A randomized study of managing obesity among adolescents by combining school with household intervention

Background: Obesity is a public health problem and the prevalence in adolescents is increasing in Brazil. Schools are the central focus of interventions aiming the prevention of obesity, however, randomized trials and cohort studies have not yet provided clear evidence of strategies to reduce prevalence of obesity. The aim is to evaluate the efficacy of combining school (primary) and household (secondary) interventions to reduce excessive weight gain among students. Methods: The intervention target fifth and sixth graders from 18 public schools (9 interventions and 9 controls) in the municipality of Duque de Caxias, at the metropolitan area of Rio de Janeiro, Brazil during the school year/calendar. Demographic, socioeconomic, anthropometric, eating behavior and food consumption data were collected at baseline using a standardized questionnaire programmed in personal digital assistant. Students were evaluated at school for their weight status and those from the intervention group who were classified as overweight or obese by Body mass index criterion are being followed monthly at home by community health agents (CHA) according to a structured intervention with aims to be chosen each month by the adolescent and the family. Primary prevention were held at the school setting and all adolescents from the intervention group are encouraged to change eating habits and food consumption and to increase physical activity and to reduce sedentary behavior. Results: A sample of 2474 students was enrolled in the baseline and the prevalence of obesity was 32%. Two interventions at school were completed in 48 classes. They were well accepted. The first consisted in health eating using education games and the second intervention consisted in culinary classes, when adolescents prepared salads using fresh vegetables and fruits. In relation to household interventions, 61 CHA were trained to visit the household of families with overweight adolescents identified at schools in 17 neighborhoods areas. Monthly families and adolescents choose from 6 aims one to follow. Discussion: This study will provide evidence whether integration of school with primary health care can prevent excessive weight gain among adolescents. Keywords: Obesity prevention, Intervention, Adolescents

Michele Ribeiro Sgambato

State University of Rio de Janeiro/ Institute of Social Medicine

PhD student in Collective Health at the State University of Rio de Janeiro - Institute of Social Medicine (2016). Master's Degree in Collective Health from Federal Fluminense University(2015). Graduated in Nutrition from Federal Fluminense University (2010). Experience in Nutrition: obesity, nutritional assessment and nutritional epidemiology.