Effectiveness of a socially adapted intervention in reducing social inequalities in adolescence weight. The PRALIMAP-INÈS school-based mixed trial

Briançon, Serge; Legrand, Karine; Muller, Laurent; Langlois, J.; Saez, Laura; Spitz, Élisabeth; Quinet, Marie-Hélène; Böhme, Philip; Lecomte, Édith; Omorou, Abdou Y.

doi:10.1038/s41366-020-0520-z

Cited by 6 publications

(14 citation statements)

References 39 publications

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“…This question refers to the matter of upstream or downstream determinants interventions intend to address ( 59 ). Among the interventions included in our review, some targeted upstream determinants (neighbourhood renewal, parenting), others downstream (cancer screening, obesity care management) ( 50 , 64 ). When downstream determinants are the lever of action, authors targeted more easily access to care or health risk ( 48 , 51 ).…”

Section: Resultsmentioning

confidence: 99%

Theoretical and practical challenges of proportionate universalism: a review

Francis-Oliviero

Cambon

Wittwer

et al. 2020

Revista Panamericana De Salud Pública

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Objective. In 2010, the principle of proportionate universalism (PU) has been proposed as a solution to reduce health inequalities. It had a great resonance but does not seem to have been widely applied and no guidelines exist on how to implement it. The two specific objectives of this scoping review were: (1) to describe the theoretical context in which PU was established, (2) to describe how researchers apply PU and related methodological issues. Methods. We searched for all articles published until 6th of February 2020, mentioning “Proportionate Universalism” or its synonyms “Targeted universalism” OR “Progressive Universalism” as a topic in all Web of Science databases. Results. This review of 55 articles allowed us a global vision around the question of PU regarding its theoretical foundations and practical implementation. PU principle is rooted in the social theories of universalism and targeting. It proposes to link these two aspects in order to achieve an effective reduction of health inequalities. Regarding practical implementation, PU interventions were rare and led to different interpretations. There are still many methodological and ethical challenges regarding conception and evaluation of PU interventions, including how to apply proportionality, and identification of needs. Conclusion. This review mapped available scientific literature on PU and its related concepts. PU principle originates from social theories. As highlighted by authors who implemented PU interventions, application raises many challenges from design to evaluation. Analysis of PU applications provided in this review answered to some of them but remaining methodological challenges could be addressed in further research.

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Section: Resultsmentioning

confidence: 99%

Theoretical and practical challenges of proportionate universalism: a review

Francis-Oliviero

Cambon

Wittwer

et al. 2020

Revista Panamericana De Salud Pública

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“…Esta cuestión está relacionada con la de los factores determinantes ascendentes y descendentes que se proponen abordar las intervenciones ( 59 ). Entre las intervenciones incluidas en nuestra revisión, algunas se centraban en los factores determinantes ascendentes (reforma del vecindario, crianza), y otras en los descendentes (detección del cáncer, control de la obesidad) ( 50 , 64 ). Cuando los factores determinantes descendentes eran el impulsor de la acción, los autores se centraron más fácilmente en el acceso a la atención o el riesgo para la salud ( 48 , 51 ).…”

Section: Resultsunclassified

Desafíos teóricos y prácticos del universalismo proporcional: una revisión

Francis-Oliviero

Cambon

Wittwer

et al. 2021

Revista Panamericana De Salud Pública

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Objetivo. En el 2010 se propuso el principio del universalismo proporcional como solución para reducir las desigualdades en materia de salud. Aunque tuvo una gran resonancia, no parece haber sido aplicado ampliamente y no existen directrices sobre cómo aplicarlo. Los dos objetivos específicos de esta revisión sistemática exploratoria fueron: 1) describir el contexto teórico en el que se estableció el universalismo proporcional, y 2) describir cómo los investigadores aplican el universalismo proporcional y las cuestiones metodológicas relacionadas. Métodos. Se buscó en todas las bases de datos de la Web of Science los artículos publicados hasta el 6 de febrero del 2020 que tuvieran como tema “universalismo proporcional” o sus sinónimos “universalismo dirigido” o “universalismo progresivo”. Resultados. Esta revisión de 55 artículos permitió obtener una visión global del universalismo proporcional en cuanto a sus fundamentos teóricos y su aplicación práctica. El principio del universalismo proporcional se basa en las teorías sociales del universalismo y el direccionamiento, y propone vincular estos dos aspectos para lograr una reducción efectiva de las desigualdades en materia de salud. Respecto de su aplicación práctica, las intervenciones basadas en este principio son poco frecuentes y dan lugar a diferentes interpretaciones. Todavía existen muchos desafíos metodológicos y éticos en relación con la concepción y evaluación de las intervenciones relacionadas con el universalismo proporcional, incluida la forma de aplicar la proporcionalidad y la identificación de las necesidades. Discusión. En esta revisión se llevó a cabo un mapeo de la literatura científica disponible sobre el universalismo proporcional y sus conceptos relacionados. Este principio se basa en teorías sociales. Tal como lo destacaron autores que implementaron intervenciones de universalismo proporcional, su aplicación plantea muchos desafíos, desde el diseño hasta la evaluación. El análisis de las aplicaciones del universalismo proporcional presentado en esta revisión respondió a algunos de ellos, pero los desafíos metodológicos restantes requieren ser abordados en futuras investigaciones.

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“…Data were from the PRALIMAP-INÈS trial (15,16) that included adolescents from September 2012 to September 2015 who had excess weight: body mass index (BMI) greater than the International Obesity Task Force (IOTF) (17) cut-off and/or waist circumference greater than the McCarthy cut-off values for age and sex (18) . Eligible adolescents were divided into two groups according to SES measured by the Family Affluence Scale (FAS) (19) .…”

Section: Study Samplementioning

confidence: 99%

“…The first limitation is that scenarios were simulated by using data from an intervention that was effective in reducing social inequalities (16) in weight status among adolescents with overweight and obesity (no difference in proportion of a 1-year reduction in BMIz between advantaged and less advantaged adolescents). This leads to a natural course, which was the context of PRALIMAP-INÈS trial and could limit the generalization of our findings.…”

Section: Limitations and Strengthsmentioning

confidence: 99%

Role of dietary intake and physical activity in reducing weight social inequalities among adolescents: an application of G-formula to PRALIMAP-INÈS trial

Dakin,

Manneville,

Langlois

et al. 2024

Br J Nutr

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Interventions aiming to reduce social inequalities of weight status in adolescents usually focus on lifestyle behaviours, but their effectiveness is limited. This study analysed the effect of achieving levels of dietary intake (DI) and/or physical activity (PA) guidelines on reducing social inequalities in weight status among adolescents. We included adolescents from the PRomotion de l’ALIMentation et de l’Activité Physique – INÉgalité de Santé (PRALIMAP-INÈS) trial with weight status data available at baseline and 1-year follow-up (n=1130). PA and DI were measured using the International Physical Activity Questionnaire and a validated food frequency questionnaire, respectively. We estimated the likelihood of a 1-year reduction in body mass index z-score (BMIz) and population risk difference (PRD) under hypothetical DI and PA levels and socioeconomic status using the parametric G-formula. When advantaged and less advantaged adolescents maintained their baseline DI and PA, we found social inequalities in weight status, with a PRD of a 1-year reduction in BMIz of -1.6% (-3.0%; -0.5%). These inequalities were not observed when less advantaged adolescents increased their proportion of achieving DI guidelines by 30% (PRD=2.2% [-0.5%; 5.0%]) unlike the same increase in PA (PRD= -3.9% [-6.8%; -1.3%]). Finally, social inequalities of weight status were not observed when levels of achievement of both PA and DI guidelines increased by 30% (PRD= 2.2% [-0.5%; 4.0%]). Enhancing DI rather than PA could be effective in reducing social inequalities in weight status among adolescents. Future interventions aiming to reduce these inequalities should mostly target DI to be effective.

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Effectiveness of a socially adapted intervention in reducing social inequalities in adolescence weight. The PRALIMAP-INÈS school-based mixed trial

Cited by 6 publications

References 39 publications

Theoretical and practical challenges of proportionate universalism: a review

Theoretical and practical challenges of proportionate universalism: a review

Desafíos teóricos y prácticos del universalismo proporcional: una revisión

Role of dietary intake and physical activity in reducing weight social inequalities among adolescents: an application of G-formula to PRALIMAP-INÈS trial

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