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

Rim Ghammam1, Jihen Maatoug1, Nawel Zammit1, Raoudha Kebaili2, Lamia Boughammoura2,
Mustafa Al’Absi3, Harry Lando4, Hassen Ghannem1
1. Department of Epidemiology, University Hospital Farhat Hached, Sousse Tunisia
2. Department of Pediatrics, University Hospital Farhat Hached , Sousse Tunisia
3. Duluth Medical Research Institute, University of Minnesota, USA.
4. Department of epidemiology & Community Health University of Minnesota, USA.
E-mails:
ghammam.rim2013@gmail.com
jihenmaatoug3107@gmail.com
nawelzommit@gmail.com
Raoudha_kebaili@yahoo.fr
Lamia_boughamoura@yahoo.fr
malabsi@umn.edu
Lando001@umn.edu
hassen_ghannem@yahoo.fr

Abstract:
Background & Objectives: We aimed to evaluate the long term effect of school based intervention to prevent non- communicable disease risk factors.

Methods: It 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.

Results: In the intervention group, the prevalence of school children who reported to be eating 5 fruits and vegetable sdaily increased signifcantly 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 signifcantly 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 signifcant decrease in school children who did recommended physical activity in the same group.

Conclusion: The 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.

Keywords: Schools, lifestyle, intervention.