Egan Lyra, Gardner Lauren A, Newton Nicola C, O'Dean Siobhan, Champion Katrina E
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia.
Prev Med Rep. 2024 Aug 13;46:102855. doi: 10.1016/j.pmedr.2024.102855. eCollection 2024 Oct.
This study evaluated the moderating effects of socioeconomic status (SES) and geographical location on the efficacy of an eHealth school-based multiple health behaviour change intervention - - in targeting alcohol and tobacco use, dietary intake, knowledge, behavioural intentions, and psychological distress over 24-months.
Data from the cluster-randomised controlled trial conducted from 2019 to 2021 in 71 Australian secondary schools were analysed (N=6639; baseline age 11-14yrs). Schools were from metropolitan (89%) and regional (11%) areas, and participants' SES was classified as low (15%), mid (37%), and high (48%) relative to the study population. Primary outcomes included alcohol and tobacco use, and a composite indicator of poor diet. Secondary outcomes were knowledge, behavioural intentions, and psychological distress. Latent growth models assessed moderating effects of SES and geographical location on between-group change over 24-months.
Geographical location moderated the intervention's effect on odds of reporting a poor diet (OR = 1.79, 95% CI = 1.32-2.43, p < 0.001) and diet-related behavioural intentions (OR = 0.71, 95% CI = 0.56-0.89, p = 0.024) over time. Subset analyses indicated that intervention participants in regional areas had higher odds of reporting a poor diet (OR = 1.61, 95% CI = 1.13-2.29, p = 0.008), while those in metropolitan areas had higher odds of improving diet-related behavioural intentions (OR = 1.13, 95% CI = 1.01-1.27, p = 0.041), compared to the control group. No other significant moderation effects were observed.
While significant disparities were generally not observed, the geographical differences in intervention effects on diet and diet-related intentions suggest that co-designed and tailored approaches may benefit disadvantaged adolescents to address the disproportionately high rates of lifestyle risk behaviours among these priority populations.
本研究评估了社会经济地位（SES）和地理位置对一项基于电子健康的校内多种健康行为改变干预措施在24个月内针对酒精和烟草使用、饮食摄入、知识、行为意图及心理困扰方面效果的调节作用。
对2019年至2021年在71所澳大利亚中学进行的整群随机对照试验数据进行分析（N = 6639；基线年龄11 - 14岁）。学校来自大都市地区（89%）和区域地区（11%），参与者的SES相对于研究人群被分为低（15%）、中（37%）和高（48%）。主要结局包括酒精和烟草使用以及不良饮食的综合指标。次要结局为知识、行为意图和心理困扰。潜在增长模型评估了SES和地理位置对24个月内组间变化的调节作用。
地理位置调节了干预措施对报告不良饮食几率（OR = 1.79，95%CI = 1.32 - 2.43，p < 0.001）以及饮食相关行为意图（OR = 0.71，95%CI = 0.56 - 0.89，p = 0.024）随时间的影响。亚组分析表明，与对照组相比，区域地区的干预参与者报告不良饮食的几率更高（OR = 1.61，95%CI = 1.13 - 2.29，p = 0.008），而大都市地区的参与者改善饮食相关行为意图的几率更高（OR = 1.13，95%CI = 1.01 - 1.27，p = 0.041）。未观察到其他显著的调节作用。
虽然总体上未观察到显著差异，但干预措施对饮食及饮食相关意图的影响存在地理差异，这表明共同设计和量身定制的方法可能有益于处境不利的青少年，以解决这些优先人群中生活方式风险行为比例过高的问题。
