Evaluation of a smoke-free beaches intervention in Barcelona: a quasi-experimental study.

BACKGROUND: We aim to assess the effect of a smoke-free beaches (SFB) intervention in Barcelona on smoking during the 2021 bathing season. METHODS: Quasi-experimental pre-post design (pre-intervention period: 15-28 May; post-intervention period: 29 May-12 September). Based on users' profiles and location, four beaches were assigned to the intervention group (IG) and five to the comparison group (CG). The intervention involved: a mayoral decree (29 May), a communication campaign and beach on-site information. We established two 3 m × 3 m transects per beach from the coastline to the promenade. Trained teams collected smoking-related information in the transects through observations and surveys to beach users. Outcomes are as follows: percentage of people reporting witnessing smoking behaviours the last fortnight and percentage of people observed smoking. We calculated and compared prevalence ratios (PRs) with adjusted Poisson regressions. RESULTS: 3751 interviews (1721 IG; 2030 CG) and 1108 observations (498 IG, 610 CG) were carried out. SFB were associated with a significant reduction in the percentage of people reporting witnessing smoking (IG (pre: 87.2%; post: 49.7%); CG (pre: 86.2%; post: 74.1%); PR (95% CI): 0.7 (0.6 to 0.8)); and in the users observed smoking in the beach (IG (pre: 3.8%; post: 3.0%); CG (pre: 2.3%; post: 9.9%); PR (95% CI): 0.3 (0.3 to 0.4)). Satisfaction scores were 8.3 (IG) and 8.1 (CG) out of 10. CONCLUSION: An SFB intervention is an effective and well-accepted measure to reduce smoking and smokers' visibility. Smoke-free measures should be extended to beaches and other non-regulated outdoor areas.

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.

[Childhood obesity prevention from a community view]. / La prevención de la obesidad infantil desde una perspectiva comunitaria.

The percentage of failure and relapse in the treatment of obesity is high. Where possible, the preferred strategy for preventing obesity is to modify eating habits and lifestyles. This article aims to provide a framework for evidence on the most effective interventions for addressing childhood obesity, both from a prevention point of view, as well as reducing it, when it is already established. After a review of the scientific literature, the issues that must be considered both in the universal and selective prevention of childhood obesity are presented. Also, in light of the controversy over the tools for measuring and controlling the problem, some clarification is provided on the criteria. Finally, the approach to the prevention of overweight and obesity with a community perspective is separated, with two short protocols being offered with diagrams of the basic procedure to follow.

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.

Longitudinal effects of the European smoking prevention framework approach (ESFA) project in Spanish adolescents.

BACKGROUND: To describe the effects of a Spanish smoking prevention programme in the context of an European project on regular smoking, in a sample of Barcelona adolescents. METHOD: A quasi-experimental design was conducted. An experimental group (EG) (1080 pupils) was exposed to programme and compared with a control group (CG) (872 students). The intervention included a school-based programme (16 sessions in 3 years), reinforcement of a smoke-free school policy, smoking cessation for teachers, brochures for parents and other community-based activities involving youth clubs and tobacco sales. RESULTS: At 12 months, 4.5% of boys and 5.6% of girls were new smokers in the EG versus 6.7% and 11.7% in the CG (P < 0.001). At 36 months, 18.6% of boys and 31.2% of girls in the EG were regular smokers versus 21.6% of boys and 38.3% of girls in the CG (P < 0.001). The main factors associated with progression to regular smoking at 36 months were to be girl, to attend to a public school and to belong to the CG. CONCLUSION: These results endorse the effectiveness of multi-modal smoking prevention programmes, which include strategies with adults who influence adolescents.

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.

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.

La prevención de la obesidad infantil desde una perspectiva comunitaria / Childhood obesity prevention from a community view

El porcentaje de fracasos y recaídas en el tratamiento de la obesidad es alto. Siempre que sea posible, la prevención de la obesidad para modificar hábitos alimentarios y estilos de vida ha de ser la conducta preferente. Este trabajo pretender ofrecer un marco de evidencia sobre los componentes más efectivos de las intervenciones para el abordaje de la obesidad infantil, tanto de su prevención como de su reducción, cuando esta ya está instaurada. A partir de la literatura científica, se presentan los aspectos que debe contemplar la prevención, tanto universal como selectiva, de la obesidad infantil. Habida cuenta también de la controversia sobre los instrumentos de registro y control del problema, se aportan algunos criterios clarificadores. Finalmente, se diferencia el abordaje de la prevención del sobrepeso y la obesidad con una perspectiva comunitaria, ofreciéndose 2 protocolos breves que esquematizan un procedimiento básico a seguir

The percentage of failure and relapse in the treatment of obesity is high. Where possible, the preferred strategy for preventing obesity is to modify eating habits and lifestyles. This article aims to provide a framework for evidence on the most effective interventions for addressing childhood obesity, both from a prevention point of view, as well as reducing it, when it is already established. After a review of the scientific literature, the issues that must be considered both in the universal and selective prevention of childhood obesity are presented. Also, in light of the controversy over the tools for measuring and controlling the problem, some clarification is provided on the criteria. Finally, the approach to the prevention of overweight and obesity with a community perspective is separated, with two short protocols being offered with diagrams of the basic procedure to follow