One-year post-intervention effectiveness of a proportionate universal intervention in reducing social inequalities of weight status among adolescents.

Marcel Uwizeye, Mohamed Dakin, Florian Manneville, Johanne Langlois, Karine Legrand, Elisabeth Spitz, Philip Böhme, Edith Lecomte, Francis Guillemin, Serge Briançon, Abdou Omorou
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Abstract

Introduction: The effectiveness of interventions in reducing social inequalities of weight status among adolescents is challenging. Studies reporting post-intervention effectiveness are scarce. We aimed to evaluate the 1-year post-intervention effectiveness of PRALIMAP-INÈS (PRomotion de l'ALIMentation et de l'Activité Physique - INÉgalité de Santé) trial.

Methods: Participants of the PRALIMAP-INÈS trial, a proportionate universal intervention of 1-year in 11-13 years-old children recruited in 35 schools of Nord-Est France which compared socially advantaged to less advantaged children, who had completed data at 1-year (T1) and 2-year follow-up visit (T2=1-year post-intervention) were included. The first group received a standard lifestyle intervention (advantaged with standard care [A.S]) and the second a reinforced lifestyle intervention (less advantaged with standard and strengthened care [LA.S.S]). This proportionate intervention led to similar benefit in the two groups after 1-year of intervention. The present work looked at the retention effect of this proportionate intervention 1-year after the end of the lifestyle program. The main outcome was the change in body mass index z-score (BMIz) from T1 to T2. Between-group outcomes changes analysis involved the t test for equivalence using a Two One-Side Test procedure and hierarchical mixed models. Multiple imputation was performed to handle missing data.

Results: This study included 505 adolescents (338 in A.S and 167 in LA.S.S groups) of mean age: 15.2±0.7 years. The equivalence was evidenced for BMIz (0.01[90% confidence interval, -0.05 to 0.07]), BMI (0.02[-0.26 to 0.29]), BMI percent of the 95th percentile of Centers for Disease Control and Prevention (CDC) growth chart reference (0.01[-0.94 to 0.96]), BMI minus 95th Percentile of CDC growth chart reference (0.01[-0.26 to 0.29]) and proportion of obesity (-0.01[-0.04 to 0.04]) from T1 to T2 between LA.S.S and A.S. Nevertheless, we did not show significant difference between the two groups for nutrition behaviors outcomes at 1-year post-intervention.

Conclusion: At 1-year post-intervention, we showed equivalence in adolescents' weight status changes whatever the socioeconomic class. Therefore, this proportionate universal intervention applied to adolescents in a school setting seems effective to prevent the worsening of the social inequalities of weight status in response to a lifestyle intervention at 1-year.

适当的普遍干预在减少青少年体重状况的社会不平等方面干预后一年的有效性。
引言:干预措施在减少青少年体重状况的社会不平等方面的有效性是具有挑战性的。报告干预后效果的研究很少。我们的目的是评估PRALIMAP-INÈS (PRomotion de l'ALIMentation et de l' activit体质- INÉgalité de sant)试验干预后1年的有效性。方法:PRALIMAP-INÈS试验的参与者,在法国东北部35所学校招募的11-13岁儿童中进行了为期1年的比例普遍干预,比较了社会优势和弱势儿童,他们在1年(T1)和2年随访(T2=干预后1年)完成了数据。第一组接受标准生活方式干预(以标准护理为优势),第二组接受强化生活方式干预(以标准和强化护理为劣势[LA.S.S])。这种比例干预在干预1年后两组的获益相似。目前的研究着眼于这种比例干预在生活方式项目结束一年后的保留效果。主要观察指标为T1至T2期间体重指数z-评分(bmi)的变化。组间结果变化分析包括使用双单侧检验程序和分层混合模型进行等价性t检验。对缺失数据进行了多次补全处理。结果:本研究共纳入505例青少年(asa组338例,la s.s s组167例),平均年龄15.2±0.7岁。从T1到T2, LA.S.S和a . s之间的BMI(0.01[90%可信区间,-0.05 ~ 0.07])、BMI(0.02[-0.26 ~ 0.29])、疾病控制与预防中心(CDC)生长图参考的BMI - 95百分位百分比(0.01[-0.94 ~ 0.96])、CDC生长图参考的BMI - 95百分位百分比(0.01[-0.26 ~ 0.29])和肥胖比例(-0.01[-0.04 ~ 0.04])均证明了等效性。干预后1年,我们没有发现两组营养行为结果有显著差异。结论:干预后1年,我们发现无论社会经济阶层如何,青少年的体重状况变化都是相同的。因此,这种适用于学校环境中的青少年的比例普遍干预似乎有效地防止了1岁时生活方式干预对体重状况的社会不平等的恶化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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