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Cardiovascular risk factors in multi-ethnic middle school students: the HEALTHY primary prevention trial.

ABSTRACT: The objective of this study was to examine the effects of an integrated, multi-component, school-based intervention programme on cardiovascular disease (CVD) risk factors among a multi-ethnic cohort of middle school students.HEALTHY was a cluster randomized, controlled, primary prevention trial. Middle school was the unit of randomization and intervention. Half of the schools were assigned to an intervention programme consisting of changes in the total school food environment and physical education classes, enhanced by educational outreach and behaviour change activities and promoted by a social marketing campaign consisting of reinforcing messages and images. Outcome data reported (anthropometrics, blood pressure and fasting lipid levels) were collected on a cohort of students enrolled at the start of 6th grade (?11-12 years old) and followed to end of 8th grade (?13-14 years old).Forty-two middle schools were enrolled at seven field centres; 4363 students provided both informed consent and CVD data at baseline and end of study. The sample was 52.7% female, 54.5% Hispanic, 17.6% non-Hispanic Black, 19.4% non-Hispanic White and 8.5% other racial/ethnic combinations, and 49.6% were categorized as overweight or obese (body mass index???85th percentile) at baseline. A significant intervention effect was detected in the prevalence of hypertension in non-Hispanic Black and White males. The intervention produced no significant changes in lipid levels.The prevalence of some CVD risk factors is high in minority middle school youth, particularly males. A multi-component, school-based programme achieved only modest reductions in these risk factors; however, promising findings occurred in non-Hispanic Black and White males with hypertension.

SUBMITTER: Willi SM

PROVIDER: S-EPMC3348358 | biostudies-literature | 2012 Jun

REPOSITORIES: biostudies-literature

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Cardiovascular risk factors in multi-ethnic middle school students: the HEALTHY primary prevention trial.

Willi S M SM Hirst K K Jago R R Buse J J Kaufman F F El Ghormli L L Bassin S S Elliot D D Hale D E DE

Pediatric obesity 20120328 3

<h4>Objective</h4>The objective of this study was to examine the effects of an integrated, multi-component, school-based intervention programme on cardiovascular disease (CVD) risk factors among a multi-ethnic cohort of middle school students.<h4>Methods</h4>HEALTHY was a cluster randomized, controlled, primary prevention trial. Middle school was the unit of randomization and intervention. Half of the schools were assigned to an intervention programme consisting of changes in the total school fo ...[more]

PMID: 22461375

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Project description:BackgroundThis current study set out to investigate the status of sleep health in 7-20-year-old students in Fuzhou and explore the related influencing factors of sleep health.MethodsA total of 38,467 children and adolescents in Fuzhou were included in the study through a random stratified cluster sampling. Data were collected from May to June 2019, in 18 primary schools and 18 middle schools from nine districts, Fuzhou. Children's parents and adolescents of sampled classes were invited to fill out a series of questionnaires about the performance of the last 6 months (sociodemographic characteristics, sleep-related lifestyle behaviors, and electronic-products usage). Multiple linear regression was carried out to analyze data.ResultsOf the total 40,888 questionnaires we released, 38,467 were valid and effective with the response rate was 94.08%. The age of the surveyed participants was 11.85 ± 3.1, including 20,013 boys and 18,454 girls. The multiple linear regression analysis identified factors associated with sleep health (p < 0.05): Boy (coef = 0.073, 95% CI: 0.030-0.115), age (coef = 1.797, 95% CI: 0.224-0.243), key school (coef = 2.069, 95% CI: 0.105-0.193), urban (coef = 0.096, 95% CI: 0.054-0.139), excessive daytime sleepiness (coef = 0.535, 95% CI: 0.432-0.639), unhealthy sleep habits (coef = 0.363, 95% CI: 0.307-0.419), eating before sleep (coef = 0.578, 95% CI: 0.527-0.630), using electronic products in bedroom (coef = 0.074, 95% CI: 0.028-0.121), screen time per day during school (coef = 0.260, 95% CI: 0.235-0.284), frequency of using electronics 30 min before bedtime (coef = 0.150, 95% CI: 0.134-0.166), strained relationship with parents (coef = 0.361, 95% CI: 0.270-0.452), strained relationship with peers (coef = 0.267, 95% CI: 0.171-0.363), excessive homework or learning (coef = 0.189, 95% CI: 0.141-0.237), time for doing homework (coef = 0.266, 95% CI: 0.245-0.287), and mood swings frequently (coef = 1.174, 95% CI: 1.127-1.221) negatively impact sleep health. Sleep alone (coef = -0.204, 95% CI: -0.262-0.147) were the risk factors for sleep health. Furthermore, frequent mood swings was considered the most influential factor on overall variables.ConclusionsSleep health is associated with factors covered sociodemographic characteristics, family sleep habits, and routine activities before bedtime. Multiple measures should be taken to improve sleep quality in a targeted manner.

Project description:BackgroundThe prevalence of cardiovascular disease (CVD) is rapidly increasing globally. With a concerning increase among adolescents due to unhealthy habits, obesity, and hypertension, understanding the current status of knowledge, attitudes, and practices (KAP) related to CVD prevention among middle school students is crucial for developing effective school-based health programs to prevent CVD.MethodsThe analytic cross-sectional survey is used in questionnaires to assess KAP related to CVD prevention among middle school students (N = 17,731) from 50 schools across 16 provinces in China in June-July 2023. The pass rate of KAP scores is categorized as good and poor. Independent predictors of good KAP of CVD prevention are ascertained using a binary logistic regression model.ResultsThe study surveyed 8,118 (45.78%) junior high school students and 9,613 (54.22%) high school students. The overall mean [standard deviation (SD)] for the knowledge, attitude, and practice scores were 26.88 (8.12), 53.53 (7.22), and 39.80 (5.96), respectively. The knowledge scores had the lowest pass rate at 56.89%. Only 6.83% of the students know "the definition of blood pressure in adolescents." Attitudes toward health were positive, though the attitude regarding "the danger of prolonged sedentary to cardiovascular health" scored lowest at 73.55%. The practice section had a pass rate of 89.30%; 40.27% of students reported that they spend more than an hour a day on screens. Only one-third of the students would go to bed before 12 o'clock. In univariate analysis, junior high school and high school students differed significantly in knowledge and practice (p < 0.001), but attitude did not differ significantly (p = 0.103).ConclusionThe majority of students lack sufficient knowledge about CVD. It is also found that socioeconomic background, family environment, and educational levels have an impact on cardiovascular health behaviors among students. Strengthening health education involving students, parents, teachers, and communities is essential to promote health knowledge and practices among adolescents.

Project description:BACKGROUND:Allergic diseases, such as asthma, dermatitis, rhinitis, and eczema, are highly prevalent in Chinese school children. Environmental factors, including air pollution and automobile exhaust, play an important role in the etiology of these diseases. However, prenatal and neonatal factors, such as gender, maternal diseases during pregnancy, and premature birth, may also be associated with allergic disease occurrence. The objective of this study was to explore prenatal and neonatal factors that are involved in the development of allergic diseases among primary and middle school students in Guangzhou, China. METHODS:A cross-sectional survey was launched by the Health Promotion Centre for Primary and Secondary Schools of the Guangzhou Municipality in October 2017. All primary and middle school students in Guangzhou were notified to participate in the questionnaire online under the direction of their parents. The results of the physical examination were reported by the schools' medical department. The results of the questionnaire were collected and analyzed by the researchers. The prevalence of asthma, allergic rhinitis, allergic dermatitis, and eczema was identified. RESULTS:Based on reported 183,449 questionnaires and medical records, the data indicate that the sex, birth weight, neonatal feeding type, delivery mode, and students' father smoking status were significantly associated with the prevalence of all four allergic diseases in primary and middle school children. In further stratified analyses of the children with normal birth weight (2500-4000?g) and without any maternal diseases during pregnancy, the factors of male sex, high birth weight, cesarean delivery, and father smoking status all increased the risk of asthma, dermatitis, rhinitis, and eczema. Also, unlike exclusive breastfeeding, breast plus formula feeding increased these risks, but pure formula feeding had the opposite effect. CONCLUSION:Prenatal and neonatal factors, including male sex, high birth weight, cesarean delivery, only child, and father smoking status are associated with the risks of allergic diseases in school children.

Project description:BACKGROUND:The impact of replacing the National Cholesterol Education Program (NCEP)/Adult Treatment Program (ATP) III cholesterol guidelines with the new 2013 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for primary prevention of cardiovascular disease is unclear. METHODS:We used risk factor and 10-year clinical event rate data from MESA, combined with estimates of efficacy of moderate and high-intensity statin therapy from meta-analyses of statin primary prevention trials to estimate (a) the change in number of subjects eligible for drug therapy and (2) the anticipated reduction in atherosclerotic cardiovascular disease (ASCVD) events and increment in type 2 diabetes mellitus (T2DM) associated with the change in cholesterol guidelines. RESULTS:Of the 6,814 MESA participants, 5,437 were not on statins at baseline and had complete data for analysis (mean age 61.4±10.3). Using the NCEP/ATP III guidelines, 1,334 (24.5%) would have been eligible for statin therapy compared with 3,015 (55.5%) under the new ACC/AHA guidelines. Among the subset of newly eligible, 127/1,742 (7.3%) had an ASCVD event during 10years of follow-up. Assuming 10years of moderate-intensity statin therapy, the estimated absolute reduction in ASCVD events for the newly eligible group was 2.06% (number needed to treat [NNT] 48.6) and the estimated absolute increase in T2DM was 0.90% (number needed to harm [NNH] 110.7). Assuming 10years of high-intensity statin therapy, the corresponding estimates for reductions in ASCVD and increases in T2DM were as follows: ASCVD 2.70% (NNT 37.5) and T2DM 2.60% (NNH 38.6). The estimated effects of moderate-intensity statins on 10-year risk for ASCVD and T2DM in participants eligible for statins under the NCEP/ATP III were as follows: 3.20% (NNT 31.5) and 1.06% (NNH 94.2), respectively. CONCLUSION:Substituting the NCEP/ATP III cholesterol guidelines with the 2013 ACC/AHA cholesterol guidelines in MESA more than doubled the number of participants eligible for statin therapy. If the new ACC/AHA cholesterol guidelines are adopted and extend the primary prevention population eligible for treatment, the risk-benefit profile is much better for moderate-intensity than high-intensity statin treatment.

Project description:Objective:To evaluate the effect of a school-based tobacco program in preventing initiation of tobacco use among adolescents in Saudi Arabia. Methods:We used a quasi-experimental controlled design. Four intervention and four control schools were selected from the regional education registry. A baseline questionnaire was administered to all grade 7 students before implementing the tobacco prevention program, Dentists Fighting Nicotine Dependence (DFND). The intervention group (n =379) received the DFND program whereas the control group (n = 255) received the regular tobacco program administered by the Department of Education. The program was delivered by trained health educators over 5?weeks. Pre- and post-test surveys (immediate and 2-year post-intervention) were collected. Study outcomes were current tobacco use, tobacco knowledge, attitude towards not using tobacco, and perceived behavioral control (PBC) of tobacco use. Covariates included sex, parent education, academic performance, absenteeism, student allowance, and religiosity. Data were analyzed using a two-level hierarchical mixed models. Results:In the immediate post-test, 597 participants (intervention, n = 366; control, n = 231) were surveyed. There was no difference in tobacco use between intervention and control schools, however, the intervention group had significantly higher mean scores for knowledge (? = 1.27, SE = 0.27, P?<?.01) and attitude toward not using tobacco (? = 5.17, SE = 2.48, P?<?.05) after adjusting for covariates. At 2-year post-intervention, 463 participants (intervention, n = 289; control, n = 173) were surveyed. There were no differences in tobacco use, knowledge, attitude or PBC between intervention and control groups. Conclusions:Our program did not impact tobacco use. In the short-term, the program significantly improved knowledge and attitude towards not using tobacco. These effects decayed 2 years post-intervention without additional programming. Increasing the effectiveness of DFND may be achieved by expanding curriculum content and practice time throughout the school years and by targeting high-risk adolescents within the program.

Project description:BackgroundCancer in the United States is a leading cause of mortality. Educating adolescents about cancer risks can improve awareness and introduce healthy lifestyle habits. Public health efforts have made significant progress in easing the burden of cancer through the promotion of early screening and healthy lifestyle advocacy. However, there are limited interventions that educate the adolescent population about cancer prevention. Previous studies have demonstrated the effectiveness of serious games (SGs) to teach adolescents about healthy lifestyle choices, but few research efforts have examined the utility of using SGs to educate youth specifically on cancer prevention.ObjectiveThis study aimed to investigate middle school students' preferences for the use of SGs for cancer prevention education. The study also characterized the students' perceptions of desired game design features for a cancer prevention SG.MethodsFocus groups were held to allow adolescents to review a game playbook and discuss gaming behaviors and preferences for an SG for cancer education. The game playbook was developed based on "Cancer, Clear & Simple," a curriculum intended to educate individuals about cancer, prevention, self-care, screening, and detection. In the game, the player learns that they have cancer and is given the opportunity to go back in time to reduce their cancer risk. A focus group discussion guide was developed and consisted of questions about aspects of the playbook and the participants' gaming experience. The participants were eligible if they were 12 to 14 years old, could speak and understand English, and had parents who could read English or Spanish. Each focus group consisted of 5 to 10 persons. The focus groups were audio recorded and professionally transcribed; they were then analyzed content-wise and thematically by 2 study team members. Intercoder reliability (kappa coefficient) among the coders was reported as 0.97. The prevalent codes were identified and categorized into themes and subthemes.ResultsA total of 18 focus groups were held with 139 participants from a Wisconsin middle school. Most participants had at least "some" gaming experience. Three major themes were identified, which were educational video games, game content, and purpose of game. The participants preferred customizable characters and realistic story lines that allowed players to make choices that affect the characters' outcomes. Middle school students also preferred SGs over other educational methods such as lectures, books, videos, and websites. The participants desired SGs to be available across multiple platforms and suggested the use of SGs for cancer education in their school.ConclusionsOlder children and adolescents consider SGs to be an entertaining tool to learn about cancer prevention and risk factors. Their design preferences should be considered to create a cancer education SG that is acceptable and engaging for youth.

Dataset Information

Cardiovascular risk factors in multi-ethnic middle school students: the HEALTHY primary prevention trial.

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Cardiovascular risk factors in multi-ethnic middle school students: the HEALTHY primary prevention trial.

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