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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 |