title: Design, randomization and methodology of the TriAtiva Program to reduce obesity in school children in Southern Brazil.
abstract: BACKGROUND
  The prevalence of child obesity in Brazil has increased rapidly in recent decades. There is, therefore, an urgent need to develop effective strategies to prevent and control child obesity. In light of these considerations, an intervention program with a focus on nutrition education and physical activity was developed for to prevent and control obesity in schools. The intervention was called the TriAtiva Program: Education, Nutrition and Physical Activity. This article describes the design, randomization and method used to evaluate the TriAtiva program.
  
  
  METHODS
  This randomized controlled cluster trial was performed in 12 municipal schools in the city of Porto Alegre/RS (six schools in the intervention group and six control schools) which offered first- through fourth grade, during one school year. The TriAtiva Program was implemented through educational activities related to healthy eating and physical activity, creating an environment which promoted student health while involving the school community and student families. The primary outcome of the present study was body mass, while its secondary outcomes were waist circumference, percent body fat, blood pressure and behavioural variables such as eating habits and physical activity levels, as well as the prevalence, incidence and remission rates of obesity.
  
  
  CONCLUSIONS
  The intervention was developed based on a comprehensive review of controlled trials of similar design. The TriAtiva Program: Education, Nutrition and Physical Activity was the first study in Southern Brazil to use a randomized controlled design to evaluate an intervention involving both nutrition education and physical activity in schools. Our results will contribute to the development of future interventions aimed at preventing and controlling child obesity in schools, especially in Brazil. Brazilian Clinical Trials Registry (REBEC) number RBR2xx2z4.
authors.affiliation: Graduate Program in Child and Adolescent Health, School of Medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil. robertafriedrich@hotmail.com.
authors.forename: Roberta R
authors.initials: RR
authors.lastname: Friedrich
authors.affiliation: Department of Nutrition, School of Medicine, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2400, Bairro Santa Cecília, Porto Alegre, 90035003, Rio Grande do Sul, Brazil. lisandreacaetano@hotmail.com.
authors.forename: Lisandrea C
authors.initials: LC
authors.lastname: Caetano
authors.affiliation: Departament of Nutrition, School of Medicine, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2400, Bairro Santa Cecília, Porto Alegre, 90035003, Rio Grande do Sul, Brazil. maridihl@gmail.com.
authors.forename: Mariana D
authors.initials: MD
authors.lastname: Schiffner
authors.affiliation: Graduate Program in Child and Adolescent Health, School of Medicine, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2400, Bairro Santa Cecília, Porto Alegre, 90035003, Rio Grande do Sul, Brazil. mariobwagner@gmail.com.
authors.forename: Mário B
authors.initials: MB
authors.lastname: Wagner
authors.affiliation: Department of Nutrition, School of Medicine, Federal University of Rio Grande do Sul, Brazil. Centre of Food and Nutrition Studies (CESAN) Clinical Hospital of Porto Alegre, Porto Alegre, 90035003, Rio Grande do Sul, Brazil. ischuch@uol.com.br.
authors.forename: Ilaine
authors.initials: I
authors.lastname: Schuch
mesh_terms: D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002648:Child; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000458:organization & administration*; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008019:Life Style; D008297:Male; D009752:Nutritional Status; D009765:Obesity / Q000517:prevention & control / Q000628:therapy; D063766:Pediatric Obesity / Q000517:prevention & control* / Q000628:therapy; D015995:Prevalence; D012572:School Health Services / Q000458:organization & administration*; D055105:Waist Circumference; D015431:Weight Loss