Overall effectiveness of PRALIMAP-INES in reducing adolescents’ nutritional and weight inequalities

Abstract

Abstract Background The PRALIMAP-INES trial was effective in reducing weight social inequalities among adolescents with overweight or obesity. Nevertheless, the question of its overall effectiveness on weight status and nutritional behaviours (NB) remains unclear. This study aims to evaluate the overall effect of the PRALIMAP-INES trial on weight status and NB among adolescents with overweight or obesity . Methods Generalized Pairwise Comparison was used to evaluate the overall benefit by prioritising outcomes comparing two groups of intervention: Advantaged with standard intervention (AS) and Less Advantaged with standard intervention and strengthened care (LASS). We used the following order: corpulence, vigorous physical activity (PA), fruits and vegetables consumption (FV), sedentary time (ST), sweetened products and beverages consumption (SPB), moderate PA and walking time (WT). This approach provided for each outcome the net benefit in favour of LASS (δ) and the overall net benefit (Δ) as their sum. Net benefit was define as the probability for an adolescent of LASS group to have favourable outcome as compared to AS group. Results We included 1223 (AS: n = 808; LASS: n = 415) adolescents (mean aged= 15.37 ± 0.72 years; 45.05% girls). The overall net benefit was estimated at 11.13% [4.15 - 18.06%; p < 0.001] meaning that an adolescent form LASS group had 11.13% higher probability to have favourable change in all weight and NB outcomes than an adolescent from AS group. For each outcome this net benefit was estimated as follow: corpulence (δ = 4.22%), vigorous PA (δ = 4.14%), FV (δ = 3.09%), ST (δ = 0.42%), SPB (δ=-0.71%), moderate PA (δ= -0.02%) and WT (δ= -0.03%). Conclusions Beyond corpulence, changes in NB in the PRALIMAP-INES trial show an overall favourable effect for adolescents in the LASS group. The overall net benefit in favour of LASS, confirm a short-term effectiveness of the trial to reduce weight social inequalities and suggests a long-term could be expected. Key messages • In the PRALIMAP-INES trial, adolescents who did not change their corpulence may have initiated changes in lifestyle behaviours. • A benefit of the PRALIMAP-INES trial could be expected in the long-term.