dc.contributor.author | Santos-Beneit, Gloria | |
dc.contributor.author | Fernández-Alvira, Juan M | |
dc.contributor.author | Tresserra-Rimbau, Anna | |
dc.contributor.author | Bodega, Patricia | |
dc.contributor.author | de Cos-Gandoy, Amaya | |
dc.contributor.author | de Miguel, Mercedes | |
dc.contributor.author | Ramírez-Garza, Sonia L | |
dc.contributor.author | Laveriano-Santos, Emily P | |
dc.contributor.author | Arancibia-Riveros, Camila | |
dc.contributor.author | Carral, Vanesa | |
dc.contributor.author | Orrit, Xavier | |
dc.contributor.author | Rodríguez, Carla | |
dc.contributor.author | Carvajal, Isabel | |
dc.contributor.author | Haro, Domenec | |
dc.contributor.author | Peyra, Carles | |
dc.contributor.author | Martínez-Gómez, Jesús | |
dc.contributor.author | Álvarez-Benavides, Antonio | |
dc.contributor.author | Estruch, Ramón | |
dc.contributor.author | Lamuela-Raventós, Rosa M | |
dc.contributor.author | Fernández-Jiménez, Rodrigo | |
dc.contributor.author | Fuster, Valentín | |
dc.date.accessioned | 2023-09-04T10:52:12Z | |
dc.date.available | 2023-09-04T10:52:12Z | |
dc.date.issued | 2023-08-02 | |
dc.identifier.citation | JAMA Cardiol. 2023 Aug 2;e232231 | es_ES |
dc.identifier.uri | http://hdl.handle.net/20.500.12105/16394 | |
dc.description.abstract | IMPORTANCE
School-based interventions offer an opportunity for health promotion in adolescence.
OBJECTIVE
To assess the effect of 2 multicomponent educational health promotion strategies of differing duration and intensity on adolescents' cardiovascular health (CVH).
DESIGN, SETTING, AND PARTICIPANTS
The SI! Program for Secondary Schools is a 4-year cluster randomized clinical intervention trial conducted in 24 secondary schools from Barcelona and Madrid, Spain, from September 7, 2017, to July 31, 2021. Eligible participants were adolescents enrolled in the first grade of secondary school.
INTERVENTIONS
Schools and their participants were randomized to receive a health promotion intervention (SI! Program) over 4 school years (long-term intervention [LTI], 8 schools, 412 adolescents) or 2 school years (short-term intervention [STI], 8 schools, 504 adolescents) or to receive the standard curriculum (control, 8 schools, 441 adolescents).
MAIN OUTCOME AND MEASURES
The primary end point was the between-group difference at 2 and 4 years in the change from baseline of the overall CVH score, as defined by the American Heart Association (range, 0-14 points, with a higher score indicating a healthier CVH profile). Intervention effects were tested with multilevel mixed-effects models. A complete-case intention-to-treat analysis was performed as the primary analysis.
RESULTS
Of the randomized students, the study enrolled 1326 adolescents (684 [51.6%] boys, mean [SD] age, 12.5 [0.4] years at recruitment) with a study completion rate of 86.0%. Baseline overall CVH scores were 10.3 points in the LTI group, 10.6 points in the STI group, and 10.5 points in the control group. After 2 years, at halfway through the LTI and at the end of the STI, the difference in the CVH score change was 0.44 points (95% CI, 0.01-0.87; P = .04) between the LTI group and the control group and 0.18 points (95% CI, -0.25 to 0.61; P = .39) between the STI group and the control group. At 4 years, differences for the LTI and STI groups vs control were 0.12 points (LTI: 95% CI, -0.19 to 0.43; P = .42) and 0.13 points (STI: 95% CI, -0.17 to 0.44; P = .38). No adverse events were reported.
CONCLUSIONS AND RELEVANCE
Overall, the tested school-based health promotion strategies in this randomized clinical trial had a neutral effect on the CVH of the adolescents. Although there was evidence of a marginal beneficial effect at a point halfway through implementation in the LTI group, such a benefit was not noted at 4 years. Further research is warranted into the efficacy of school-based health promotion programs.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT03504059. | es_ES |
dc.description.sponsorship | This work was supported by the
SHE Foundation-la Caixa Foundation (LCF/PR/CE16/
10700001) and the Fundació la Marató de TV3
(369/C/2016). Dr Santos-Beneit is recipient of grant
LCF/PR/MS19/12220001 funded by “la Caixa”
Foundation (ID 100010434). Dr Tresserra-Rimbau
is a Serra Húnter Fellow. Dr Laveriano-Santos is
supported by the FI-SDUR (EMC/503/2021) grant
from the Generalitat de Catalunya.
Mr Martínez-Gómez was a postgraduate fellow of
the Ministerio de Ciencia e Innovación at the
Residencia de Estudiantes (2020-2022) and is a
recipient of grant FPU21/04891 (Ayudas para la
formación de profesorado universitario, FPU-2021)
from the Ministerio de Educación, Cultura y
Deporte. Dr Álvarez-Benavides is a María Zambrano
fellow. Dr Fernández-Jiménez is recipient of grants
PI19/01704 and PI22/01560 funded by the ISCIII
and cofunded by the European Union. Support was
also provided by the Ministerio de Ciencia,
Innovación y Universidades (AEI/FEDER, UE, grant
PID2020-114022RB-I00), and Generalitat de
Catalunya. The Institute for Nutrition and Food
Safety Research (INSA-UB) is a Unit of Excellence
(María de Maeztu CEX2021-001234-M). The Centro
Nacional de Investigaciones Cardiovasculares
(CNIC) is supported by the ISCIII, the Ministerio de
Ciencia e Innovación (MCIN) and the Pro CNIC
Foundation, and is a Severo Ochoa Center of
Excellence (grant CEX2020-001041-S funded by
MICIN/AEI/10.13039/501100011033). | es_ES |
dc.language.iso | eng | es_ES |
dc.publisher | JAMA Network | es_ES |
dc.type.hasVersion | VoR | es_ES |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | * |
dc.title | School-Based Cardiovascular Health Promotion in Adolescents: A Cluster Randomized Clinical Trial. | es_ES |
dc.type | journal article | es_ES |
dc.rights.license | Atribución 4.0 Internacional | * |
dc.identifier.pubmedID | 37531100 | es_ES |
dc.identifier.doi | 10.1001/jamacardio.2023.2231 | es_ES |
dc.contributor.funder | Fundación La Caixa | es_ES |
dc.contributor.funder | Fundación La Marató TV3 | es_ES |
dc.contributor.funder | Ministerio de Ciencia e Innovación (España) | es_ES |
dc.contributor.funder | Ministerio de Educación, Cultura y Deporte (España) | es_ES |
dc.contributor.funder | Instituto de Salud Carlos III | es_ES |
dc.contributor.funder | Ministerio de Ciencia, Innovación y Universidades (España) | es_ES |
dc.contributor.funder | Ministerio de Ciencia e Innovación. Centro de Excelencia Severo Ochoa (España) | es_ES |
dc.contributor.funder | Fundación ProCNIC | es_ES |
dc.description.peerreviewed | Sí | es_ES |
dc.identifier.e-issn | 2380-6591 | es_ES |
dc.relation.publisherversion | 10.1001/jamacardio.2023.2231 | es_ES |
dc.identifier.journal | JAMA cardiology | es_ES |
dc.repisalud.orgCNIC | CNIC::Grupos de investigación::Imagen y Salud Cardiovascular | es_ES |
dc.repisalud.institucion | CNIC | es_ES |
dc.rights.accessRights | open access | es_ES |
dc.relation.projectFECYT | info:eu-repo/grantAgreement/ES/LCF/PR/CE16/10700001 | es_ES |
dc.relation.projectFECYT | info:eu-repo/grantAgreement/ES/369/C/2016 | es_ES |
dc.relation.projectFECYT | info:eu-repo/grantAgreement/ES/LCF/PR/MS19/12220001 | es_ES |
dc.relation.projectFECYT | info:eu-repo/grantAgreement/ES/FPU21/04891 | es_ES |
dc.relation.projectFECYT | info:eu-repo/grantAgreement/ES/PI19/01704 | es_ES |
dc.relation.projectFECYT | info:eu-repo/grantAgreement/ES/PI22/01560 | es_ES |
dc.relation.projectFECYT | info:eu-repo/grantAgreement/ES/PID2020-114022RB-I00 | es_ES |
dc.relation.projectFECYT | info:eu-repo/grantAgreement/ES/CEX2021-001234-M | es_ES |
dc.relation.projectFECYT | info:eu-repo/grantAgreement/ES/CEX2020-001041-S/MICIN/AEI/10.13039/501100011033 | es_ES |