title: Sustainability of the results of a non communicable diseases prevention program among youth in the region of Sousse, Tunisia.
abstract: BACKGROUND
  Implementation of a healthy lifestyle at an early age is described as a successful intervention to prevent non communicable diseases. However, successful programs are not necessarily sustainable. The purpose of this study was to evaluate a 1-year sustainability of a 3-year comprehensive intervention conducted to promote a healthy lifestyle among schoolchildren.
  
  
  METHODS
  A cohort study of 204 schoolchildren enrolled in middle schools was conducted after a quasi-experimental study in the region of Sousse, Tunisia. The survey lasted 1 year. An exposed group (n=105) was selected from the intervention group and the not-exposed group (n=99) was selected from the control group. The exposition was the intervention. The same questionnaire used at pre-intervention and post-intervention was self-administered to collect data about tobacco use, physical activity and eating habits. The biometric measurements were taken by trained medical doctors at schools.
  
  
  RESULTS
  After 1 year of follow-up, none of participants became smokers in the exposed group. However, in the not-exposed group five (5.1%) participants became smokers. The proportion of schoolchildren who experimented with tobacco for the first time increased insignificantly by 2.9% (p=0.77) in the exposed group versus a significant increase by 11.1% (p=0.001) in the not-exposed group. Concerning the recommended physical activity practice, fast food and fried food consumption and overweight, there were no significant changes in the two groups.
  
  
  CONCLUSIONS
  A 3-year non communicable diseases prevention program has limited sustainable effects among schoolchildren in the short-term. Its repetition or a continued program through multisectoral actions is required.
authors.affiliation: Department of Epidemiology University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Nawel
authors.initials: N
authors.lastname: Zammit
authors.affiliation: Department of Epidemiology University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Jihene
authors.initials: J
authors.lastname: Maatoug
authors.affiliation: Department of Epidemiology University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Rim
authors.initials: R
authors.lastname: Ghammam
authors.affiliation: Department of Pediatrics University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Kebaili
authors.initials: K
authors.lastname: Raoudha
authors.affiliation: Department of Pediatrics University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Boughammoura
authors.initials: B
authors.lastname: Lamia
authors.affiliation: Duluth Medical Research Institute, University of Minnesota, Minneapolis, United States of America.
authors.forename: Al'Absi
authors.initials: A
authors.lastname: Mustafa
authors.affiliation: Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, United States of America.
authors.forename: Lando
authors.initials: L
authors.lastname: Harry
authors.affiliation: Department of Epidemiology University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Hassen
authors.initials: H
authors.lastname: Ghannem
keywords: adolescent; lifestyle; schools