School-based intervention to promote healthy nutrition in Sousse, Tunisia

Kebaili, Raoudha; Harrabi, Imed; Maatoug, Jihène; Ghammam, Rim; Slama, Slim; Ghannem, H.

doi:10.1515/ijamh-2013-0306

Cited by 14 publications

(24 citation statements)

References 13 publications

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“…Although a significant number of school-based studies look into modifying nutrition and physical activity behaviors to combat the obesity problem in developed countries, only a handful have been conducted in the developing world. In Tunisia, a school-based study on nutrition promotion is the only other known study on the topic ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

School-Based Intervention as a Component of a Comprehensive Community Program for Overweight and Obesity Prevention, Sousse, Tunisia, 2009–2014

Maatoug¹,

Msakni²,

Zammit³

et al. 2015

Prev. Chronic Dis.

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IntroductionCombating 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.MethodsA 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.ResultsResults 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).ConclusionThis 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.

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Section: Introductionmentioning

confidence: 99%

School-Based Intervention as a Component of a Comprehensive Community Program for Overweight and Obesity Prevention, Sousse, Tunisia, 2009–2014

Maatoug¹,

Msakni²,

Zammit³

et al. 2015

Prev. Chronic Dis.

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“…Five interventions reportedly targeted more than one setting: school and family [54,56], preschool and family [59], school and community [52], and school, family and community [60]. Included interventions addressed physical activity ( n = 12) [47,48,49,53,54,55,56,59,60,61,62,63], dietary behaviour ( n = 6) [46,48,49,59,60,64,65], and eight reported on anthropometric outcomes [52,53,54,55,60,62,63,66]. Only one intervention [59] targeted preschool-age children, while all others targeted school-age children.…”

Section: Resultsmentioning

confidence: 99%

“…Interventions included curriculum changes [48,53,54,55,62], additional sessions of physical activity or physical education [46,47,48,49,53,54,59,60,61,63,64,66], additional teaching around healthy eating and lifestyles in general [46,47,48,49,52,53,54,59,60,64,65], providing training or materials to teachers or parents [46,47,53,54,55,56,59,60,62,64], organising sports tournaments or leagues [48,60,63], providing or improving school meals [52], and changing different aspects of the school environment [46,47,52,56,60,62,64]. All but one intervention involved several different components, the exception being a low-cost physical activity promotion intervention that primarily involved providing sports equipment, toys, and upgrades to the school playground in order to stimulate more free play [56].…”

Section: Resultsmentioning

confidence: 99%

“…There was no overall evidence of effect on dietary behaviour. Only two studies [49,65] out of six reported an overall positive effect, while the remaining four interventions reported no effects [46,48,59,60,64]. More studies reported improvements in physical activity, and particularly fitness, with 6 of 12 interventions reporting positive overall effects [48,49,53,55,56,62].…”

Section: Resultsmentioning

confidence: 99%

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Childhood Obesity Prevention in Africa: A Systematic Review of Intervention Effectiveness and Implementation

Klingberg

Draper

Micklesfield

et al. 2019

IJERPH

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Childhood obesity is of increasing concern in many parts of Africa. We conducted a systematic search and review of published literature on behavioural childhood obesity prevention interventions. A literature search identified peer-reviewed literature from seven databases, and unindexed African journals, including experimental studies targeting children age 2–18 years in African countries, published in any language since 1990. All experimental designs were eligible; outcomes of interest were both behavioural (physical activity, dietary behaviours) and anthropometric (weight, body mass index, body composition). We also searched for process evaluations or other implementation observations. Methodological quality was assessed; evidence was synthesised narratively as a meta-analysis was not possible. Seventeen articles describing 14 interventions in three countries (South Africa, Tunisia and Uganda) were included. Effect scores indicated no overall effect on dietary behaviours, with some beneficial effects on physical activity and anthropometric outcomes. The quality of evidence was predominantly weak. We identified barriers and facilitators to successful interventions, and these were largely resource-related. Our systematic review highlights research gaps in targeting alternative settings to schools, and younger age groups, and a need for more rigorous designs for evaluating effectiveness. We also recommend process evaluations being used more widely.

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“…The baseline results indicate an important proportion of low physical activity, tobacco use, overweight and obesity. The effectiveness of the three years' intervention program in students of Sousse Tunisia has been evaluated in previous studies 15 – 18 . Tracking the effects of the intervention in schools a year after its achievement has shown that it still has some positive effects.…”

Section: Discussionmentioning

confidence: 99%

Long term effect of a school based intervention to prevent chronic diseases in Tunisia, 2009-2015

Ghammam¹,

Maatoug²,

Zammit³

et al. 2018

Afr H. Sci.

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Background & ObjectivesWe aimed to evaluate the long term effect of school based intervention to prevent non- communicable disease risk factors.MethodsIt was a quasi experimental study conducted during the period of 2009–2015. We involved school children aged from 11 to 16 years old. For the assessment of the program's effectiveness, subjects in both groups were examined at baseline, at the end of the 3-year intervention period and at the follow-up, one year after program's cessation.ResultsIn the intervention group, the prevalence of school children who reported to be eating 5 fruits and vegetable sdaily increased significantly from 30.0% at pre-assessment to 33.2% at post-assessment, one year after (p=0.02, p=0.41 respectively). For the control group, this prevalence had significantly decreased from 40.2% at baseline to 35.0% at post-intervention, at the follow up, this proportion increased to 44.5%(p=0.001, p<10−3 respectively). Concerning smoking habits, we observed a decreasing trend in the intervention group from 5.7% at pre-assessment, to 4.8% at post-assessment and to 3.4% at the follow-up (p=0.19 and p=0.25 respectively). There was also a significant decrease in school children who did recommended physical activity in the same group.ConclusionThe present work showed that interventions promoting healthy lifestyles should be maintained. Developing countries should be encouraged and supported to design, conduct, and evaluate robust preventive interventions.

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School-based intervention to promote healthy nutrition in Sousse, Tunisia

Cited by 14 publications

References 13 publications

School-Based Intervention as a Component of a Comprehensive Community Program for Overweight and Obesity Prevention, Sousse, Tunisia, 2009–2014

School-Based Intervention as a Component of a Comprehensive Community Program for Overweight and Obesity Prevention, Sousse, Tunisia, 2009–2014

Childhood Obesity Prevention in Africa: A Systematic Review of Intervention Effectiveness and Implementation

Long term effect of a school based intervention to prevent chronic diseases in Tunisia, 2009-2015

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