小时的青少年人数(8.6%;95%CI = 3.8;13.4)显著增加。对照学校没有观察到变化。干预结束时,与对照学校的青少年相比,干预学校的青少年更有可能进行推荐水平的身体活动(OR = 1.44;95%CI = 1.00;2.08)。其他生活方式因素没有明显变化。总之,这项多成分干预措施在促进弱势地区青少年的身体活动方面是有效的。然而,其他生活方式因素在干预后没有明显变化。本研究在 Clinicaltrials.gov 注册,编号为 NCT02439827。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bcf/6352556/567f82cb980a/ijerph-16-00267-g001.jpg

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