Fidelity of implementation of Reptes, an alcohol and cannabis selective prevention program for youngsters.

OBJECTIVE: Implementation fidelity is a key dimension in process evaluation but has been scarcely studied. Reptes is a selective alcohol and cannabis use prevention program performed in vulnerable young people (16-21 years) from different educational and leisure settings. The study aimed to describe the components of this program, its implementation fidelity, and satisfaction among participants and facilitators. METHOD: A descriptive cross-sectional study was conducted. Implementation fidelity was assessed in terms of adherence, dose, participant responsiveness, and quality of the intervention through self-reports completed by 15 facilitators and self-administered questionnaires by 99 youth from the 15 groups completing the program. RESULTS: 70.7% of the groups performed 30 of the 43 planned activities with high use of various teaching methods, except for Information and Communication Technology resources. Fidelity implementation was above 70%. 2/3 groups completed an acceptable intervention and 1/3 completed a qualified intervention. Satisfaction was higher than 7. CONCLUSIONS: Our results show high implementation fidelity and satisfaction compared with those from similar studies.

Reproducibilidad del cuestionario POIBA-¿Cómo nos movemos?, en escolares colombianos de tercer grado de primaria / Reproducibility of the "POiBA-How do we Move?" Questionnaire in Colombian Third-Grade Elementary Schools / Reprodutibilidade do questionário POiBA-(como nos movemos?) em estudantes colombianos da terceira série do ensino fundamental

Introducción: disponer de instrumentos reproducibles que midan la actividad física y los comportamientos sedentarios es una prioridad para la vigilancia y promoción de estilos de vida saludables en niños y niñas. En esta investigación se evaluó la reproducibilidad prueba-reprueba del cuestionario POIBA-¿Cómo nos movemos? en escolares colombianos. Materiales y métodos: participaron 125 estudian- tes de tercer grado de primaria de una institución educativa colombiana. En dos ocasiones se aplicó el cuestionario POIBA-¿Cómo nos movemos?, que evalúa la actividad física realizada para transportarse a la institución educativa y desde esta, durante el tiempo escolar (clases de educación física y recreo), extraescolar (deportiva, con entrenador) y libre. Se emplearon índices kappa y kappa ponderado en los ítems categóricos y el coeficiente de correlación intraclase con modelo de efectos mixtos en los ítems con escala cuantitativa. Resultados: en los ítems sobre actividad física en el ámbito escolar y deportivo predominaron kappas superiores a 0.70. Las preguntas sobre el transporte a la institución educativa y desde esta tuvieron coeficientes kappa cercanos a 0.90. Los ítems de tiempo frente a pantallas alcanzaron coeficientes kappa alrededor de 0.5, y los correspondientes a la hora de acostarse y levantarse obtuvieron coeficientes de correlación intraclase entre 0.40 y 0.72. Conclusiones: el cuestionario POIBA-¿Cómo nos movemos? es una opción para evaluar la actividad física de escolares en el contexto latinoamericano. Los ítems sobre actividad física de transporte, en el ámbito escolar y deportivo, tuvieron los mayores índices de reproducibilidad.

Introduction: Reproducible instruments measuring physical activity and sedentary behaviors are a priority for monitoring and promoting healthy lifestyles for boys and girls. This study evaluated the test-retest reproducibility of the "Prevención de la Obesidad Infantil en Barcelona (Childhood Obesity Prevention in Barcelona) [POIBA]-How do we move?" questionnaire in Colombian school children. Materials and methods: One hundred twenty-five third-grade primary students from a public educational institution in Colombia participated in the "POIBA-How do we move?" questionnaire, which was conducted twice. The survey measured physical activity during travel to and from school, school hours (physical education classes and recess), extracurricular activities (sports with a coach), and leisure time. To assess reproducibility, categorical questions and questions with a quantitative scale were evaluated using kappa and weighted kappa indices and an intraclass correlation coefficient with a mixed-effects model. Results: In the questions about physical activity at school and sports practice, kappas higher than 0.70 predominated. The questions about commuting to and from school had kappa coefficients close to 0.90. The kappa coefficients for the screen-time questions were around 0.5, and the intraclass correlation coefficients for questions about going to bed and getting up were between 0.40 and 0.72. Conclusions: The "POIBA-How do we move?" questionnaire is a valuable tool for evaluating the physical activity of school children in a Latin American context. The questions concerning physical activity during commuting to and from school, school hours, and sports environment had the highest reproducibility indices.

Introdução: dispor de instrumentos reprodutíveis que meçam a atividade física e os comportamentos sedentários é uma prioridade para a monitorização e promoção de estilos de vida saudáveis em meninos e meninas. Nesta pesquisa, a reprodutibilidade teste-reteste do Questionário POIBA ­ (como nos movemos?) foi avaliada em estudantes colombianos. Materiais e métodos: participaram do estudo 125 alunos da terceira série do ensino fundamental de uma instituição educacional colombiana. Foi aplicado o questionário POIBA ­ (como nos movemos?) em dois momentos, que avalia a atividade física realizada para o transporte de e para a instituição de ensino, no horário escolar (aulas de educação física e recreio), extracurricular (esportes, com treinador) e no tempo livre. Para avaliar a reprodutibi- lidade, foram utilizados os índices Kappa e Kappa ponderado para itens categóricos e o coeficiente de correlação intraclasse com modelo de efeitos mistos para itens com escala quantitativa. Resultados: nos itens sobre atividade física no ambiente escolar e esportivo predominaram Kappas superiores a 0.70. As questões sobre transporte de ida e volta para a instituição de ensino apresentaram coeficientes Kappa próximos a 0.90. Os itens tempo de tela atingiram coeficientes Kappa em torno de 0.5, e os correspondentes a hora de dormir e acordar obtiveram coeficientes de correlação intraclasse entre 0.40 e 0.72. Conclusões: o questionário POIBA ­ (como nos movemos?) é uma opção para avaliação da atividade física de estudantes no contexto latino-americano. Os itens sobre atividade física de transporte, no ambiente escolar e esportivo apresentaram os maiores índices de reprodutibilidade

Fidelity of implementation of Reptes, an alcohol and cannabis selective prevention program for youngsters / Fidelidad de implementación de Reptes, un programa de prevención selectiva del consumo juvenil de alcohol y cánnabis

Objective: Implementation fidelity is a key dimension in process evaluation but has been scarcely studied.Reptes is a selective alcohol and cannabis use prevention program performed in vulnerable young people(16-21 years) from different educational and leisure settings. The study aimed to describe the componentsof this program, its implementation fidelity, and satisfaction among participants and facilitators.Method: A descriptive cross-sectional study was conducted. Implementation fidelity was assessed interms of adherence, dose, participant responsiveness, and quality of the intervention through self-reportscompleted by 15 facilitators and self-administered questionnaires by 99 youth from the 15 groups com-pleting the program.Results: 70.7% of the groups performed 30 of the 43 planned activities with high use of various teachingmethods, except for Information and Communication Technology resources. Fidelity implementation wasabove 70%. 2/3 groups completed an acceptable intervention and 1/3 completed a qualified intervention.Satisfaction was higher than 7.Conclusions: Our results show high implementation fidelity and satisfaction compared with those fromsimilar studies.(AU)

Objetivo: La fidelidad en la implementación es una dimensión clave en el proceso de evaluación, pero hasido escasamente estudiada. Reptes es un programa de prevención selectiva del consumo de alcohol ycánnabis dirigido a jóvenes vulnerables (16-21a ˜nos) de diferentes espacios educativos y de ocio y tiempolibre. El estudio pretende describir los componentes de este programa, su fidelidad de implementacióny la satisfacción de los/las participantes y los/las facilitadores/as.Método: Se realizó un estudio descriptivo transversal. La fidelidad de implementación fue valorada enclave de adherencia, dosis, capacidad de respuesta de los/las participantes y calidad de la interven-ción a través de los informes autocumplimentados por los/las 15 facilitadores/as del programa y loscuestionarios autocompletados por los/las 99 jóvenes de los 15 grupos que completaron el programa.Resultados: El 70,7% de los grupos realizaron 30 de las 43 actividades planificadas, con un uso elevado delas estrategias de aprendizaje, excepto para los recursos basados en las tecnologías de la información yla comunicación. La fidelidad de implementación se situó por encima del 70%. Dos tercios de los gruposcompletaron una intervención aceptable y un tercio completó una intervención cualificada. La satisfacciónse situó por encima de 7.Conclusiones: Nuestros resultados muestran una alta fidelidad en la implementación y la satisfacción encomparación con estudios similares.(AU)

Climate Change and Health in Urban Areas with a Mediterranean Climate: A Conceptual Framework with a Social and Climate Justice Approach.

The consequences of climate change are becoming increasingly evident and highlight the important interdependence between the well-being of people and ecosystems. Although climate change is a global phenomenon, its causes and consequences vary dramatically across territories and population groups. Among settings particularly susceptible to health impacts from climate change are cities with a Mediterranean climate. Here, impacts will put additional pressure on already-stressed ecosystems and vulnerable economies and societies, increasing health inequalities. Therefore, this article presents and discusses a conceptual framework for understanding the complex relationship between climate change and health in the context of cities with Mediterranean climate from a social and climate justice approach. The different elements that integrate the conceptual framework are: (1) the determinants of climate change; (2) its environmental and social consequences; (3) its direct and indirect impacts on health; and (4) the role of mitigation and adaptation policies. The model places special emphasis on the associated social and health inequalities through (1) the recognition of the role of systems of privilege and oppression; (2) the distinction between structural and intermediate determinants of climate change at the root of health inequalities; (3) the role of individual and collective vulnerability in mediating the effects of climate change on health; and (4) the need to act from a climate justice perspective to reverse health inequities.

La prevención universal del consumo de drogas en el entorno escolar: el valor de la monitorización continua / Universal prevention of substance use in school settings: the need for continuous monitoring

Este trabajo presenta la experiencia de gestión por los servicios de salud pública de la ciudad de Barcelona de dos programas de prevención universal del consumo de sustancias adictivas ofrecidos en educación secundaria, revisando el periodo de 1989-1990 a 2016-2017. Ambos programas mostraron su efectividad en evaluaciones con grupo de comparación, se promueven desde los servicios de salud pública de forma gratuita y son impartidos por los/las docentes usando manuales estandarizados, con material de apoyo y formación. La cobertura alcanzada en los últimos años ha bajado del 40% al 25% de las escuelas. Se observan cambios en la aceptación y la realización de los programas que podrían relacionarse con aspectos de seguimiento y logística de los servicios de salud pública, los cambios en la disponibilidad de sustancias psicoactivas y los recortes presupuestarios en educación. La monitorización de los programas efectivos por los servicios de salud pública es fundamental para preservar su realización. (AU)

This paper documents the management of two programs for the universal prevention of substance use offered in secondary schools by the public health services of the city of Barcelona, reviewing the period from 1989–1990 to 2016–2017. Both programs had proven effectiveness in evaluations with a comparison group, they are promoted by the public health agency free of cost, and are taught by teachers, using standardized manuals with support materials and training. The coverage achieved over recent years declined from 40% to 25%. Changes observed in the acceptance and implementation of these programs could be related with logistics and follow-up by the public health services, changes in substance availability, and with budget cuts in education. The monitoring of effective programs by public health services is essential to preserve their actual implementation. (AU)

[Universal prevention of substance use in school settings: the need for continuous monitoring]. / La prevención universal del consumo de drogas en el entorno escolar: el valor de la monitorización continua.

This paper documents the management of two programs for the universal prevention of substance use offered in secondary schools by the public health services of the city of Barcelona, reviewing the period from 1989-1990 to 2016-2017. Both programs had proven effectiveness in evaluations with a comparison group, they are promoted by the public health agency free of cost, and are taught by teachers, using standardized manuals with support materials and training. The coverage achieved over recent years declined from 40% to 25%. Changes observed in the acceptance and implementation of these programs could be related with logistics and follow-up by the public health services, changes in substance availability, and with budget cuts in education. The monitoring of effective programs by public health services is essential to preserve their actual implementation.

Three-Year Follow-Up of the POIBA Intervention on Childhood Obesity: A Quasi-Experimental Study.

Childhood obesity has increased worldwide over the past four decades. This quasi-experimental study aimed to assess the effectiveness of a multicomponent and multilevel school-based intervention (POIBA) at 3 years of follow-up. The nutrition intervention focused on food groups, food pyramid, nutrients, portions, and balanced menus. In total, 3624 children participated in the study. Anthropometric measurements and information on food frequency and behavior, physical activity, and daily screen use were collected in the intervention (IG) and comparison group (CG). Positive unadjusted changes toward adherence to recommendations were found for water, meat, sweets, and fried potato consumption, proper breakfast, not having dinner in front of the TV, out-of-school physical activity, and daily screen use. Three scores were used to calculate the proportion of children making more than one change to improve healthy habits regarding physical activity (global Activity score), nutrition (global Nutrition score), and both (global score). Students exposed to the intervention had a significantly better global Activity score (16.2% IG vs. 11.9% CG; p = 0.012) and Global score (63.9% IG vs. 58.5% CG; p = 0.025). Intervention effects on obesity incidence at 3-year follow-up lost significance but maintained the positive trend. In conclusion, school-based interventions including a family component could be useful to address the childhood obesity problem.

[Personality traits associated with the substance consumption in young people in a context of vulnerability]. / Rasgos de la personalidad asociados al consumo de sustancias en jóvenes en contexto de vulnerabilidad.

OBJECTIVE: To analyze the patterns of alcohol and cannabis consumption, and their associated factors, in young people aged 16 and 21 in a context of vulnerability. METHOD: Cross-sectional study based on a pre-test questionnaire from an evaluation study, administered to a convenience sample of 365 young people from Social Guarantee Programs (SGP), or who attended activities of community entities from disadvantaged neighborhoods in Barcelona. Dependent variables were experimental, regular, and problematic alcohol and cannabis consumption, while independent variables were impulsivity, sensation seeking, expectations, and beliefs regarding drug use, social skills, and contextual variables. Associations were established using multivariate logistic regression models. RESULTS: The prevalence of intensive alcohol consumption (24.2% for binge drinking and 33.3% for binge drinking) and experimental (51.1%) and problematic cannabis use (12.9%) was higher in SGP students than entity youth. Likewise, they presented higher scores on the impulsivity scales, sensation seeking, expectations and beliefs favorable to alcohol consumption. In general, the prevalence of experimental alcohol consumption was higher in girls than in boys. Regular binge drinking was associated with intense sensations seeking (adjusted odds ratio [aOR]: 1.06; 95% confidence interval [95%CI]: 1.01-1.12), while attending SGP was associated with problematic cannabis use (aOR: 2.73; 95%CI: 1.26-5.89). Positive expectations to alcohol and cannabis use were associated with problematic substance use. CONCLUSION: Individual risk, linked to the higher risk trajectories of SGP students, is associated with a higher problematic consumption of alcohol and cannabis than in young people from community entities exposed to an environmental risk of high frequency of consumption.

Community-Based Interventions to Reduce Alcohol Consumption and Alcohol-Related Harm in Adults.

Alcohol consumption was associated with 3 million deaths worldwide in 2016. Although community action has proven to be effective and has become a priority area of the global strategy to reduce alcohol consumption, there is a gap in the knowledge of community interventions to reduce alcohol use among adults. This study aims to analyze the evidence on effective community-based interventions to reduce alcohol consumption and harm among adults and to identify their components and underlying theories. Search strategy involved five databases (January 2000-March 2020). We included multicomponent, evaluated, and community interventions addressing to adults in urban settings of high-income countries. Furthermore, two conceptual frameworks were adapted to identify the social determinants of alcohol related harms and modifiable factors through community interventions. The initial search yielded 164 articles. The final sample included eight primary studies. Six of them were effective and shared three components (community mobilization; law enforcement and media campaigns), they combined approaches at individual and environmental levels addressing structural determinants of health and some cultural aspects related to consumption. Health outcomes focused mainly on reducing consumption, modifying patterns and acute effects on health. Few studies addressed social problems arising from harmful consumption. This review has identified several effective community-based interventions to reduce harmful use of alcohol among adults as well as some mechanisms and theories supporting them. It also provides a framework to guide new designs, with potential evidence of factors, as well as possible combinations of methods to improve health at community level across different settings and contexts.

Adaptation and Evaluation of the Nutrition Environment Measures Survey in Stores to Assess Mediterranean Food Environments (NEMS-S-MED).

The Nutrition Environment Measures Surveys are valid and reliable measures of community and consumer food environments. This article describes the adaptation and evaluation of the Nutrition Environment Measures Survey in Stores (NEMS-S) for Mediterranean urban contexts (NEMS-S-MED). Trained raters used the adapted NEMS-S-MED tool to observe and rate food outlets in 21 census tracts and 43 food stores across the city of Madrid, Spain. We evaluated inter-rater and intra-rater reliabilities, construct validity, and the tool's ability to discriminate between store types and between stores by area-level Socio-Economic Status (SES). Overall, the mean NEMS-S-MED score was 20.7 (SD = 9.8), which ranged from 7 to 43. Most food items displayed substantial or almost perfect inter-rater and intra-rater agreements; the percentage agreement across availability items was almost perfect and kappa statistics were also very high (median κ = 1.00 for inter-rater; κ = 0.92 for intra-rater). Furthermore, the NEMS-S-MED tool was able to discriminate between store types and census tracts of different SES. The adapted NEMS-S-MED instrument is a reliable and valid audit tool to assess the consumer food environment in Mediterranean urban contexts. Well-constructed measurement tools, such as the NEMS-S-MED, may facilitate the development of effective policy interventions to increase healthy food access and affordability.

School and town factors associated with risky alcohol consumption among Catalan adolescents.

Risky alcohol consumption among adolescents has health and social consequences. Evidence identifying the school context that determines alcohol consumption among rural and urban adolescents is lacking. This study aimed to describe the contextual school and town factors determining risky alcohol consumption among rural and urban 10th-grade adolescents (15-17 years old) from Catalonia (northeastern Spain). The study had a cross-sectional design. Cluster sampling with the class as the sampling unit was used, and a total of 1268 10th-grade adolescents from Catalonia nested in 26 high schools participated in the study. A computerized and self-administrated questionnaire was used to collect individual variables. Contextual variables were collected from the Catalan police registers, geocoded sources, and governmental internet databases, and by aggregation of answers from the self-administrated questionnaire. The prevalence of risky alcohol consumption was calculated, and a multilevel Poisson regression analysis with robust variance was conducted with data from adolescents nested within high schools. The results show that risky alcohol consumption is higher among rural adolescents (59.3%) than among urban youth (51.1%) (p < 0.005). Positive expectancies, drunkenness of siblings and friends, and most of the variables indicating accessibility are associated with risky alcohol consumption at the individual level. At the contextual level, the sports center rate and the high school's percentage of risky student alcohol consumption are strongly associated with individual risky alcohol consumption. The town environment (rural or urban), the unemployment rate, and the number of pubs and nightclubs lost their significance after adjustment by the individual and mediating variables. In conclusion, individual factors, such as the influence of drinking patterns of siblings and friends, and more alcohol access opportunities, are associated with adolescents' risky alcohol consumption. The associated contextual factors are the sports center rate and the percentage of risky classmate alcohol consumers. Interventions targeting adolescents should focus at community and high school levels, trying to reduce adolescents' accessibility to alcohol.

The Incidence of Obesity, Assessed as Adiposity, Is Reduced After 1 Year in Primary Schoolchildren by the POIBA Intervention.

BACKGROUND: Childhood obesity is becoming a serious problem, and prevention programs are needed. OBJECTIVE: The purpose of this study was to evaluate, after 1 y, the effectiveness of a multicomponent, school-based obesity intervention program. METHODS: This intervention, conducted in Barcelona, Spain, was a quasi-experimental obesity primary prevention intervention targeting schoolchildren aged 9-10 y. Participants were assigned to an intervention group (IG) (1464 students) or to a comparison group (CG) (1609 students). The intervention consisted of a 9-session classroom program, 6 weekly sessions of physical education and out-of-school physical activity, and a workshop for families. It lasted from October 2011 to May 2012. Data obtained at baseline (spring 2011) and follow-up (spring 2012) included information on nutrition and physical activity, through 2 self-reported questionnaires, and measurement of weight, height, triceps skinfold thickness, and waist circumference. The cumulative incidence rate (CIR) of obesity was calculated from triceps skinfold measures. A multilevel logistic regression model was fitted to determine the association between the intervention and the CIR of obesity. The effect size of the program was estimated with Cohen's criteria. RESULTS: The overall prevalence of obesity at baseline was 12.7%. At the 12-mo follow-up, the incidence of obesity was 7.8% in the IG compared with 11.4% in the CG (P < 0.005), representing 31% fewer new cases of obesity in the IG. The Cohen's d effect size of the program was 0.33. In the multilevel analysis, there was a protective effect of the intervention on the CIR of obesity at 12 mo (OR: 0.7; 95% CI: 0.5, 0.9) (P = 0.009). CONCLUSIONS: The first Prevención de la Obesidad Infantil en Barcelona (Childhood Obesity Prevention in Barcelona) (POIBA) intervention, targeting children aged 9-10 y, reduced the incidence of obesity as measured by adiposity. The intervention could prevent 1 in 3 new cases of childhood obesity in this age range.

[What works in selective prevention of alcohol and cannabis use among vulnerable young people?] / ¿Qué funciona en la prevención selectiva del consumo de alcohol y cánnabis en jóvenes vulnerables?

OBJECTIVE: Selective prevention tackle vulnerable factors associated to problem consumption and social exclusion. There are few effective programs in our context. Study aims were first to identify selective programs of alcohol and cannabis consumption for youths between 16-21, and second, to review intervention, evaluation and effects quality. METHODS: MEDLINE, PubMed, Google academics, EDDRA, SAMHSA, PBE and recommendations of PND were reviewed. Inclusion criteria were: 1) English/ Spanish programs, 2) publications <10 years, 3) target population 16- 21 years old 4) alcohol/ cannabis psicoeducational or socioeducational programs, 5) selective or selective/indicated programs and 6) evaluated programs. The description and quality of the intervention, its evaluation methods, and the presentation of its effects were assessed according to 20 criteria emerged from different recommendations. RESULTS: Fourteen programs followed the inclusion criteria, 10 of followed minimum quality intervention and evaluation criteria, however only 5 shown significant effects. Effective programs tackled negative emotions associated to consumption, promoted skills to cope it and reduce frequency of alcohol consumption, but rarely cannabis consumption. CONCLUSIONS: There are few selective prevention programs, and different studies shown that they have intervention or evaluation weaknesses, but mostly about program effects. The most effective are: PreVenture, The Climate Schools: Alcohol and Cannabis Course, Programa TND, Keepin' it REAL and Weekend is coming.

OBJETIVO: La prevención selectiva aborda los factores de vulnerabilidad asociados al consumo problemático y a la exclusión social. Existen pocos programas en nuestro entorno que sean efectivos. Los objetivos del estudio fueron primero identificar programas de prevención selectiva del consumo de alcohol/cannabis para jóvenes de 16 a 21 años y segundo, revisar la calidad de la intervención, la evaluación y los efectos generados. METODOS: Se revisaron las bases de datos MEDLINE, PubMed, Google académico, EDDRA, SAMHSA, PBE y las recomendaciones del Plan Nacional de Drogas. Los criterios de inclusión fueron: 1) programas en español/inglés, 2) publicaciones <10 años, 3) población diana 16- 21 años 4) programas psicoeducativos o socioeducativos de alcohol/cánnabis, 5) de prevención selectiva o selectiva/indicada y 6) que estuvieran evaluados. La descripción de las intervenciones y su calidad, sus métodos de evaluación y la presentación de los resultados y su eficacia fueron valorados de acuerdo a 20 criterios surgidos de diferentes recomendaciones. RESULTADOS: Catorce de los programas evaluados cumplieron los criterios de inclusión, 10 de ellos cumplieron los criterios de calidad mínimos respecto a la intervención y la evaluación, pero sólo 5 mostraron resultados. Los programas efectivos abordaron las emociones negativas asociadas al consumo, trabajando las habilidades para afrontarlo, y consiguieron reducir la frecuencia del consumo de alcohol, pero raramente de cánnabis. CONCLUSIONES: Existen pocos programas de prevención selectiva y diversos trabajos muestran las debilidades en la calidad de la intervención o la evaluación, pero sobre todo respecto a los efectos que generan. Los más efectivos han resultado ser PreVenture, The Climate Schools: Alcohol and Cannabis Course, Programa TND, Keepin' it REAL y Saluda al fin de semana.

A childhood obesity prevention programme in Barcelona (POIBA Project): Study protocol of the intervention.

BACKGROUND: Childhood obesity preventive interventions should promote a healthy diet and physical activity at home and school. This study aims to describe a school-based childhood obesity preventive programme (POIBA Project) targeting 8-to-12- year-olds. DESIGN AND METHODS: Evaluation study of a school-based intervention with a pre-post quasi-experimental design and a comparison group. Schools from disadvantaged neighbourhoods are oversampled. The intervention consists of 9 sessions, including 58 activities of a total duration between 9 and 13 hours, and the booster intervention of 2 sessions with 8 activities lasting 3 or 4 hours. They are multilevel (individual, family and school) and multicomponent (classroom, physical activity and family). Data are collected through anthropometric measurements, physical fitness tests and lifestyle surveys before and after the intervention and the booster intervention. In the intervention group, families complete two questionnaires about their children's eating habits and physical activity. The outcome variable is the cumulative incidence rate of obesity, obtained from body mass index values and body fat assessed by triceps skinfold thickness. The independent variables are socio-demographic, contextual, eating habits, food frequency, intensity of physical activity and use of new technologies. EXPECTED IMPACT FOR PUBLIC HEALTH: It is essential to implement preventive interventions at early ages and to follow its effects over time. Interventions involving diet and physical activity are the most common, being the most effective setting the school. The POIBA Project intervenes in both the school and family setting and focuses on the most disadvantaged groups, in which obesity is most pronounced and difficult to prevent.

Socioeconomic position and occupational social class and their association with risky alcohol consumption among adolescents.

OBJECTIVES: To compare different measures of socioeconomic position (SEP) and occupational social class (OSC) and to evaluate their association with risky alcohol consumption among adolescents attending the last mandatory secondary school (ages 15-17 years). METHODS: This was a cross-sectional study. 1268 adolescents in Catalonia (Spain) participated in the study. Family affluence scale (FAS), parents' OSC, parents' level of education and monthly familiar income were used to compare socioeconomic indicators. Logistic regression analyses were conducted to evaluate socioeconomic variables and missing associated factors, and to observe the relation between each SEP variable and OSC adjusting by sociodemographic variables. RESULTS: Familiar income had more than 30% of missing values. OSC had the fewest missing values associated factors. Being immigrant was associated with all SEP missing values. All SEP measures were positively associated with risky alcohol consumption, yet the strength of these associations diminished after adjustment for sociodemographic variables. Weekly available money was the variable with the strongest association with risky alcohol consumption. CONCLUSIONS: OSC seems to be as good as the other indicators to assess adolescents' SEP. Adolescents with high SEP and those belonging to upper social classes reported higher levels of risky alcohol consumption.

¿Qué funciona en la prevención selectiva del consumo de alcohol y cánnabis en jóvenes vulnerables? / What works in selective prevention of alcohol and cannabis use among vulnerable young people?

Fundamentos: La prevención selectiva aborda los factores de vulnerabilidad asociados al consumo problemático y a la exclusión social. Existen pocos programas en nuestro entorno que sean efectivos. Los objetivos del estudio fueron primero identificar programas de prevención selectiva del consumo de alcohol/cannabis para jóvenes de 16 a 21 años y segundo, revisar la calidad de la intervención, la evaluación y los efectos generados. Métodos: Se revisaron las bases de datos MEDLINE, PubMed, Google académico, EDDRA, SAMHSA, PBE y las recomendaciones del Plan Nacional de Drogas. Los criterios de inclusión fueron: 1) programas en español/inglés, 2) publicaciones <10 años, 3) población diana 16- 21 años 4) programas psicoeducativos o socioeducativos de alcohol/cánnabis, 5) de prevención selectiva o selectiva/indicada y 6) que estuvieran evaluados. La descripción de las intervenciones y su calidad, sus métodos de evaluación y la presentación de los resultados y su eficacia fueron valorados de acuerdo a 20 criterios surgidos de diferentes recomendaciones. Resultados: Catorce de los programas evaluados cumplieron los criterios de inclusión, 10 de ellos cumplieron los criterios de calidad mínimos respecto a la intervención y la evaluación, pero sólo 5 mostraron resultados. Los programas efectivos abordaron las emociones negativas asociadas al consumo, trabajando las habilidades para afrontarlo, y consiguieron reducir la frecuencia del consumo de alcohol, pero raramente de cánnabis. Conclusiones: Existen pocos programas de prevención selectiva y diversos trabajos muestran las debilidades en la calidad de la intervención o la evaluación, pero sobre todo respecto a los efectos que generan. Los más efectivos han resultado ser PreVenture, The Climate Schools: Alcohol and Cannabis Course, Programa TND, Keepin' it REAL y Saluda al fin de semana

Background: Selective prevention tackle vulnerable factors associated to problem consumption and social exclusion. There are few effective programs in our context. Study aims were first to identify selective programs of alcohol and cannabis consumption for youths between 16-21, and second, to review intervention, evaluation and effects quality. Methods: MEDLINE, PubMed, Google academics, EDDRA, SAMHSA, PBE and recommendations of PND were reviewed. Inclusion criteria were: 1) English/ Spanish programs, 2) publications <10 years, 3) target population 16- 21 years old 4) alcohol/ cannabis psicoeducational or socioeducational programs, 5) selective or selective/indicated programs and 6) evaluated programs. The description and quality of the intervention, its evaluation methods, and the presentation of its effects were assessed according to 20 criteria emerged from different recommendations. Results: Fourteen programs followed the inclusion criteria, 10 of followed minimum quality intervention and evaluation criteria, however only 5 shown significant effects. Effective programs tackled negative emotions associated to consumption, promoted skills to cope it and reduce frequency of alcohol consumption, but rarely cannabis consumption. Conclusions: There are few selective prevention programs, and different studies shown that they have intervention or evaluation weaknesses, but mostly about program effects. The most effective are: PreVenture, The Climate Schools: Alcohol and Cannabis Course, Programa TND, Keepin' it REAL and Weekend is coming

Validation of 'POIBA-How do we eat?' questionnaire in 9-10 years old schoolchildren.

Background: It is difficult to obtain good food reports with Food Frequency Questionnaires (FFQ) among children. In addition, validated questionnaires are scarce. Objective: The aim of this study was to validate the 'POIBA-How do we eat?' (POIBA-HDWE) FFQ and whether it could be administered to children under 10 years of age. Design: We validated the FFQ POIBA-HDWE as part of the Childhood Obesity Prevention Program (POIBA project) in Barcelona. Forty-two out of 63 primary school students (9-10 years old) answered three questionnaires: FFQ POBA-HDWE; another questionnaire, 'POIBA-How do our children eat?' (POIBA-HDOCE), which was administered to the children's parents; and the 24-h recall computer program 'Young Adolescents' Nutrition Assessment on Computer' (YANA-C), which was used on three different days as a gold standard. We tested for correlations using the Spearman test for non-parametric variables. Results: We found low compliance with food recommendations (<50%). The POIBA-HDWE and POIBA-HDOCE questionnaires showed a moderate correlation for soft drinks (r = 0.49; p < 0.01), nuts (r = 0.59; p < 0.01), dairy products (r = 0.41; p < 0.01) and juices (r = 0.49; p < 0.01). There were moderate correlations between POIBA-HDWE and YANA-C for fried potatoes (r = 0.42; p = 0.01), dairy products (r = 0.53; p < 0.01), juices (r = 0.41; p < 0.01), and grains(r = 0.50; p < 0.01). Food frequency questions showed a homogeneity of 0.69, and a sensitivity of over 60% for all food items except chips (37.5%) and sweets (51.7%). Conclusions: The POIBA-HDWE FFQ showed moderate correlations with the gold standard, high sensitivity for most food types and acceptable internal consistency. It is an easy and affordable tool for recording food frequency in children under 10 years old.

Multiple lifestyle risk behaviours and excess weight among adolescents in Barcelona, Spain / Múltiples conductas de riesgo y exceso de peso en adolescentes de Barcelona, España

Objective: We aimed to analyse the prevalence of having multiple lifestyle risk behaviours (LRB) and the potential relationship between excess weight (including overweight and obesity) and cumulative multiple LRB among adolescents in Barcelona, Spain. Methods: A cross-sectional study was performed among a representative sample of 3,114 secondary school students in Barcelona. Height and weight were objectively measured and excess weight was defined in accordance with World Health Organization criteria. Information on screen time, breakfast, physical activity and sleep duration was obtained through a self-administered questionnaire. Results: More than 80% of the students had at least two LRBs. In compulsory schooling, the adjusted prevalence ratio (aPR) of excess weight increased with a higher number of reported LRBs (four LRBs: aPR=1.56; 95% confidence interval: 1.19-2.05). Conclusions These results highlight the importance of a multiple-behaviour approach in preventive programmes aimed at reducing adolescent obesity (AU)

Objetivo: Estimar la prevalencia de adoptar múltiples conductas de riesgo y analizar la potencial asociación entre exceso de peso y adopción de conductas de riesgo en adolescentes de Barcelona, España. Métodos: Estudio transversal realizado a una muestra representativa de 3114 estudiantes de secundaria de Barcelona. Se obtuvieron medidas objetivas de peso y altura, y se definió el exceso de peso según criterios de la Organización Mundial de la Salud. Las conductas de riesgo analizadas fueron el tiempo delante de pantallas, las horas de sueño, el desayuno y la actividad física, obtenidas mediante un cuestionario autoadministrado. Resultados: Más del 80% de los estudiantes declaró adoptar al menos dos conductas de riesgo. En estudiantes de educación secundaria obligatoria, la razón de prevalencia ajustada (RPa) de presentar exceso de peso aumentaba con el número de conductas de riesgo adoptadas (cuatro conductas de riesgo: RPa=1,56; intervalo de confianza del 95%: 1,19-2,05). Conclusiones : Los resultados muestran la importancia de un enfoque multicomponente en los programas de prevención de la obesidad infantojuvenil (AU)

Importancia del proceso en la evaluación de la efectividad de una intervención sobre obesidad infantil / The importance of the process in evaluating the effectiveness of a childhood obesity campaign

La prevención del exceso de peso infantil es actualmente uno de los grandes retos de la salud pública. Ello está generando una intensificación en la producción de evidencias científicas, dando lugar a todo un corpus de conocimiento sobre los componentes esenciales de las intervenciones desarrolladas en ámbitos como el escolar. En este sentido, es fácilmente identificable una tendencia creciente a orientar las aportaciones de las investigaciones hacia la evaluación de los resultados, analizados en términos de efectividad; raramente se pone el foco de atención en el trabajo de campo. Partiendo de la descripción del proceso de desarrollo de una intervención multicomponente, diseñada para prevenir el exceso de peso en escolares de 3° de Educación Primaria, el objetivo de este artículo es incidir en los elementos de dicho proceso considerando cuestiones importantes en su desarrollo, tales como la plausibilidad y la factibilidad en el medio concreto (AU)

The prevention of childhood obesity is one of the greatest public health challenges of modern times. This has triggered the generation of a wealth of scientific evidence, culminating in a body of knowledge concerning the essential components of campaigns implemented in the school setting. In this regard, a growing trend towards the evaluation of research results in terms of effectiveness has become apparent, while the fieldwork itself very rarely comes under the spotlight. By considering the implementation process description of a multicomponent campaign designed to prevent childhood obesity in boys and girls in the 3rdyear of primary education in Spain (9-10 years of age), the aim of this paper is to influence the elements of this process by considering important aspects pertaining to its implementation, such as its plausibility and feasibility in the particular context (AU)

Multiple lifestyle risk behaviours and excess weight among adolescents in Barcelona, Spain.

OBJECTIVE: We aimed to analyse the prevalence of having multiple lifestyle risk behaviours (LRB) and the potential relationship between excess weight (including overweight and obesity) and cumulative multiple LRB among adolescents in Barcelona, Spain. METHODS: A cross-sectional study was performed among a representative sample of 3,114 secondary school students in Barcelona. Height and weight were objectively measured and excess weight was defined in accordance with World Health Organization criteria. Information on screen time, breakfast, physical activity and sleep duration was obtained through a self-administered questionnaire. RESULTS: More than 80% of the students had at least two LRBs. In compulsory schooling, the adjusted prevalence ratio (aPR) of excess weight increased with a higher number of reported LRBs (four LRBs: aPR=1.56; 95% confidence interval: 1.19-2.05). CONCLUSIONS: These results highlight the importance of a multiple-behaviour approach in preventive programmes aimed at reducing adolescent obesity.