ARTÍCULO
School-based intervention on healthy behaviour among ecuadorian adolescents: effect of a cluster-randomized controlled trial on screen-time health behavior, health promotion and society
Fecha
2015Registro en:
1471-2458
10.1186/s12889-015-2274-4
Autor
Andrade Tenesaca, Dolores Susana
Verloigne, Maité
Cardon, Greet
Kolsteren, Patrick
Ochoa Aviles, Angelica Maria
Verstraeten, Roosmarijn
Donoso Moscoso, Silvana Patricia
Lachat, Carl
Institución
Resumen
Background: Effective interventions on screen-time behaviours (television, video games and computer time) are
needed to prevent non-communicable diseases in low- and middle-income countries. The present manuscript
investigates the effect of a school-based health promotion intervention on screen-time behaviour among 12- to
15-year-old adolescents. We report the effect of the trial on screen-time after two stages of implementation.
Methods: We performed a cluster-randomised pair matched trial in urban schools in Cuenca-Ecuador. Participants
were adolescents of grade eight and nine (mean age 12.8 ± 0.8 years, n = 1370, control group n = 684) from 20 schools
(control group n = 10). The intervention included an individual and environmental component tailored to the local
context and resources. The first intervention stage focused on diet, physical activity and screen-time behaviour, while
the second stage focused only on diet and physical activity. Screen-time behaviours, primary outcome, were assessed
at baseline, after the first (18 months) and second stage (28 months). Mixed linear models were used to analyse the
data.
Results: After the first stage (data from n = 1224 adolescents; control group n = 608), the intervention group had a
lower increase in TV-time on a week day (β = −15.7 min; P = 0.003) and weekend day (β = −18.9 min; P = 0.005), in total
screen-time on a weekday (β = −25.9 min; P = 0.03) and in the proportion of adolescents that did not meet the
screen-time recommendation (β = −4 percentage point; P = 0.01), compared to the control group. After the
second stage (data from n = 1078 adolescents; control group n = 531), the TV-time on a weekday (β = 13.1 min; P = 0.02),
and total screen-time on a weekday (β = 21.4 min; P = 0.03) increased more in adolescents from the intervention group.
No adverse effects were reported.
Discussion and Conclusion: A multicomponent school-based intervention was only able to mitigate the increase in
adolescents’ television time and total screen-time after the first stage of the intervention or in other words, when the
intervention included specific components or activities that focused on reducing screen-time. After the second stage of
the intervention, which only included components and activities related to improve healthy diet and physical activity and
not to decrease the screen-time, the adolescents increased their screen-time again. Our findings might imply that
reducing screen-time is only possible when the intervention focuses specifically on reducing screen-time.