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Sustainability of and Adherence to Preschool Health Promotion Among Children 9 to 13 Years Old

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dc.creatorFernández-Jiménez, Rodrigospa
dc.creatorBriceño, Germanspa
dc.creatorCéspedes, Jaimespa
dc.creatorVargas, Sarhaspa
dc.creatorGuijarro, Jenniferspa
dc.creatorBaxter, Jorgespa
dc.creatorHunn, Marilynspa
dc.creatorSantos-Beneit, Gloriaspa
dc.creatorRodríguez, Carlaspa
dc.creatorCéspedes, Maria Paulaspa
dc.creatorBagiella, Emiliaspa
dc.creatorMoreno, Zoraydaspa
dc.creatorCarvajal, Isabelspa
dc.creatorFuster, Valentinspa
dc.date.accessioned2020-05-25T23:56:38Z
dc.date.available2020-05-25T23:56:38Z
dc.date.created2020spa
dc.description.abstractBackground: Long-term evaluations of child health promotion programs are required to assess their sustainability and the need for reintervention. Objectives: This study sought to explore the long-term impact of a preschool health promotion intervention delivered in an urban low-income area of Colombia (phase 1) and to assess the effect of a new community-based intervention (phase 2). Methods: In phase 1, a cross-sectional analysis of knowledge, attitudes, and habits (KAH) toward a healthy lifestyle and ideal cardiovascular health (ICH) scores of 1,216 children 9 to 13 years old was performed. Of the total, 596 had previously received a preschool health promotion intervention at 3 to 5 years old, whereas the remaining 620 were not previously intervened (intervention-naive group). In phase 2, all children were cluster randomized 1:1 to receive either a 4-month educational intervention (the SI! Program) to instill healthy behaviors in community centers (24 clusters, 616 children) or to control (24 clusters, 600 children). Previously intervened and intervention-naive children were not mixed in the same cluster. The primary outcomes were the change from baseline in KAH and ICH scores. Intervention effects were tested for with linear mixed-effects models. Results: In phase 1, ?85% of children had nonideal cardiovascular health, and those who previously received a preschool intervention showed a negligible residual effect compared with intervention-naive children. In phase 2, the between-group (control vs. intervention) differences in the change of the overall KAH and ICH scores were 0.92 points (95% confidence interval [CI]: ?0.28 to 2.13; p = 0.133) and ?0.20 points (95% CI: ?0.43 to 0.03; p = 0.089), respectively. No booster effect was detected. However, a dose-response effect was observed, with maximal benefit in children attending >75% of the scheduled intervention; the difference in the change of KAH between the high- and low-adherence groups was 3.72 points (95% CI: 1.71 to 5.73; p less than 0.001). Conclusions: Although overall significant differences between the intervention and control groups were not observed, high adherence rates to health promotion interventions may improve effectiveness and outcomes in children. Reintervention strategies may be required at multiple stages to induce sustained health promotion effects (Salud Integral Colombia [SI! Colombia II]; NCT03119792) © 2020eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1016/j.jacc.2020.01.051
dc.identifier.issn7351097
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/22474
dc.language.isoengspa
dc.publisherElsevier USAspa
dc.relation.citationEndPage1578
dc.relation.citationIssueNo. 13
dc.relation.citationStartPage1565
dc.relation.citationTitleJournal of the American College of Cardiology
dc.relation.citationVolumeVol. 75
dc.relation.ispartofJournal of the American College of Cardiology, ISSN:7351097, Vol.75, No.13 (2020); pp. 1565-1578spa
dc.relation.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85081994207&doi=10.1016%2fj.jacc.2020.01.051&partnerID=40&md5=57ffa51f6cf2aa8cfc8a1e27644c2470spa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subject.keywordAdolescentspa
dc.subject.keywordArticlespa
dc.subject.keywordAttitudespa
dc.subject.keywordChildspa
dc.subject.keywordColombiaspa
dc.subject.keywordControlled studyspa
dc.subject.keywordCross-sectional studyspa
dc.subject.keywordDose responsespa
dc.subject.keywordFemalespa
dc.subject.keywordHabitspa
dc.subject.keywordHealth promotionspa
dc.subject.keywordHealthy lifestylespa
dc.subject.keywordHumanspa
dc.subject.keywordLowest income groupspa
dc.subject.keywordMajor clinical studyspa
dc.subject.keywordMalespa
dc.subject.keywordOutcome assessmentspa
dc.subject.keywordPhase 2 clinical trialspa
dc.subject.keywordPreschool childspa
dc.subject.keywordRandomized controlled trialspa
dc.subject.keywordColombiaspa
dc.subject.keywordChildspa
dc.subject.keywordHealth promotionspa
dc.subject.keywordHealthy lifestylespa
dc.subject.keywordPreschoolspa
dc.subject.keywordPreventionspa
dc.titleSustainability of and Adherence to Preschool Health Promotion Among Children 9 to 13 Years Oldspa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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