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

Background: Integrated actions against selected risk factors (i.e. smoking, physical inactivity, and unhealthy diet) can lead to the reduction of major chronic diseases. Objective: To implement and evaluate a school-based intervention program to prevent cardiovascular risk factors among children. Materials and Methods: Design: Pre- test post-test quasi experimental design with a control group. Setting: Four secondary schools in Sousse, Tunisia. Intervention: The overall intervention program lasted for a school year and incorporated educative actions concerning tobacco use, physical activity, and healthy diet. Results: Globally, knowledge, behaviors, and intentions concerning smoking improved in both groups between baseline and the end of the study, particularly in the intervention group. Nutrition knowledge, behaviors, and intentions improved in both groups between baseline and final stage, particularly in the intervention group. At the final stage, there was an increase in the proportion of children walking to and from school in the intervention group. There was also an increase in the percentage of children with intention of practicing sport in the future particularly in the intervention group. There were no significant differences in BMI after the intervention neither in intervention nor in control groups. At the end of the study, the incidence of overweight and obesity was similar to that at baseline. Conclusions: This pilot study has demonstrated the potential of school as a suitable setting for the promotion of healthy lifestyles in children. The study resulted in substantial improvements concerning knowledge, behaviors, and intentions in the intervention group.