A youth-led social marketing intervention to encourage healthy lifestyles, the EYTO (European Youth Tackling Obesity) project: a cluster randomised controlled0 trial in Catalonia, Spain

Elisabet Llauradó, Magaly Aceves-Martins, Lucia Tarro, Ignasi Papell-Garcia, Francesc Puiggròs, Lluís Arola, Jordi Prades-Tena, Marta Montagut, Carlota M Moragas-Fernández, Rosa Solà, Montse Giralt, Elisabet Llauradó, Magaly Aceves-Martins, Lucia Tarro, Ignasi Papell-Garcia, Francesc Puiggròs, Lluís Arola, Jordi Prades-Tena, Marta Montagut, Carlota M Moragas-Fernández, Rosa Solà, Montse Giralt

Abstract

Background: The encouragement of healthy lifestyles for obesity prevention in young people is a public health priority. The European Youth Tackling Obesity (EYTO) project is a multicentric intervention project with participation from the United Kingdom, Portugal, the Czech Republic and Spain. The general aim of the EYTO project is to improve lifestyles, including nutritional habits and physical activity practice, and to prevent obesity in socioeconomically disadvantaged and vulnerable adolescents. The EYTO project works through a peer-led social marketing intervention that is designed and implemented by the adolescents of each participating country. Each country involved in the project acts independently. This paper describes the "Som la Pera" intervention Spanish study that is part of the EYTO project.

Methods/design: In Spain, the research team performed a cluster randomised controlled intervention over 2 academic years (2013-2015) in which 2 high-schools were designated as the control group and 2 high-schools were designated as the intervention group, with a minimum of 121 schoolchildren per group. From the intervention group, 5 adolescents with leadership characteristics, called "Adolescent Challenge Creators" (ACCs), were recruited. These 5 ACCs received an initial 4 h training session about social marketing principles and healthy lifestyle theory, followed by 24 sessions (1.30 h/session) divided in two academic years to design and implement activities presented as challenges to encourage healthy lifestyles among their peers, the approximately 180-200 high-school students in the intervention group. During the design of the intervention, it was essential that the ACCs used the 8 social marketing criteria (customer orientation, behaviour, theory, insight, exchange, competition, segmentation and methods mix). The expected primary outcomes from the Spanish intervention will be as follows: increases in the consumption of fruits and vegetables and physical activity practice along with reductions in TV/computer/game console use. The secondary outcomes will be as follows: increased breakfast consumption, engagement with local recreation and reduced obesity prevalence. The outcomes will be measured by the Health Behaviour in School-aged Children Study (HBSC) survey at baseline and at the end of the intervention. In the control group, no intervention was implemented, but the outcome measurements were collected in parallel with the intervention group.

Discussion: This study described a new methodology to improve lifestyles and to address adolescent obesity.

Trial registration: ClinicalTrials.gov: NCT02157402. Registered 03 June 2014.

Figures

Fig. 1
Fig. 1
Spanish Intervention Schedule of the European Youth Tackling Obesity (EYTO) Project

References

    1. Baker JL, Farpour-Lambert NJ, Nowicka P, Pietrobelli A, Weiss R. Evaluation of the overweight/obese child – practical tips for the primary health care provider: recommendations from the Childhood Obesity Task Force of the European Association for the Study of Obesity. Obes Facts. 2010;3:131–137. doi: 10.1159/000295112.
    1. Bodzsar EB, Zsakai A. Recent trends in childhood obesity and overweight in the transition countries of Eastern and Central Europe. Ann Hum Biol. 2014;41(Suppl 3):263–270. doi: 10.3109/03014460.2013.856473.
    1. Kakinami L, Paradis G, O’Loughlin J, Séguin L, Delvin EE, Lambert M. Is the obesity epidemic worsening the cardiovascular risk factor profile of children? Evidence from two Québec samples measured 10 years apart. Ann Hum Biol. 2012;39(Suppl 4):322–326. doi: 10.3109/03014460.2012.690889.
    1. World Health Organization. WHO European Childhood Obesity Surveillance Iniciative (COSI). 2014. []
    1. Drewnowski A, Eichelsdoerfer P. Can low-income Americans afford a healthy diet? Nutr Today. 2010;44(Suppl 6):246–249.
    1. McLaren L. Socioeconomic status and obesity. Epidemiol Rev. 2007;29:29–48. doi: 10.1093/epirev/mxm001.
    1. Ben-Sefer E, Ben-Natan M, Ehrenfeld M. Childhood obesity: current literature, policy and implications for practice. Int Nurs Rev. 2009;56(Suppl 2):166–173. doi: 10.1111/j.1466-7657.2008.00708.x.
    1. Lobstein T, Baur LA. Policies to prevent childhood obesity in the European Union. Eur J Public Health. 2005;15(Suppl 6):576–579. doi: 10.1093/eurpub/cki068.
    1. Lobstein T, Jackson-Leach R, Moodie ML, Hall KD, Gortmaker SL, Swinburn BA, et al. Child and adolescent obesity: part of a bigger picture. Lancet. 2015;S0140–6736(14):61746–3. doi:10.1016/S0140-6736(14)61746-3.
    1. Kar SS, Dube R, Kar SS. Childhood obesity-an insight intro preventive strategies. Aviccena J Med. 2014;4(Suppl4):88–93. doi: 10.4103/2231-0770.140653.
    1. Krukowski RA, West DS, Harvey-Berino J, Prewitt TE. Neighborhood impact on healthy food availability and pricing in food stores. J Community Health. 2010;35(Suppl 3):315–320. doi: 10.1007/s10900-010-9224-y.
    1. Evans GW, Jones-Rounds ML, Belojevic G, Vermeylen F. Family income and childhood obesity in eight European cities: the mediating roles of neighborhood characteristics and physical activity. Soc Sci Med. 2012;75:477–481. doi: 10.1016/j.socscimed.2012.03.037.
    1. Perry CL. Preadolescent and adolescent influences and health. In: Committee on Capitalizing on Social Science and Behavioral Research to Improve the Public Health, Division of Health Promotion and Disease Prevention, editor. Promoting health: intervention strategies from social and behavioral research. Washington, DC: National Academy Press; 2001. pp. 217–253.
    1. Story M, Lytle LA, Birnbaum AS, Perry CL. Peer-led, school-based nutrition education for young adolescents: feasibility and process evaluation of the TEENS study. J Sch Health. 2002;72(Suppl 3):121–127. doi: 10.1111/j.1746-1561.2002.tb06529.x.
    1. Khambalia AZ, Dickinson S, Hardy LL, Gill T, Baur LA. A synthesis of existing systematic reviews and meta-analyses of school-based behavioural interventions for controlling and preventing obesity. Obes Rev. 2012;13:214–233. doi: 10.1111/j.1467-789X.2011.00947.x.
    1. Maxwell K. Friends: the role of peer influence across adolescent risk behaviors. J Youth Adolesc. 2002;31(Suppl 4):267–277. doi: 10.1023/A:1015493316865.
    1. Steinberg L, Monahan KC. Age differences in resistance to peer influence. Dev Psychol. 2007;43(Suppl 6):1531–1543. doi: 10.1037/0012-1649.43.6.1531.
    1. Valente TW, Fujimoto K, Soto D, Ritt-Olson A, Unger JB. A comparison of peer influence measuresas predictors of smoking among predominately Hispanic/Latino high school adolescents. J Adolesc Health. 2013;52(Suppl 3):358–364. doi: 10.1016/j.jadohealth.2012.06.014.
    1. Bell SL, Audrey S, Cooper AR, Noble S, Campbell R. Lessons from a peer-led obesity prevention programme in English schools. Health Promot Int. In press.
    1. Evidence for policy and practice - Centre (EPPI-Centre). A review of the effectiveness and appropriateness of peer-delivered health promotion interventions for young people. University of London; 1999.
    1. Garcia-Marco L, Moreno LA, Vicente-Rodríguez G. Impact of social marketing in the prevention of childhood obesity. Adv Nutr. 2012;3(Suppl 4):611–615. doi: 10.3945/an.112.001958.
    1. Kotler P, Zaltman G. Social marketing: an approach to planned social change. J Mark. 1971;35(Suppl 3):3–12. doi: 10.2307/1249783.
    1. Andreasen A. Social marketing: definition and domain. Journal of Public Policy & Marketing. 1994;13(Suppl 1):108–114.
    1. Storey JD, Saffitz GB, Rimón JG. Social marketing. In: Glanz K, Rimer BK, Viswanath K, editors. Health behavior and health education. Theory, research and practice. 4. San Francisco: Jossey Bass; 2008. pp. 435–464.
    1. Kotler P, Roberto EL, Roberto N. Social marketing strategies for changing public behavior. New York: Free Press; 2002.
    1. National Social Marketing Centre. Social marketing benchmark criteria NSMC []
    1. Berkowitz JM, Huhman M, Nolin MJ. Did augmenting the VERB campaign advertising in select communities have an effect on awareness, attitudes, and physical activity? Am J Prev Med. 2008;34(Suppl.6):S257–S266. doi: 10.1016/j.amepre.2008.03.005.
    1. Craig CL, Bauman A, Gauvin L, Robertson J, Murumets K. ParticipACTION: a mass media campaign targeting parents of inactive children; knowledge, saliency, and trialing behaviours. Int J Behav Nutr Phys Act. 2009;9(Suppl.6):88. doi: 10.1186/1479-5868-6-88.
    1. Richards J, Hackett A, Duggan B, Ellis T, Forrest D, Grey P. An evaluation of an attempt to change the snacking habits of pre-school children using social marketing. Public Health. 2009;123(Suppl.1):e31–e37. doi: 10.1016/j.puhe.2009.07.001.
    1. Evans WD, Necheles J, Longjohn M, Christoffel KK. The 5-4-3-2-1 go! Intervention: social marketing strategies for nutrition. J Nutr Educ Behav. 2007;39:S55–S59. doi: 10.1016/j.jneb.2006.08.024.
    1. Evans W, Christoffel KK, Neckeles J, Becker AB, Snider J. Outcomes of the 5-4-3-2-1 Go! Childhood obesity community trial. Am J Health Behav. 2011;35:189–198.
    1. Crocker H, Lucas R, Wardle J. Cluster-randomized trial to evaluate the “Change for Life” mass media/ social marketing campaign in the UK. BMC Public Health. 2012;12:404. doi: 10.1186/1471-2458-12-404.
    1. Mellanby A, Rees J, Tripp J. Peer-led and adult-led school health education: a critical review of available comparative research. Health Educ Res. 2000;15(Suppl.5):533–545. doi: 10.1093/her/15.5.533.
    1. Morton MH, Montgomery P. Youth empowerment programs for improving adolescents’ self-efficacy and self-esteem: a systematic review. Res Soc Work Pract. 2013;23:22–33. doi: 10.1177/1049731512459967.
    1. Currie C, Griebler R, Inchley J, Theunissen A, Molcho M, Samdal O, et al. Health Behaviour in School-aged Children (HBSC) study protocol: background, methodology and mandatory items for the 2009/10 survey. Edinburgh & Vienna: CAHRU & LBIHPR; 2010.
    1. Currie C, Nic Gabhainn S, Godeau E, International HBSC Network Coordinating Committee The Health Behaviour in School-aged Children: WHO Collaborative Cross-National (HBSC) study: origins, concept, history and development 1982–2008. Int J Public Health. 2009;54(Suppl 2):131–139. doi: 10.1007/s00038-009-5404-x.
    1. Chan AW, Tetzlaff JM, Gøtzsche PC, Altman DG, Mann H, Berlin JA, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346:e7586. doi: 10.1136/bmj.e7586.
    1. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, Altman DG, Barbour V, Macdonald H, Johnston M, Lamb SE, Dixon-Woods M, McCulloch P, Wyatt JC, Chan AW, Michie S. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348:g1687. doi: 10.1136/bmj.g1687.
    1. Schulz KF, Altman DG, Moher D, CONSORT Group CONSORT 2010 Statement: updated guidelines for reporting parallel group randomized trials. Open Med. 2010;4(Suppl 1):e60–e68.
    1. Vine M, Hargreaves MB, Briefel RR, Orfield C. Expanding the role of primary care in the prevention and treatment of childhood obesity: a review of clinic and community-based recommendations and interventions. J Obes. 2013. In press.
    1. Stead M, Hastings G, McDermott L. The meaning, effectiveness and future of social marketing. Obes Rev. 2007;8(Suppl 1):189–193. doi: 10.1111/j.1467-789X.2007.00340.x.
    1. Garcia-Marco L, Vicente Rodríguez G, Borys JM, Le Bodo Y, Pettisgrew S, Moreno LA. Contribution of social marketing strategies to community-based obesity prevention programmes in children. Int J Obes (Lond) 2011;35(Suppl 4):472–479. doi: 10.1038/ijo.2010.221.
    1. Waxman A. Why a global strategy on diet, physical activity and health? World Rev Nutr Diet. 2005;95(R):162. doi: 10.1159/000088302.

Source: PubMed

3
订阅