Sustainability of and Adherence to Preschool Health Promotion Among Children 9 to 13 Years Old
Background: Long-term evaluations of child health promotion programs are required to assess their sustainability and the need for reintervention. Objectives: This study sought to explore the long-term impact of a preschool health promotion intervention delivered in an urban low-income area of Colomb...
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| Formato: | Artículo (Article) |
| Lenguaje: | Inglés (English) |
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Elsevier USA
2020
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| Acceso en línea: | https://repository.urosario.edu.co/handle/10336/22474 https://doi.org/10.1016/j.jacc.2020.01.051 |
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ir-10336-224742022-05-02T12:37:20Z Sustainability of and Adherence to Preschool Health Promotion Among Children 9 to 13 Years Old Fernández-Jiménez, Rodrigo Briceño, German Céspedes, Jaime Vargas, Sarha Guijarro, Jennifer Baxter, Jorge Hunn, Marilyn Santos-Beneit, Gloria Rodríguez, Carla Céspedes, Maria Paula Bagiella, Emilia Moreno, Zorayda Carvajal, Isabel Fuster, Valentin Adolescent Article Attitude Child Colombia Controlled study Cross-sectional study Dose response Female Habit Health promotion Healthy lifestyle Human Lowest income group Major clinical study Male Outcome assessment Phase 2 clinical trial Preschool child Randomized controlled trial Colombia Child Health promotion Healthy lifestyle Preschool Prevention Background: Long-term evaluations of child health promotion programs are required to assess their sustainability and the need for reintervention. Objectives: This study sought to explore the long-term impact of a preschool health promotion intervention delivered in an urban low-income area of Colombia (phase 1) and to assess the effect of a new community-based intervention (phase 2). Methods: In phase 1, a cross-sectional analysis of knowledge, attitudes, and habits (KAH) toward a healthy lifestyle and ideal cardiovascular health (ICH) scores of 1,216 children 9 to 13 years old was performed. Of the total, 596 had previously received a preschool health promotion intervention at 3 to 5 years old, whereas the remaining 620 were not previously intervened (intervention-naive group). In phase 2, all children were cluster randomized 1:1 to receive either a 4-month educational intervention (the SI! Program) to instill healthy behaviors in community centers (24 clusters, 616 children) or to control (24 clusters, 600 children). Previously intervened and intervention-naive children were not mixed in the same cluster. The primary outcomes were the change from baseline in KAH and ICH scores. Intervention effects were tested for with linear mixed-effects models. Results: In phase 1, ?85% of children had nonideal cardiovascular health, and those who previously received a preschool intervention showed a negligible residual effect compared with intervention-naive children. In phase 2, the between-group (control vs. intervention) differences in the change of the overall KAH and ICH scores were 0.92 points (95% confidence interval [CI]: ?0.28 to 2.13; p = 0.133) and ?0.20 points (95% CI: ?0.43 to 0.03; p = 0.089), respectively. No booster effect was detected. However, a dose-response effect was observed, with maximal benefit in children attending >75% of the scheduled intervention; the difference in the change of KAH between the high- and low-adherence groups was 3.72 points (95% CI: 1.71 to 5.73; p less than 0.001). Conclusions: Although overall significant differences between the intervention and control groups were not observed, high adherence rates to health promotion interventions may improve effectiveness and outcomes in children. Reintervention strategies may be required at multiple stages to induce sustained health promotion effects (Salud Integral Colombia [SI! Colombia II]; NCT03119792) © 2020 2020 2020-05-25T23:56:38Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion 7351097 https://repository.urosario.edu.co/handle/10336/22474 https://doi.org/10.1016/j.jacc.2020.01.051 eng info:eu-repo/semantics/openAccess application/pdf Elsevier USA instname:Universidad del Rosario |
| institution |
EdocUR - Universidad del Rosario |
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DSpace |
| language |
Inglés (English) |
| topic |
Adolescent Article Attitude Child Colombia Controlled study Cross-sectional study Dose response Female Habit Health promotion Healthy lifestyle Human Lowest income group Major clinical study Male Outcome assessment Phase 2 clinical trial Preschool child Randomized controlled trial Colombia Child Health promotion Healthy lifestyle Preschool Prevention |
| spellingShingle |
Adolescent Article Attitude Child Colombia Controlled study Cross-sectional study Dose response Female Habit Health promotion Healthy lifestyle Human Lowest income group Major clinical study Male Outcome assessment Phase 2 clinical trial Preschool child Randomized controlled trial Colombia Child Health promotion Healthy lifestyle Preschool Prevention Fernández-Jiménez, Rodrigo Briceño, German Céspedes, Jaime Vargas, Sarha Guijarro, Jennifer Baxter, Jorge Hunn, Marilyn Santos-Beneit, Gloria Rodríguez, Carla Céspedes, Maria Paula Bagiella, Emilia Moreno, Zorayda Carvajal, Isabel Fuster, Valentin Sustainability of and Adherence to Preschool Health Promotion Among Children 9 to 13 Years Old |
| description |
Background: Long-term evaluations of child health promotion programs are required to assess their sustainability and the need for reintervention. Objectives: This study sought to explore the long-term impact of a preschool health promotion intervention delivered in an urban low-income area of Colombia (phase 1) and to assess the effect of a new community-based intervention (phase 2). Methods: In phase 1, a cross-sectional analysis of knowledge, attitudes, and habits (KAH) toward a healthy lifestyle and ideal cardiovascular health (ICH) scores of 1,216 children 9 to 13 years old was performed. Of the total, 596 had previously received a preschool health promotion intervention at 3 to 5 years old, whereas the remaining 620 were not previously intervened (intervention-naive group). In phase 2, all children were cluster randomized 1:1 to receive either a 4-month educational intervention (the SI! Program) to instill healthy behaviors in community centers (24 clusters, 616 children) or to control (24 clusters, 600 children). Previously intervened and intervention-naive children were not mixed in the same cluster. The primary outcomes were the change from baseline in KAH and ICH scores. Intervention effects were tested for with linear mixed-effects models. Results: In phase 1, ?85% of children had nonideal cardiovascular health, and those who previously received a preschool intervention showed a negligible residual effect compared with intervention-naive children. In phase 2, the between-group (control vs. intervention) differences in the change of the overall KAH and ICH scores were 0.92 points (95% confidence interval [CI]: ?0.28 to 2.13; p = 0.133) and ?0.20 points (95% CI: ?0.43 to 0.03; p = 0.089), respectively. No booster effect was detected. However, a dose-response effect was observed, with maximal benefit in children attending >75% of the scheduled intervention; the difference in the change of KAH between the high- and low-adherence groups was 3.72 points (95% CI: 1.71 to 5.73; p less than 0.001). Conclusions: Although overall significant differences between the intervention and control groups were not observed, high adherence rates to health promotion interventions may improve effectiveness and outcomes in children. Reintervention strategies may be required at multiple stages to induce sustained health promotion effects (Salud Integral Colombia [SI! Colombia II]; NCT03119792) © 2020 |
| format |
Artículo (Article) |
| author |
Fernández-Jiménez, Rodrigo Briceño, German Céspedes, Jaime Vargas, Sarha Guijarro, Jennifer Baxter, Jorge Hunn, Marilyn Santos-Beneit, Gloria Rodríguez, Carla Céspedes, Maria Paula Bagiella, Emilia Moreno, Zorayda Carvajal, Isabel Fuster, Valentin |
| author_facet |
Fernández-Jiménez, Rodrigo Briceño, German Céspedes, Jaime Vargas, Sarha Guijarro, Jennifer Baxter, Jorge Hunn, Marilyn Santos-Beneit, Gloria Rodríguez, Carla Céspedes, Maria Paula Bagiella, Emilia Moreno, Zorayda Carvajal, Isabel Fuster, Valentin |
| author_sort |
Fernández-Jiménez, Rodrigo |
| title |
Sustainability of and Adherence to Preschool Health Promotion Among Children 9 to 13 Years Old |
| title_short |
Sustainability of and Adherence to Preschool Health Promotion Among Children 9 to 13 Years Old |
| title_full |
Sustainability of and Adherence to Preschool Health Promotion Among Children 9 to 13 Years Old |
| title_fullStr |
Sustainability of and Adherence to Preschool Health Promotion Among Children 9 to 13 Years Old |
| title_full_unstemmed |
Sustainability of and Adherence to Preschool Health Promotion Among Children 9 to 13 Years Old |
| title_sort |
sustainability of and adherence to preschool health promotion among children 9 to 13 years old |
| publisher |
Elsevier USA |
| publishDate |
2020 |
| url |
https://repository.urosario.edu.co/handle/10336/22474 https://doi.org/10.1016/j.jacc.2020.01.051 |
| _version_ |
1740172101863604224 |
| score |
12,131701 |