title: Socio-demographic association of non communicable diseases' risk factors in a representative population of school children: a cross-sectional study in Sousse (Tunisia).
abstract: BACKGROUND
  A better understanding of socio-demographic characteristics of subgroups, which have a high risk to develop chronic diseases, is essential to develop more efficient interventional programs especially for youth. This study aimed to determine the association between clusters of non communicable diseases (NCDs') risk factors and the socio-demographic characteristics among a sample of Tunisian school children.
  
  
  METHODS
  We conducted, in 2013/2014, a cross-sectional study among a proportional and stratified school children sample, selected in 17 elementary public schools in Sousse (Tunisia). A cluster analysis was used to identify different NCDs risk factors clusters, based on tobacco use, physical inactivity, unhealthy diet, and excess weight. Subsequent χ2-tests were used to identify differences between the NCDs risk factors clusters in regards to socio-demographic characteristics.
  
  
  RESULTS
  Four clusters of NCDs risk factors were found: 1) Cluster 1: physical inactivity behavior with normal weight, 2) Cluster 2: physical inactivity behavior associated to excess weight, 3) Cluster 3: unhealthy diet associated to excess weight and low practice of physical activity, and 4) Cluster 4: smoking behavior with physical activity behavior. The pattern of cluster membership differed across sex (<10-3), school level, and socioeconomic level (<10-3) but there was no significant difference between clusters for mother's education levels and household tenure.
  
  
  CONCLUSIONS
  This study can have important implications for health policy and practice. Indeed, it found that many subjects have simultaneous multiple NCDs risk factors which leads to identify groups at risk and implement integrated intervention program.
authors.affiliation: .
authors.forename: Meriam
authors.initials: M
authors.lastname: El Ghardallou
authors.affiliation: .
authors.forename: Jihene
authors.initials: J
authors.lastname: Maatoug
authors.affiliation: .
authors.forename: Imed
authors.initials: I
authors.lastname: Harrabi
authors.affiliation: .
authors.forename: Sihem Ben
authors.initials: SB
authors.lastname: Fredj
authors.affiliation: .
authors.forename: Sahli
authors.initials: S
authors.lastname: Jihene
authors.affiliation: .
authors.forename: Emna
authors.initials: E
authors.lastname: Dendana
authors.affiliation: .
authors.forename: Bhiri
authors.initials: B
authors.lastname: Sana
authors.affiliation: .
authors.forename: Nawel
authors.initials: N
authors.lastname: Zammit
authors.affiliation: .
authors.forename: Lamia
authors.initials: L
authors.lastname: Boughammoura
authors.affiliation: .
authors.forename: Hassen
authors.initials: H
authors.lastname: Ghannem
keywords: adolescents; chronic diseases; cluster analysis; risk factors