title: A youth-led social marketing intervention to encourage healthy lifestyles, the EYTO (European Youth Tackling Obesity) project: a cluster randomised controlled0 trial in Catalonia, Spain.
abstract: BACKGROUND
  The encouragement of healthy lifestyles for obesity prevention in young people is a public health priority. The European Youth Tackling Obesity (EYTO) project is a multicentric intervention project with participation from the United Kingdom, Portugal, the Czech Republic and Spain. The general aim of the EYTO project is to improve lifestyles, including nutritional habits and physical activity practice, and to prevent obesity in socioeconomically disadvantaged and vulnerable adolescents. The EYTO project works through a peer-led social marketing intervention that is designed and implemented by the adolescents of each participating country. Each country involved in the project acts independently. This paper describes the "Som la Pera" intervention Spanish study that is part of the EYTO project.
  
  
  METHODS
  In Spain, the research team performed a cluster randomised controlled intervention over 2 academic years (2013-2015) in which 2 high-schools were designated as the control group and 2 high-schools were designated as the intervention group, with a minimum of 121 schoolchildren per group. From the intervention group, 5 adolescents with leadership characteristics, called "Adolescent Challenge Creators" (ACCs), were recruited. These 5 ACCs received an initial 4 h training session about social marketing principles and healthy lifestyle theory, followed by 24 sessions (1.30 h/session) divided in two academic years to design and implement activities presented as challenges to encourage healthy lifestyles among their peers, the approximately 180-200 high-school students in the intervention group. During the design of the intervention, it was essential that the ACCs used the 8 social marketing criteria (customer orientation, behaviour, theory, insight, exchange, competition, segmentation and methods mix). The expected primary outcomes from the Spanish intervention will be as follows: increases in the consumption of fruits and vegetables and physical activity practice along with reductions in TV/computer/game console use. The secondary outcomes will be as follows: increased breakfast consumption, engagement with local recreation and reduced obesity prevalence. The outcomes will be measured by the Health Behaviour in School-aged Children Study (HBSC) survey at baseline and at the end of the intervention. In the control group, no intervention was implemented, but the outcome measurements were collected in parallel with the intervention group.
  
  
  CONCLUSIONS
  This study described a new methodology to improve lifestyles and to address adolescent obesity.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT02157402. Registered 03 June 2014.
authors.affiliation: Health Education and Promotion, NFOC Group, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain. elisabet.llaurado@urv.cat.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Llauradó
authors.affiliation: Health Education and Promotion, NFOC Group, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain. magaly.aceves@estudiants.urv.cat.
authors.forename: Magaly
authors.initials: M
authors.lastname: Aceves-Martins
authors.affiliation: Health Education and Promotion, NFOC Group, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain. lucia.tarro@urv.cat.
authors.forename: Lucia
authors.initials: L
authors.lastname: Tarro
authors.affiliation: Centre Tecnològic de Nutrició i Salut (CTNS), TECNIO, CEICS , Avinguda Universitat, 1, Reus, 43204, Spain. ignasi.papell@ctns.cat.
authors.forename: Ignasi
authors.initials: I
authors.lastname: Papell-Garcia
authors.affiliation: Centre Tecnològic de Nutrició i Salut (CTNS), TECNIO, CEICS , Avinguda Universitat, 1, Reus, 43204, Spain. francesc.puiggros@ctns.cat.
authors.forename: Francesc
authors.initials: F
authors.lastname: Puiggròs
authors.affiliation: Centre Tecnològic de Nutrició i Salut (CTNS), TECNIO, CEICS , Avinguda Universitat, 1, Reus, 43204, Spain. lluis.arola@urv.cat.|Departament de Bioquímica i Biotecnologia, Nutrigenomics Research Group, Universitat Rovira i Virgili, Tarragona, Spain. lluis.arola@urv.cat.
authors.forename: Lluís
authors.initials: L
authors.lastname: Arola
authors.affiliation: Departamento de Estudios de Comunicación, Universitat Rovira i Virgili, Tarragona, Spain. jordi.prades@urv.cat.
authors.forename: Jordi
authors.initials: J
authors.lastname: Prades-Tena
authors.affiliation: Departamento de Estudios de Comunicación, Universitat Rovira i Virgili, Tarragona, Spain. marta.montagut@urv.cat.
authors.forename: Marta
authors.initials: M
authors.lastname: Montagut
authors.affiliation: Departamento de Estudios de Comunicación, Universitat Rovira i Virgili, Tarragona, Spain. carlotamaria.moragas@urv.cat.
authors.forename: Carlota M
authors.initials: CM
authors.lastname: Moragas-Fernández
authors.affiliation: Unit of Lipids and Arteriosclerosis Research, CIBERDEM, NFOC group, Facultat de Medicina i Ciències de la Salut, Hospital Universitari Sant Joan, IISPV, Universitat Rovira i Virgili, C/Sant Llorenç 21, Reus, 43201, Spain. rosa.sola@urv.cat.
authors.forename: Rosa
authors.initials: R
authors.lastname: Solà
authors.affiliation: Unit of Pharmacology, NFOC group, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain. montse.giralt@urv.cat.
authors.forename: Montse
authors.initials: M
authors.lastname: Giralt
mesh_terms: D000293:Adolescent; D016000:Cluster Analysis; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008019:Life Style; D008297:Male; D063766:Pediatric Obesity / Q000517:prevention & control / Q000628:therapy*; D010379:Peer Group; D012919:Social Behavior; D040241:Social Marketing; D013030:Spain