旨在减少青少年中与非传染性疾病相关的行为风险因素：孟加拉国一项基于学校的健康教育计划的方案。
Towards reducing behavioral risk factors of non-communicable diseases among adolescents: protocol for a school-based health education program in Bangladesh.
机构信息
Chi Research & Infotec Ltd, Dhaka, Bangladesh.
Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
出版信息
BMC Public Health. 2019 Jul 25;19(1):1002. doi: 10.1186/s12889-019-7229-8.
BACKGROUND
Developing strategies aimed at reducing behavioral risk factors and hence the prevalence of non-communicable diseases (NCDs) is a major challenge to the policy makers today. Like the same age group worldwide, the prevalence of obesity, unhealthy dietary habit, physical inactivity, smoking and alcohol intake is high among the adolescents of Bangladesh. Studies showed promising results of an early intervention at adolescent age in reducing the likelihood of NCDs at adult age. So, this study is designed to implement a behavior change intervention and evaluate the effectiveness of the intervention in reducing the behavioral risk factors of NCDs among the adolescents of Bangladesh.
METHODS
A before-after designed intervention study will be conducted in two randomly selected secondary schools- one will be selected randomly as intervention school and the another as control school. A baseline survey will be conducted among the students of both schools by a pre-tested questionnaire to attain their current status of knowledge, attitude and practices related to NCDs. Afterward, students will be enrolled in the intervention group who will meet the eligibility criteria from the intervention school. The intervention will be given through a health promotion session to a group of students, not more than 25 at a time, by trained facilitators. A post-intervention end line survey will be conducted among all the participants from both schools using the same questionnaire 3 months after the baseline survey.
DISCUSSION
An intervention has been developed based on some principals of two psychosocial theory- Motivational Interview and Social Cognitive Theory. Emphasis will be given on motivating the adolescents towards a healthy lifestyle, supporting self-efficacy to be changed, guiding self-regulatory ways along with facilitating desired changing process by empowering them with choices about the preventive measures of NCDs. This intervention is expected to increase awareness by equipping the adolescents with specific knowledge and skills and thus, facilitate an eventual change in their practiced risk behaviors. Besides, this intervention will address multiple behaviors at a time, and will be delivered to a group of adolescents, to attain the cost-effectiveness and thereby making it more realistic in the resource-poor context of Bangladesh.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03975335, registered on 01.06.2019. Retrospectively registered.
背景
制定旨在减少行为风险因素、从而降低非传染性疾病（NCD）患病率的策略，是当前政策制定者面临的一项重大挑战。与全球同年龄段人群一样，孟加拉国青少年中肥胖症、不健康饮食习惯、缺乏身体活动、吸烟和饮酒的比例较高。研究表明，在青少年时期进行早期干预，可降低成年后患 NCD 的可能性，这一结果令人充满希望。因此，本研究旨在实施一项行为改变干预，并评估该干预在降低孟加拉国青少年 NCD 行为风险因素方面的有效性。
方法
将在两所随机选定的中学中开展一项前后对照干预研究——其中一所将随机选定为干预学校，另一所为对照学校。将通过预测试问卷对这两所学校的学生进行基线调查，以了解他们在与 NCD 相关的知识、态度和实践方面的现状。之后，将从干预学校中符合纳入标准的学生中招募干预组学生。干预将通过由经过培训的辅导员对一组学生（每次不超过 25 人）进行健康促进课程来进行。在基线调查后 3 个月，将使用相同的问卷对这两所学校的所有参与者进行干预后终线调查。
讨论
根据两项心理社会理论——动机性访谈和社会认知理论的一些原则，已经制定了一项干预措施。重点将放在激励青少年养成健康的生活方式上，支持他们改变自我效能感，引导自我监管方式，并通过赋予他们关于 NCD 预防措施的选择，为他们提供所需的改变过程的支持。这项干预预计将通过为青少年提供具体的知识和技能，提高他们的认识，从而促进他们实践中风险行为的最终改变。此外，这项干预措施将同时针对多种行为，并将提供给一组青少年，以实现成本效益，从而使其在孟加拉国资源匮乏的背景下更具现实意义。
试验注册
ClinicalTrials.gov NCT03975335，于 2019 年 6 月 1 日注册。回顾性注册。
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