Effect of a Multicomponent Intervention on Lifestyle Factors among Brazilian Adolescents from Low Human Development Index Areas: A Cluster-Randomized Controlled Trial.

Promoting healthy lifestyle factors (e.g., physical activity, healthy eating, less screen time) among young people is a relevant and challenging step toward reducing non-communicable diseases. This study aimed to evaluate the effect of a multicomponent intervention on lifestyle factors among adolescents from schools in low Human Development Index (HDI < 0.500) areas. The Fortaleça sua Saúde program was conducted with 548 adolescents aged 11⁻18 years old in the intervention group and 537 in the control group. The four-month intervention included strategies focused on training teachers, new opportunities for physical activity in the school environment, and health education strategies for the school community (including parents). Moderate- to-vigorous physical activity level (≥420 min/week), TV watching and computer use/gaming (<2 h/day), daily consumption of fruit juice, fruit, vegetables, soft drinks, savory foods and sweets, and current alcohol and tobacco use were measured before and after intervention. McNemar's test and logistic regression (odds ratio [OR] and a 95% confidence interval [95% CI]) were used, considering p < 0.05. In the intervention schools, a significant increase occurred in the number of adolescents who met physical activity guidelines (5.3%; 95% CI = 0.8; 9.8) and who reported using computer for <2 h a day (8.6%; 95% CI = 3.8; 13.4) after intervention. No changes were observed in the control schools. At the end of the intervention, adolescents from intervention schools were more likely to practice physical activity at recommended levels (OR = 1.44; 95% CI = 1.00; 2.08) than adolescents from control schools. No significant change was observed for the other lifestyle factors. In conclusion, this multicomponent intervention was effective in promoting physical activity among adolescents from vulnerable areas. However, other lifestyle factors showed no significant change after intervention. This study is registered at Clinicaltrials.gov NCT02439827.

Effect of a multicomponent intervention on variables related to screen time in adolescents: a cluster-randomized controlled trial / Efeito de uma intervenção multicomponente sobre variáveis relacionadas ao tempo de tela em adolescentes: ensaio randomizado controlado por conglomerado

The aim of this study was to evaluate the effect of an intervention on screen time and on psychoso-cial factors (Attitude, self-efficacy, support of family and school members) associated with reduced screen time in students. A cluster-randomized controlled trial was conducted in three schools in the intervention group (n = 548) and three in the control group (n = 537). The intervention focused on teacher training, opportunities for practicing physical activity at school and reducing screen time, as well as health education. The questionnaire (applied in July and December 2014) included questions about time using TV and computer / video game on weekdays and weekend days (Combined in full-screen time). The psychosocial factors were obtained through scales. The control variables were school and income. The analysis included binary logistic regression models and generalized linear models. The effect size was calculated with analyzes stratified by sex and age (p < 0.05). The intervention group reduced TV (boys: OR = 2.86; CI95%: 1.06-7.71) time and computer/video game (girls: OR = 3.34; CI95%: 1.14-9.84; 11 to 13 years: OR = 3.08; CI95%: 1.17-8.08) for < 2 hours / day (p < 0.05). Positive effects of the intervention were observed on attitude (among girls and adolescents of both age groups) and school support (all subgroups), with effect sizes ranging from 0.21 to 0.54. We concluded that the intervention caused improvements in certain components of the screen time, as well as attitude and school support. Interventions in the school context can help reduce screen time in the young population

O objetivo desse estudo foi avaliar o efeito de uma intervenção sobre tempo de tela e em fatores psicossociais (atitude, autoeficácia, suporte da família e dos membros da escola) associados à redução do tempo de tela em escolares. Ensaio randomizado controlado por conglomerado realizado em três escolas no grupo intervenção (n = 548) e três no grupo controle (n = 537). A intervenção focou na capacitação de professores, oportuni-dades para prática de atividade física na escola e redução do tempo de tela, bem como educação em saúde. O questionário (aplicado em julho e dezembro de 2014) incluiu questões sobre tempo usando TV e computador/videogame em dias de semana e fim de semana (combinados em tempo de tela total). Os fatores psicossociais foram obtidos por meio de escalas. As variáveis de controle foram escola e classe econômica. A análise incluiu modelos de regressão logística binária e modelos lineares generalizados. O tamanho do efeito foi calculado, com análises estratificadas por sexo e faixa etária (p < 0,05). Após o acompanhamento, escolares da inter-venção tiveram maiores chances de reduzir o tempo de TV (rapazes: OR = 2,86; IC95%: 1,06-7,71) e computador/videogame (moças: OR = 3,34; IC95%: 1,14-9,84; 11 a 13 anos: OR = 3,08; IC95%: 1,17-8,08) para < 2 horas/dia (p < 0,05). Efeitos positivos da intervenção ocorreram sobre atitude (entre moças e adolescentes de ambas as faixas etárias) e suporte escolar (todos subgrupos), com tamanhos de efeito variando de 0.21 a 0.54. Conclui-se que a intervenção ocasionou melhoras em determinados componentes do tempo de tela, assim como na atitude e no suporte escolar. Intervenções no contexto escolar podem colaborar para a redução do tempo de tela na população jovem