Analysis of different anthropometric indicators in the detection of high blood pressure in school adolescents: a cross-sectional study with 8295 adolescents.

BACKGROUND: High blood pressure is strongly associated with obesity in different populations. However, it is unclear whether different anthropometric indicators of obesity can satisfactorily predict high blood pressure in the school setting. OBJECTIVES: This study evaluated the sensitivity and specificity of body mass index, waist circumference, and waist to height ratio in the detection of high blood pressure in adolescents. METHODS: The sample consisted of 8295 adolescents aged 10-17 years. Weight was measured using a digital scale, height with a stadiometer, and waist circumference using a tape measure. Blood pressure was measured by an automatic blood pressure measuring device. ROC curves were used for the analysis of sensitivity and specificity of the three anthropometric indices in identifying high blood pressure. Binary Logistic Regression was used to assess the association of body mass index, waist circumference, and waist to height ratio with high blood pressure. RESULTS: Low values of sensitivity were observed for body mass index (0.35), waist circumference (0.37), and waist to height ratio (0.31) and high values of specificity for body mass index (0.86), waist circumference (0.82), and waist to height ratio (0.83) in the detection of high blood pressure. An association was observed between adolescents classified with high body mass index (OR=3.57 [95% CI=3.10-4.10]), waist cirumference (OR=3.24 [95% CI=2.83-3.72]), and waist to height ratio (OR=2.94 [95% CI=2.54-3.40]) with high blood pressure. CONCLUSIONS: Body mass index, waist circumference, and waist to height ratio presented low sensitivity to identify adolescents with high blood pressure. However, adolescents classified with high body mass index, waist circumference, and waist to height ratio demonstrated a high association of presenting high blood pressure.

Implementation of the "Saúde na Boa" intervention: process evaluation and characteristics of participants and dropouts / Implementação da intervenção "Saúde na Boa": avaliação de processo e características dos estudantes permanecentes e não permanecentes

School-based interventions have been evaluated to examine its implementation quality and to identify the characteristics of successful participants. The objective was to analyze the process evaluation of the "Saúde na Boa" intervention and to test differences between successful participants and dropouts. Twenty schools were randomly selected to receive the intervention (n= 10) or the control (n= 10), in Recife-PE and Florianopolis-SC. The process evaluation was performed in the intervention schools using a checklist of items from five domains (knowledge, visibility, environment, Physical Education classes and extracurricular activities). The operational intervention quality was classified using the median score from each domain (median from 0.0 to 1.0= low, from 1.1 to 2.0= moderate, and from 2.1 to 3.0= high). Student characteristics were assessed at baseline (March 2006) and were compared between the participants who successfully completed the intervention (n= 989) and the dropouts (n= 1,166). We verified moderate to high operational quality of the intervention for knowledge (median= 2.0), fruit distribution and bike rack installation (median= 1.5), acquisition of materials (median= 3.0) and distribution of journals (median= 2.0). Students who dropped out were significantly more frequent in male (47.8% vs. 40.3%), in workers students (49.2% vs. 44.2%), those who smoked (21.8% vs. 13.6%) and consumed alcoholic beverages (57.4% vs. 49.5%), and slept ≥8 h/day (19.5% vs. 27.3%), than participants who did not drop out. Therefore, the "Saúde na Boa" intervention was of moderate operational quality. Participants and dropout students differed according to their gender, work status and use of licit drugs.

Intervenções no ambiente escolar têm sido avaliadas para analisar a qualidade da implementação de suas ações e o perfil dos participantes envolvidos. O objetivo deste estudo foi analisar os resultados da avaliação de processo da intervenção "Saúde na Boa"; e testar diferenças entre estudantes permanecentes e não permanecentes até o final da intervenção. Das vinte escolas selecionadas, dez foram sorteadas para a condição "intervenção" e dez compuseram o grupo "controle", em Recife/PE, e Florianópolis/SC. A avaliação de processo foi realizada nestas escolas, considerando cinco eixos (conhecimento, visibilidade, ambiente, aulas de Educação Física e atividades extraclasse), classificando-se a qualidade operacional da intervenção conforme a mediana do escore em cada um destes fatores (Mediana= 0,0 a 1,0: baixa; 1,1 a 2,0: moderada; 2,1 a 3,0: elevada). As características dos estudantes na linha de base (março de 2006) foram comparadas entre os permanecentes (n= 989) e não permanecentes (n= 1166). Verificou-se qualidade operacional moderada à elevada da intervenção para os itens conhecimento da intervenção (Mediana= 2,0), distribuição de frutas e instalação de bicicletários (Mediana= 1,5), aquisição de materiais (Mediana= 3,0) e distribuição de boletins (Mediana= 2,0). O grupo de não permanecentes apresentou significativamente maior frequência de rapazes (47,8% vs. 40,3%), de jovens que trabalhavam (49,2% vs. 44,2), que consumiam cigarros (21,8% vs. 13,6%) e bebidas alcoólicas (57,4% vs. 49,5%), e dormiam ≥8 h/dia (19,5% vs. 27,3%) do que os permanecentes. Portanto, a intervenção apresentou qualidade operacional moderada, e o perfil do abandono diferiu com relação ao sexo, ocupação e consumo de drogas lícitas.