title: School-Based Intervention as a Component of a Comprehensive Community Program for Overweight and Obesity Prevention, Sousse, Tunisia, 2009-2014.
abstract: BACKGROUND
  Combating obesity at an early age, by improving physical activity and nutrition-related behaviors, is vital to the prevention of more critical health concerns in adulthood. This intervention study evaluated the effectiveness of a school-based component of a community behavioral intervention on overweight and obesity rates of adolescents in Sousse, Tunisia.
  
  
  METHODS
  A quasi-experimental school-based intervention was conducted with an intervention group (in Sousse Jawhara and Sousse Riadh) and a control group (in Sousse Msaken). The intervention (which was a physical activity and nutrition program) lasted 3 years, with data at preintervention collected during the 2009-2010 school year and at postintervention collected during the 2013-2014 school year. Descriptive statistics and multivariate analysis were used to determine the effect of the intervention on risk of excess weight.
  
  
  RESULTS
  Results showed a significant increase in fruit and vegetable intake by the intervention group (P = .04). The intervention group had an increase in students in the normal weight category (P = .03) and a decrease in students in the overweight category (P = .03).The intervention effect was a protective factor against excess weight for the participating schoolchildren (OR, 0.84; P = .02).
  
  
  CONCLUSIONS
  This study showed that a school-based intervention is successful in increasing healthy dietary habits and in reducing risk of excess weight. It also showed the importance of a multisectoral approach to provide an environment conducive to healthy behaviors for adolescents.
authors.affiliation: University Hospital Farhat Hached, Sousse 4000, Tunisia. Email: jihenmaatoug3107@gmail.com.
authors.forename: Jihene
authors.initials: J
authors.lastname: Maatoug
authors.affiliation: University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Zineb
authors.initials: Z
authors.lastname: Msakni
authors.affiliation: University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Nawel
authors.initials: N
authors.lastname: Zammit
authors.affiliation: University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Sana
authors.initials: S
authors.lastname: Bhiri
authors.affiliation: University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Imed
authors.initials: I
authors.lastname: Harrabi
authors.affiliation: University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Lamia
authors.initials: L
authors.lastname: Boughammoura
authors.affiliation: World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt.
authors.forename: Slim
authors.initials: S
authors.lastname: Slama
authors.affiliation: University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Chaieb
authors.initials: C
authors.lastname: Larbi
authors.affiliation: University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Hassen
authors.initials: H
authors.lastname: Ghannem
mesh_terms: D000293:Adolescent; D002648:Child; D003191:Comprehensive Health Care / Q000379:methods*; D002149:Energy Intake; D015444:Exercise / Q000502:physiology; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D065228:Non-Randomized Controlled Trials as Topic; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D050177:Overweight / Q000517:prevention & control*; D063766:Pediatric Obesity / Q000517:prevention & control*; D015397:Program Evaluation; D065840:Protective Factors; D012307:Risk Factors; D012572:School Health Services / Q000639:trends; D011795:Surveys and Questionnaires; D014416:Tunisia; D014675:Vegetables