Prevenção primária e secundária da obesidade: ensaio comunitário randomizado em escolares de Duque de Caxias, Rio de Janeiro
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UERJ |
Texto Completo: | http://www.bdtd.uerj.br/handle/1/17298 |
Resumo: | The prevalence of obesity among children and adolescents is high in Brazil and in the world, being considered a serious public health problem. Schools can be an important link in preventing obesity due to its scope and its scope and its role in forming behaviors. However, interventions in different countries to prevent obesity at school level have shown contradictory results. In this Thesis, a randomized community trial called PAAPPAS (Parents, Students, Health Agents and Teachers for Healthy Eating), conducted with 5th and 6th grade students from eighteen public schools in Duque de Caxias, Rio de Janeiro. The objective was to evaluate the effectiveness of combining primary and secondary intervention to reduce excessive weight gain in adolescents by encouraging healthy eating and increasing physical activity. The main outcome of the study was to reduce excessive weight gain from the intervention group over the control group through interventions that stimulated healthy food consumption, physical activity and reduced physical inactivity during the 2016 school year. Anthropometric measurements and food consumption occured at the beginning and end of the school year. Primary prevention consisted of six sessions of nutrition education and physical activity carried out in schools and the secondary was directed to overweight students, with home-based guidance provided by community health agents. For longitudinal analyzes, mixed linear models were used through the PROC MIXED procedure, which takes into account missing and unbalanced data. The analyzes were performed using the Statistical Analysis System (SAS) software. An analysis was also performed according to adherence to the protocol in the activities in class and according to the performance of home visits by health agents. The mean variation in body mass index did not differ between the control and intervention groups. There was a reduction the percentage of lower body fat in the experiemental group, compared to the control in boys. The intervention group increased physical activity by 12.5 minutes per week compared to control and there was an increase in the food frequency score of health foods only among girls (0.29; p = 0.04). The subgroup with home and school intervention also showed a greater increase in %body fat compared to the control group (0.89; p = 0.01). Behavioral changes combining school and home intervention increased physical activity and healthy eating habits, but did not promote a reduction in weight gain, suggesting the possibility of their increase. |
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Sichieri, RoselyMarques, Emanuele SouzaBezerra, Flavia FioruciPereira, Rosangela AlvesYokoo, Edna Massaehttp://lattes.cnpq.br/6870816684132936Sgambato, Michele Ribeiromichelesgambato@hotmail.com2022-03-16T14:59:53Z2020-03-02SGAMBATO, Michele Ribeiro. Prevenção primária e secundária da obesidade: ensaio comunitário randomizado em escolares de Duque de Caxias, Rio de Janeiro. 2020. 163 f. Tese (Doutorado em Saúde Coletiva) - Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2020.http://www.bdtd.uerj.br/handle/1/17298The prevalence of obesity among children and adolescents is high in Brazil and in the world, being considered a serious public health problem. Schools can be an important link in preventing obesity due to its scope and its scope and its role in forming behaviors. However, interventions in different countries to prevent obesity at school level have shown contradictory results. In this Thesis, a randomized community trial called PAAPPAS (Parents, Students, Health Agents and Teachers for Healthy Eating), conducted with 5th and 6th grade students from eighteen public schools in Duque de Caxias, Rio de Janeiro. The objective was to evaluate the effectiveness of combining primary and secondary intervention to reduce excessive weight gain in adolescents by encouraging healthy eating and increasing physical activity. The main outcome of the study was to reduce excessive weight gain from the intervention group over the control group through interventions that stimulated healthy food consumption, physical activity and reduced physical inactivity during the 2016 school year. Anthropometric measurements and food consumption occured at the beginning and end of the school year. Primary prevention consisted of six sessions of nutrition education and physical activity carried out in schools and the secondary was directed to overweight students, with home-based guidance provided by community health agents. For longitudinal analyzes, mixed linear models were used through the PROC MIXED procedure, which takes into account missing and unbalanced data. The analyzes were performed using the Statistical Analysis System (SAS) software. An analysis was also performed according to adherence to the protocol in the activities in class and according to the performance of home visits by health agents. The mean variation in body mass index did not differ between the control and intervention groups. There was a reduction the percentage of lower body fat in the experiemental group, compared to the control in boys. The intervention group increased physical activity by 12.5 minutes per week compared to control and there was an increase in the food frequency score of health foods only among girls (0.29; p = 0.04). The subgroup with home and school intervention also showed a greater increase in %body fat compared to the control group (0.89; p = 0.01). Behavioral changes combining school and home intervention increased physical activity and healthy eating habits, but did not promote a reduction in weight gain, suggesting the possibility of their increase.A prevalência de obesidade entre crianças e adolescentes é alta no Brasil e no mundo, sendo considerado um grave problema de saúde pública. Escolas podem desempenhar um importante elo na prevenção da obesidade devido sua abrangência e seu papel formador de comportamentos. Contudo, as intervenções realizadas em diferentes países para prevenção da obesidade a nível escolar têm mostrado resultados contraditórios. Nessa Tese, são avaliados os dados de um ensaio de base escolar randomizado denominado PAAPPAS (Pais, Alunos, Agendes de Saúde e Professores Pela Alimentação Saudável), conduzido com alunos do 5º e 6º ano de dezoito escolas públicas do município de Duque de Caxias, Rio de Janeiro. O objetivo geral foi avaliar a eficácia da combinação da intervenção primária e secundária para redução do ganho excessivo de peso de adolescentes, por meio do estímulo à alimentação saudável e aumento da atividade física. O desfecho principal do estudo foi a redução do ganho de peso excessivo do grupo intervenção em relação ao grupo controle, por meio de intervenções que estimularam o consumo de alimentos saudáveis, atividade física e redução de sedentarismo durante o ano letivo de 2016. A coleta de medidas antropométricas e consumo alimentar ocorreram no início e no fim do ano letivo. A prevenção primária consistiu em seis sessões de educação nutricional e estímulo a realização de atividade física realizadas nas escolas e a secundária foi dirigida aos escolares com excesso de peso, sendo as orientações domiciliares realizadas por agentes comunitários de saúde, previa mente treinados. Para as análises longitudinais foram utilizados modelos lineares mistos através do procedimento PROC MIXED, que leva em consideração os dados faltantes e desbalanceados. As análises foram realizadas no software Statistical Analysis System (SAS). Foi realizada também análise segundo adesão ao protocolo nas atividades realizadas em classe e segundo a realização de visitas domiciliares pelos agentes de saúde. A variação média do índice de massa corporal não apresentou diferença entre os grupos controle e intervenção. Houve redução do percentual de gordura corporal menor no grupo experimental, comparado ao controle nos meninos. O grupo intervenção aumentou a atividade física em 12,5 minutos por semana em relação ao controle e ocorreu aumento no escore de frequência alimentar de alimentos saudáveis apenas entre as meninas (0,29; p = 0,04). O subgrupo com intervenção domiciliar e na escola também apresentou maior aumento de % de gordura corporal em relação ao grupo controle (0,89; p = 0,01). As mudanças comportamentais combinando a intervenção na escola e nos domicílios aumentaram a atividade física e os hábitos alimentares saudáveis, mas não promoveu redução do ganho de peso, sugerindo a possibilidade do seu aumento.Submitted by Marcia CB/C (marciagraziadio@yahoo.com.br) on 2022-03-16T14:59:53Z No. of bitstreams: 1 Tese - Michele Ribeiro Sgambato - 2020 - Completa.pdf: 3606394 bytes, checksum: 6c08c8ecea6cca5a2121fa7102e5edff (MD5)Made available in DSpace on 2022-03-16T14:59:53Z (GMT). No. of bitstreams: 1 Tese - Michele Ribeiro Sgambato - 2020 - Completa.pdf: 3606394 bytes, checksum: 6c08c8ecea6cca5a2121fa7102e5edff (MD5) Previous issue date: 2020-03-02Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPqapplication/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Saúde ColetivaUERJBrasilCentro Biomédico::Instituto de Medicina SocialInterventionAdolescentsObesityIntervençãoAdolescentesObesidadeCIENCIAS DA SAUDE::SAUDE COLETIVAPrevenção primária e secundária da obesidade: ensaio comunitário randomizado em escolares de Duque de Caxias, Rio de JaneiroPrimary and secundary prevention of obesity: a randomized community trial in schoolchildren from Duque de Caxias, Rio de Janeiroinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALTese - Michele Ribeiro Sgambato - 2020 - Completa.pdfTese - Michele Ribeiro Sgambato - 2020 - Completa.pdfapplication/pdf3606394http://www.bdtd.uerj.br/bitstream/1/17298/2/Tese+-+Michele+Ribeiro+Sgambato+-+2020+-+Completa.pdf6c08c8ecea6cca5a2121fa7102e5edffMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82123http://www.bdtd.uerj.br/bitstream/1/17298/1/license.txte5502652da718045d7fcd832b79fca29MD511/172982024-02-26 20:20:41.036oai:www.bdtd.uerj.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T23:20:41Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
Prevenção primária e secundária da obesidade: ensaio comunitário randomizado em escolares de Duque de Caxias, Rio de Janeiro |
dc.title.alternative.eng.fl_str_mv |
Primary and secundary prevention of obesity: a randomized community trial in schoolchildren from Duque de Caxias, Rio de Janeiro |
title |
Prevenção primária e secundária da obesidade: ensaio comunitário randomizado em escolares de Duque de Caxias, Rio de Janeiro |
spellingShingle |
Prevenção primária e secundária da obesidade: ensaio comunitário randomizado em escolares de Duque de Caxias, Rio de Janeiro Sgambato, Michele Ribeiro Intervention Adolescents Obesity Intervenção Adolescentes Obesidade CIENCIAS DA SAUDE::SAUDE COLETIVA |
title_short |
Prevenção primária e secundária da obesidade: ensaio comunitário randomizado em escolares de Duque de Caxias, Rio de Janeiro |
title_full |
Prevenção primária e secundária da obesidade: ensaio comunitário randomizado em escolares de Duque de Caxias, Rio de Janeiro |
title_fullStr |
Prevenção primária e secundária da obesidade: ensaio comunitário randomizado em escolares de Duque de Caxias, Rio de Janeiro |
title_full_unstemmed |
Prevenção primária e secundária da obesidade: ensaio comunitário randomizado em escolares de Duque de Caxias, Rio de Janeiro |
title_sort |
Prevenção primária e secundária da obesidade: ensaio comunitário randomizado em escolares de Duque de Caxias, Rio de Janeiro |
author |
Sgambato, Michele Ribeiro |
author_facet |
Sgambato, Michele Ribeiro michelesgambato@hotmail.com |
author_role |
author |
author2 |
michelesgambato@hotmail.com |
author2_role |
author |
dc.contributor.advisor1.fl_str_mv |
Sichieri, Rosely |
dc.contributor.referee1.fl_str_mv |
Marques, Emanuele Souza |
dc.contributor.referee2.fl_str_mv |
Bezerra, Flavia Fioruci |
dc.contributor.referee3.fl_str_mv |
Pereira, Rosangela Alves |
dc.contributor.referee4.fl_str_mv |
Yokoo, Edna Massae |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/6870816684132936 |
dc.contributor.author.fl_str_mv |
Sgambato, Michele Ribeiro michelesgambato@hotmail.com |
contributor_str_mv |
Sichieri, Rosely Marques, Emanuele Souza Bezerra, Flavia Fioruci Pereira, Rosangela Alves Yokoo, Edna Massae |
dc.subject.eng.fl_str_mv |
Intervention Adolescents Obesity |
topic |
Intervention Adolescents Obesity Intervenção Adolescentes Obesidade CIENCIAS DA SAUDE::SAUDE COLETIVA |
dc.subject.por.fl_str_mv |
Intervenção Adolescentes Obesidade |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::SAUDE COLETIVA |
description |
The prevalence of obesity among children and adolescents is high in Brazil and in the world, being considered a serious public health problem. Schools can be an important link in preventing obesity due to its scope and its scope and its role in forming behaviors. However, interventions in different countries to prevent obesity at school level have shown contradictory results. In this Thesis, a randomized community trial called PAAPPAS (Parents, Students, Health Agents and Teachers for Healthy Eating), conducted with 5th and 6th grade students from eighteen public schools in Duque de Caxias, Rio de Janeiro. The objective was to evaluate the effectiveness of combining primary and secondary intervention to reduce excessive weight gain in adolescents by encouraging healthy eating and increasing physical activity. The main outcome of the study was to reduce excessive weight gain from the intervention group over the control group through interventions that stimulated healthy food consumption, physical activity and reduced physical inactivity during the 2016 school year. Anthropometric measurements and food consumption occured at the beginning and end of the school year. Primary prevention consisted of six sessions of nutrition education and physical activity carried out in schools and the secondary was directed to overweight students, with home-based guidance provided by community health agents. For longitudinal analyzes, mixed linear models were used through the PROC MIXED procedure, which takes into account missing and unbalanced data. The analyzes were performed using the Statistical Analysis System (SAS) software. An analysis was also performed according to adherence to the protocol in the activities in class and according to the performance of home visits by health agents. The mean variation in body mass index did not differ between the control and intervention groups. There was a reduction the percentage of lower body fat in the experiemental group, compared to the control in boys. The intervention group increased physical activity by 12.5 minutes per week compared to control and there was an increase in the food frequency score of health foods only among girls (0.29; p = 0.04). The subgroup with home and school intervention also showed a greater increase in %body fat compared to the control group (0.89; p = 0.01). Behavioral changes combining school and home intervention increased physical activity and healthy eating habits, but did not promote a reduction in weight gain, suggesting the possibility of their increase. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020-03-02 |
dc.date.accessioned.fl_str_mv |
2022-03-16T14:59:53Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
SGAMBATO, Michele Ribeiro. Prevenção primária e secundária da obesidade: ensaio comunitário randomizado em escolares de Duque de Caxias, Rio de Janeiro. 2020. 163 f. Tese (Doutorado em Saúde Coletiva) - Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2020. |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/17298 |
identifier_str_mv |
SGAMBATO, Michele Ribeiro. Prevenção primária e secundária da obesidade: ensaio comunitário randomizado em escolares de Duque de Caxias, Rio de Janeiro. 2020. 163 f. Tese (Doutorado em Saúde Coletiva) - Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2020. |
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http://www.bdtd.uerj.br/handle/1/17298 |
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por |
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UERJ |
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Brasil |
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Centro Biomédico::Instituto de Medicina Social |
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Universidade do Estado do Rio de Janeiro |
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