title: Challenges and results of a school-based intervention to manage excess weight among school children in Tunisia 2012-2014.
abstract: BACKGROUND
  Obesity is a serious health issue and predisposes individuals to an increased risk of morbidity and mortality. Its prevalence in children has increased worldwide.
  
  
  OBJECTIVE
  To demonstrate the feasibility and effectiveness of a school-based management program based on healthy lifestyle promotion for obese and overweight adolescents in Sousse, Tunisia.
  
  
  METHODS
  We conducted a quasi-experimental study among overweight and obese school children enrolled in 7th and 8th grades in Sousse, Tunisia with two groups, intervention and control. The 1-year intervention was based on promoting healthy eating and physical activity through a collective intervention for all recruited children and an individual intervention only for obese children who require intensive managing. Data collection was done before, at the end and at a 4-month follow up of the intervention, both in intervention and control groups.
  
  
  RESULTS
  The body mass index Z score decreased significantly from pre-intervention to post-intervention (1.89±0.57 to 1.76±0.63, p<0.001) and from post-intervention to the follow-up (1.76±0.63 to 1.55±0.68, p<0.001) in the intervention group. In the control group, it decreased significantly from pre-intervention to post-intervention but not significantly from post-intervention to follow-up assessment. Calorie intake decreased significantly both in intervention and control groups.
  
  
  CONCLUSIONS
  This project began with introducing a new culture of health management in schools on one side and with increasing awareness of the importance of obesity prevention and treatment. The support of authorities for this type of action is very important to guarantee its sustainability.
authors.affiliation: Department of Epidemiology, University Hospital Farhat Hached, Sousse.
authors.forename: Jihen
authors.initials: J
authors.lastname: Maatoug
authors.affiliation: Department of Epidemiology, University Hospital Farhat Hached, Sousse.
authors.forename: Sihem Ben
authors.initials: SB
authors.lastname: Fredj
authors.affiliation: Department of Epidemiology, University Hospital Farhat Hached, Sousse.
authors.forename: Zeineb
authors.initials: Z
authors.lastname: Msakni
authors.affiliation: Department of Epidemiology, University Hospital Farhat Hached, Sousse.
authors.forename: Emna
authors.initials: E
authors.lastname: Dendana
authors.affiliation: Department of Epidemiology, University Hospital Farhat Hached, Sousse.
authors.forename: Jihene
authors.initials: J
authors.lastname: Sahli
authors.affiliation: Department of Epidemiology, University Hospital Farhat Hached, Sousse.
authors.forename: Imed
authors.initials: I
authors.lastname: Harrabi
authors.affiliation: Department of Epidemiology, University Hospital Farhat Hached, Sousse.
authors.forename: Firas
authors.initials: F
authors.lastname: Chouikha
authors.affiliation: Pediatric Department, University Hospital Farhat Hached, Sousse.
authors.forename: Lamia
authors.initials: L
authors.lastname: Boughamoura
authors.affiliation: Department of Community Medicine, Primary Care and Emergency, University Hospitals of Geneva, Geneva.
authors.forename: Slim
authors.initials: S
authors.lastname: Slama
authors.affiliation: Department of Child and Adolescent, University Hospitals of Geneva, Geneva.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Farpour-Lambert
authors.affiliation: Department of Epidemiology, University Hospital Farhat Hached, Sousse.
authors.forename: Hassen
authors.initials: H
authors.lastname: Ghannem
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D015992:Body Mass Index; D003376:Counseling / Q000379:methods*; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006282:Health Personnel; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D050177:Overweight / Q000453:epidemiology / Q000517:prevention & control*; D012572:School Health Services; D012574:Schools; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D014416:Tunisia / Q000453:epidemiology
keywords: adolescent; intervention; obesity; schools