Rawal Tina, Muris Jean W M, Mishra Vijay Kumar, Arora Monika, Tandon Nikhil, van Schayck Onno C P
Health Promotion Division, Public Health Foundation of India, Gurgaon, India.
Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
Dialogues Health. 2023 Dec;2:100123. doi: 10.1016/j.dialog.2023.100123. Epub 2023 Mar 8.
Emerging lifestyle changes due to rapid urbanization have led to an epidemiological transition and the rising prevalence of obesity is responsible for major non-communicable diseases (NCDs) which have further aggravated due to the COVID-19 pandemic. This study aims to assess the effectiveness of a comprehensive school-based intervention on diet and physical activity-related behavior of adolescents.
In 2019, a cluster-randomized controlled trial was conducted in randomly selected ( = 8) private schools. A 2-year intervention program was implemented over consecutive academic years (2019-2020 and 2020-2021) with students who were in the 6th and 7th grades when the study began. Four schools were randomly assigned to the intervention ( = 794) and four schools to the control group ( = 774).
The difference in changes in diet and physical-activity-related behaviors of the students between the intervention and control schools were not significant in the intention to treat analysis probably due to the large drop-out due to COVID-19 measures: 304 students were available for follow-up in the intervention group and 122 in the control group (391 cases were excluded to make data comparable with baseline survey). The intake of vegetables (once a day) [β = 0.35, OR = 1.42, 95% CI (1.03, 1.95)] in the per-protocol analysis has increased among adolescents in the intervention group as compared to the control group.
The findings of this study indicated a positive effect of the intervention on diet and physical-activity-related changes in the expected direction and highlights the importance of addressing such behavior to prevent obesity among adolescents and thus NCDs in the later stage of life.
快速城市化带来的新兴生活方式变化导致了流行病学转变,肥胖患病率的上升是主要非传染性疾病(NCDs)的成因,而COVID-19大流行使这些疾病进一步加剧。本研究旨在评估一项基于学校的综合干预措施对青少年饮食和身体活动相关行为的有效性。
2019年,在随机选择的8所私立学校开展了一项整群随机对照试验。在连续两个学年(2019 - 2020年和2020 - 2021年)对研究开始时处于六年级和七年级的学生实施了一项为期两年的干预计划。四所学校被随机分配到干预组(n = 794),四所学校被分配到对照组(n = 774)。
在意向性分析中,干预学校和对照学校学生在饮食和身体活动相关行为变化方面的差异不显著,这可能是由于COVID - 19措施导致大量学生退出:干预组有304名学生可供随访,对照组有122名学生(排除391例以使数据与基线调查具有可比性)。在符合方案分析中,与对照组相比,干预组青少年每天食用蔬菜(一次)的摄入量有所增加[β = 0.35,OR = 1.42,95% CI(1.03,1.95)]。
本研究结果表明干预措施对饮食和身体活动相关变化产生了预期方向的积极影响,并突出了应对此类行为以预防青少年肥胖从而预防后期生活中的非传染性疾病的重要性。