National Intervention Programs Research Articles

2009–10 USDA Fresh Fruit and Vegetable Program (FFVP) in Indiana Improved Several Factors that Lead to Improved Health

US children consume inadequate amounts of fruit (F) and vegetables (V). In 2008, FFVP became a permanent national intervention program to combat this problem. Data from Indiana students at 3 intervention and 3 control schools during the 2009–10 program year were analyzed by logistic regression to determine probability of improvements in children's knowledge about daily F and V needs and their intention to eat, preference for, and daily variety (n=1486). Differences in daily intake were determined with analysis of covariance, with small differences in rate of free and reduced lunch treated as a covariate. No changes were found for control students. The probability that intervention students knew daily F and V were needed for health increased (+7% for fruit, p=0.04; +11% for vegetables, p=0.002) as did probability of eating more than one kind of F (+12%, p=0.001) or V (+9%, p=0.004) daily. There were no improvements in intention to eat F daily (p=0.203), though those with the intention were high at the onset of the program (74%). The frequency of students that intended to eat daily V began lower (40%) and the probability of eating daily V increased (9%, p=0.05) over time. Students’ preferences for F and V did not change (p=0.83, 0.932). Daily F intake in school increased about 0.5 times per day (p<0.001) with no change for V (p=0.247). These data show FFVP may improve children's health.Grant Funding Source : Indiana University

Trend in eating habits among Lithuanian school-aged children in context of social inequality: three cross-sectional surveys 2002, 2006 and 2010

BackgroundIntermittent monitoring of food intake at the population level is essential for the planning and evaluation of national dietary intervention programs. Social-economic changes in Lithuania have likely affected dietary habits, but only a limited number of temporal studies on food intake trends among young population groups have been published. The aim of this study was to investigate changes in eating habits among Lithuanian school-aged children from 2002 to 2010, and to explore the association of these changes with the respondents' reported socio-economic status (SES).MethodsWe used Lithuanian data from the cross-national Health Behaviour in School-aged Children (HBSC) study collected in 2002, 2006 and 2010. Analyses were conducted on comparable questionnaire-based data from children aged 11, 13 and 15 (total n = 17,189) from a random sample of schools. A food frequency questionnaire was used to investigate frequencies of food consumption. Logistic regression was used to examine the affects of changing social variables on reported diet trends.ResultsIn Lithuania, school-aged children have low intakes of fruits and vegetables. Only 21.1% of boys and 27.1% of girls reported daily fruit consumption. Similarly, 24.9% of boys and 29.6% of girls disclosed vegetable intake at least once daily. Comparing 2010 to 2002, the proportion of girls who consumed fruits daily increased from 24.2% to 31.0% (p < 0.001) but the proportion of boys who consumed vegetables daily decreased from 29.3% to 23.1% (p < 0.001). In 2006, for both sexes, there were observed increases in regular (at least five days a week) intake of sweets and chocolates, biscuits and pastries, and soft drinks; however, in the next survey (2010) these figures decreased. In addition, between 2006 and 2010, a substantial decrease in regular consumption of chips and fast food was also detected. Fruit and vegetable consumption as well as intake of sweets and chocolates, biscuits and pastries and soft drinks increased with family social-economic status and family material wealth. Trends in consumption of fruits, and other foods, and their association with changing social variables were demonstrated using the ORs estimated by three logistic models, using 2002 as the reference point. Changes in social variables from 2002 to 2010 affected the likelihood of daily consumption of fruits among boys by 22.5% (the corresponding OR decreased from 1.11 to 0.86) and among girls by 34.0% (the corresponding OR decreased from 1.41 to 1.12). Over the study period, changing social variables had little impact on the daily consumption of vegetables and other foods.ConclusionsBased on the food consumption trends observed in Lithuania, increases in consumption of fruits and vegetables should be promoted, along with a reduction in the intake of less healthy choices, such as soft drinks and high-fat, high-sugar snack foods, by diminishing social inequalities in food consumption.

How to use programme theory to evaluate the effectiveness of schemes designed to improve the work environment in small businesses

Due to the many constraints that small businesses (SBs) face in meeting legislative requirements, occupational health and safety (OHS) regulatory authorities and other OSH actors have developed programmes which can reach out to SBs and motivate and assist them in improving the work environment. A number of conceptual models help to enhance our understanding of OHS interventions in SBs and their effectiveness. However, they have mainly been evaluated on output rather than the process relating to the change theory underlying the intervention, and hence have seldom been rigorously evaluated. Thus little is known about how particular features of SBs can be taken into account when designing and implementing national programmes. This paper shows how realist analysis and programme theory may be used as a framework for evaluating, developing and improving national intervention programmes for the improvement of the work environment and reducing injuries in SBs. It illustrates this for a specific New Zealand intervention: the Workplace Safety Discount scheme and its implementation in the agriculture sector. In practice, realist analysis should be performed during the planning, implementation and management stages so that ongoing findings can be fed back to the participant social actors to help them make appropriate changes to enhance the likelihood of success.

The Surveillance of the Microbial Quality of Selected Ready to Eat Foods in the State of Qatar

Foodborne illness continues to cause significant morbidity and mortality both nationally and internationally. Protecting the human host from exposure to foodborne pathogens and reducing the incidence of foodborne illness are the central goals of established national food safety intervention program. Foodborne illness is a reportable disease in the State of Qatar. Protecting the food supply from the microbial risk of known foodborne pathogens is critical to national food security; particularly in the State of Qatar where the population has a high level of dependence on imported food. There are many surveillance activities utilized by local public health officials targeted at mitigating the risk associated with foodborne illness and improving food security. A risk based method of sampling high risk ready to eat foods in the State of Qatar is one such activity to monitor the distribution and incidence of hygiene indicators and pathogens in our food supply. Three common retail hypermarkets were chosen with high risk ready to eat foods items identified for inclusion in the study The aims of this paper are ;-To perform baseline surveillance of Ready to Eat Foods at the retail level in the State of Qatar. To identify ready to eat foods (RTE) which may pose a greater risk to the population in acquiring foodborne illness. To determine if gaps exist in the food safety surveillance system related to public health and hygiene. Sample collection was conducted at three retail hypermarkets in the State of Qatar over a one year period. The laboratory will utilize a variety of wet laboratory procedures - pre-enrichment, enrichment, selective isolation and confirmatory microbiological procedures according to the National Health Authority Central Laboratories-Microbiological Analytical Manual-1st Ed., 2008 on all food samples analyzed. All samples analyzed by the Central Food Laboratory were done in duplicate. There are no significant common foodborne pathogens infecting High Risk Ready to Eat foods from identified retail hypermarkets in the State of Qatar(E. coli 0157:H7, B. cereus, Staphylococcus aureus, Clostridium perfringens, Salmonella spp., Listeria monocytogenes, Vibrio parahaemolyticus). There is a statistical difference in levels of hygiene indicators (Enterobacteriaceae, SPC) by retail store location.

Incidence of Obstetric and Foetal Complications during Labor and Delivery at a Community Health Centre, Midwives Obstetric Unit of Durban, South Africa

The objectives of this retrospective cohort study were to estimate the incidence of obstetric complications during labor and delivery and their demographic predictors. A total of 2706 pregnant women were consecutively admitted to a midwife obstetric unit with labor pain between January and December 2007 constituted the sample. Among them 16% were diagnosed with obstetrical and foetal complications. The most frequently observed foetal and obstetric complications were foetal distress (35.5/1000) and poor progress of labor (28.3/1000), respectively. Primigravid and grandmultiparity women were 12 (OR = 11.89) and 5 (OR = 4.575) times, respectively, more likely to have complications during labor and delivery. Women without antenatal care had doubled (OR = 1.815, 95% CI, 1.310; 2.515) the chance of having complications. Mothers age <20 years was protective (OR = 0.579, 95% CI, 0.348; 0.963) of complications during delivery compared to women who were ≥35 years. National and local policies and intervention programmes must address the need of the risk groups of pregnant women during labor and delivery.

Obesity and chronic diseases, whose business?

Recently, Uusitupa, Tuomilehto and Puska, all leading researchers in chronic disease prevention, emphasized the urgent need for development and implementation of population-based strategies in the prevention of obesity and type-2 diabetes,1 which are among the leading non-communicable diseases in the world. The authors reviewed available evidence showing that prevention through lifestyle modification is feasible and cost-effective. They found that community-wide and national intervention programmes are seldom conducted today and argue for the implementation of a population-based strategy in combination with a high-risk strategy. In addition, they propose governmental action like taxation and regulation to promote healthy food selection. Population-based strategies tackling unhealthy diets, physical inactivity and obesity can be expected to generate large health gains while paying for themselves through reduction of future health care costs.2 A prominent strategy in the EU during the last decade, in the fight against obesity and its comorbidities, has been to create a mechanism whereby different stakeholders from governments, consumer organizations, interest groups and industry meet to discuss current public health challenges and potential solutions under …

The DHHS Office on Women's Health Initiative to Improve Women's Heart Health: Focus on Knowledge and Awareness Among Women with Cardiometabolic Risk Factors

Abstract Background: The diversity of the U.S. population and disparities in the burden of cardiovascular disease (CVD) require that public health education strategies must target women and racial/ethnic minority groups to reduce their CVD risk factors, particularly in high-risk communities, such as women with the metabolic syndrome (MS). The data reported here were based on a cross-sectional face-to-face survey of women recruited from four participating sites as part of the national intervention program, Improving, Enhancing and Evaluating Outcomes of Comprehensive Heart Care in High-Risk Women. Measures included baseline characteristics, sociodemographics, CVD related-knowledge and awareness, and Framingham risk score (FRS). There were 443 of 698 women (63.5%) with one or more risk factors for the MS: non-Hispanic white (NHW), 51.5%; non-Hispanic black (NHB), 21.0%; Hispanic, 22.6%. Greater frequencies of MS occurred among Hispanic women (p<0.0001), those with less than a high school education (70.0%) (p<0.0001), Medicaid recipients (57.8%) (p<0.0001), and urbanites (43.3%) (p<0.001). Fewer participants with MS (62.6%) knew the leading cause of death compared to those without MS (72.1%) (p<0.0001). MS was associated with a lack of knowledge of the composite of knowing the symptoms of a heart attack plus the need to call 911 (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.17-0.97, p=0.04). Current strategies to decrease CVD risk are built on educating the public about traditional factors, including hypertension, smoking, and elevated low-density lipoprotein cholesterol (LDL-C). An opportunity to broaden the scope for risk reduction among women with cardiometabolic risk derives from the observation that women with the MS have lower knowledge about CVD as the leading cause of death, the symptoms of a heart attack, and the ideal option for managing a CVD emergency.

The frequency and predictors of helmet use among Iranian motorcyclists: A quantitative and qualitative study

Objective This study examines the rate of helmet use and identifies barriers and facilitators of wearing helmets among Iranian motorcyclists. A mixed-method approach was used, including a structured seasonal survey with specific observations of a random sample of 6010 riders and qualitative methods that included 29 in-depth interviews and seven focus groups ( n = 31). Results Only 10% of motorcyclists wear a standard helmet while riding. However, another 23% of motorcyclists used non-standard or partial helmets that covered only part of the head and do not prevent head trauma injuries effectively. We observed only 2 of 264 child passengers and 22 of 1951 adult passengers wearing helmets. Almost no one used protective pants or clothing made to be more visible in traffic. Themes emerged from qualitative interviews and were grouped into three main categories: (1) helmet characteristics; (2) social and cultural factors; and (3) personal and psychological factors. Conclusion Overall, the motorcyclists in our study believed that wearing a safety helmet protects them against serious injuries or death during a crash; however, only a small percentage of the motorcyclists used safety helmets. National intervention programs addressing motorcycle safety should aim to overcome barriers to and promote facilitators of helmet use, including providing inexpensive standard helmets, banning manufacturing/using unsafe partial or dummy helmets, as well as enforcing helmet use on a consistent basis.

Consumption pattern of pulses, vegetables and nutrients among rural population in India

In spite of several national nutritional intervention programmes, the prevalence of micronutrient malnutrition continues to be a major public health problem in India, and the economic cost of micronutrient malnutrition is 0.8 to 2.4% of the GDP. The most vulnerable segments of the population are children, adolescents, pregnant women and lactating mothers. The objective of this communication was to assess the consumption pattern of pulses and vegetables (including roots and tubers) among the rural population in India, utilizing a population based cross-sectional survey. In general, the rural population subsists on inadequate diets, where the mean intakes of pulses and vegetables were found to be below the recommended dietary intakes (RDI). The intakes of leafy and non-leafy vegetables were less than RDI in 88 and 67% of households respectively, while the corresponding figure for pulses was 73%. Similarly, the diets of rural population were grossly deficient in micronutrients such as vitamin A, iron, riboflavin and folic acid. Thus, the study revealed that the diets of rural population in India were grossly deficient in vegetables and pulses. Therefore, it is suggested that the rural communities through health and nutrition education, should be encouraged to consume a variety of vegetables and pulses.

Übergewicht und Adipositas bei Kindern und Jugendlichen in Deutschland

The increasing prevalence of overweight and obesity is a reason for concern not only in Germany but also in other countries. There are various methods and data sources that can be used to assess the extent of this public health problem. The present publication gives an overview of the reference systems that are in use in Germany to assess body mass index (BMI), which is calculated from height and weight, and an overview from several data sources: the school entry examinations, the HBSC study of the WHO, and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Current prevalence estimates are based on the KiGGS survey, which found that, based on the Kromeyer-Hauschild reference system, 14.8% of the children and adolescents in Germany aged 2-17 years are overweight, including 6.1% suffering from obesity. In absolute numbers referring to the most recent population numbers, this corresponds to 1.7 million overweight children and adolescents in Germany aged 2 years and older, 750,000 of whom are obese. This description of the status quo represents the benchmark for all future studies of BMI that aim at assessing temporal trends and, thus, the efficacy of national prevention and intervention programs. Regular examinations of certain age groups of children and adolescents in Germany, such as the school entry examinations, can be used for the assessment of temporal trends, if certain standards are followed during the examination. Studies that rely on self-reported height and weight instead of measurements, such as the German part of the HBSC study, however, need a correction based on the subjective body perception. The KiGGS participants themselves are also subject to follow-up interviews and examinations. Thus, it will be possible to regularly update the assessment of the prevalence of overweight and obesity. The Kromeyer-Hauschild reference system should not be replaced by the KiGGS BMI data, in order not to artificially lower the prevalences of overweight and obesity. It should, however, not be used for children below 2 years of age.

Estimates of Reduction in Prevalence of Diabetes Mellitus and Health Care Costs Reduced through the Intervention Program for Obese People in Japan

In the structural reform bill of health care, which passed the Diet in fiscal year 2006, the number of patients with lifestyle-related diseases and the number of those who will potentially develop such diseases in 2015 should be reduced by 25% from the number in 2008 through the national intervention program against obesity. We estimated the reduction in prevalence of diabetes mellitus, as a representative lifestyle-related disease, and the health care costs reduced by controlling obesity. Firstly, we estimated the prevalence (95% confidence interval) of obese people by conducting the National Health and Nutrition Examination Survey in 2005. Secondly, we estimated the proportion of obese people that should be reduced in order to reduce diabetes prevalence by 25% using the data from the National Diabetic Patients Survey in 2002. Thirdly, we estimated changes in prevalence of diabetes mellitus when the proportion of obese people was reduced by 20%, 40%, 60%, 80%, and 100%. Finally, we estimated how much health care costs would be reduced if the number of obese people was reduced by 20%. It is extremely difficult to reduce the prevalence of diabetes mellitus by 25% by only reducing the proportion of obese people. From our estimation of changes in the prevalence of diabetes mellitus when the proportion of obese people was reduced, the intervention for people aged from 40 years to 59 years was more effective than that for people in other age groups for both male and female. The health care costs of diabetes mellitus can be reduced by yen 841,210,000,000 for male and by yen 75,930,000,000 for female. It is almost impossible to reduce the prevalence of diabetes mellitus by 25% although it is cost-effective to target on people aged from 40 to 59 years against obesity to reduce the prevalence of diabetes mellitus.

Crisis Intervention for Workers in Severely Stressful Situations After Massive Layoffs and Labor Disputes

Due to the economic crisis and globalization, many workers have been suffering from severe occupational stress due to job insecurity and struggles related to downsizing and restructuring. This study aims to assess the stress levels among workers involved in fierce labor disputes and massive layoffs and to evaluate their specific needs and satisfaction with counseling services set up to help workers cope with severely stressful situations? The authors provided crisis intervention to workers in traumatic situations to compare the differential level of stress responses and needs among the workers remaining employed in a large auto factory, those laid off by it, and those laid off by other companies in the same region (Pyeongtaek, Gyeonggi Province). We measured stress levels using the worker's stress response inventory (WSRI) and heart rate variability (HRV), and assessed workers' satisfaction with the counseling services. 502 workers participated in the program. Fifty-seven percent of them consulted with occupational problems. The mean WSRI score of the workers remaining employed in the automobile factory was higher than that of the unemployed (employed: 39.8+/-19.9, unemployed: 29.3+/-18.8). Ninety-five percent of workers responded that they were satisfied or very satisfied with the counseling services. This study suggests the urgent need for the establishment of a national crisis intervention program dedicated to supporting workers in severely stressful situations.

Teaching and Learning Guide for: Cultural Approaches to Understanding School Violence

Teaching and Learning Guide for: Cultural Approaches to Understanding School Violence

Identifying environmental risk factors for human neural tube defects before and after folic acid supplementation.

BackgroundBirth defects are a major cause of infant mortality and disability in many parts of the world. Neural tube defects (NTDs) are one of the most common types of birth defects. In 2001, the Chinese population and family planning commission initiated a national intervention program for the prevention of birth defects. A key step in the program was the introduction of folic acid supplementation. Of interest in the present study was to determine whether folic acid supplementation has the same protective effect on NTDs under various geographical and socioeconomic conditions within the Chinese population and the nature in which the influence of environmental factors varied after folic acid supplementation.MethodsIn this study, Heshun was selected as the region of interest as a surrogate for helping to answer some of the questions raised in this study on the impact of the intervention program. Spatial filtering in combination with GIS software was used to detect annual potential clusters from 1998 to 2005 in Heshun, and Kruskal-wallis test and multivariate regression were applied to identify the environmental risk factors for NTDs among various regions.ResultsIn 1998, a significant (p < 0.100) NTDs cluster was detected in the west of Heshun. After folic acid supplementation, the significant clusters gradually moved from west to east. However, during the study period, most of the clusters appeared in the middle region of Heshun where more than 95 percent of the coal mines of Heshun are located. For the analysis, buffer regions of the coal mine zone were built in a GIS environment. It was found that the correlations between environmental risk factors and NTDs vary among the buffer regions.ConclusionThis suggests that the government needs to adapt the intervention measures according to local conditions. More attention needs to be paid to the poor and to people living in areas near coal mines.

Hearing Screening for Newborns: The Midwife's Role in Early Hearing Detection and Intervention

Universal newborn hearing screening is becoming the standard of care in the United States. However, there has been some controversy around this pediatric preventive health care practice. In 2001, the US Preventative Services Task Force (USPSTF), the leading independent panel of experts on prevention and primary care in the United States, reviewed the scientific literature and found inconclusive evidence to recommend for or against universal newborn hearing screening. As a result of this lack of recommendation, some pediatric providers were not screening the hearing of all newborn infants. The USPSTF released an update in July 2008 concluding there is scientific evidence to recommend newborn hearing screening for all infants. Universal newborn hearing screening is the first step in the national Early Hearing Detection and Intervention (EHDI) program. EHDI includes not only universal newborn hearing screening but also diagnostic evaluation for any infant failing the initial hearing screen and intervention services for any infant diagnosed with hearing loss. During the prenatal and postnatal periods, obstetric care providers can play a vital role in the EHDI process through education, screening, referral, and assistance with follow-up. Through these services, clinicians can work with parents and pediatric care providers to help newborns and infants develop communication and language skills that will last a lifetime.

The Japanese National Health Screening and Intervention Program Aimed at Preventing Worsening of the Metabolic Syndrome

Similar to the healthcare systems in other industrialized countries, the Japanese healthcare system is facing the problem of increasing medical expenditure. In Japan, this situation may be primarily attributed to advanced technological developments, an aging population, and increasing patient demand. Japan also faces the problem of a declining youth population due to a low birth rate. Taken together, these problems present the healthcare system with a very difficult financial situation. Several reforms have been undertaken to contain medical expenditure, such as increasing employee copayment for health insurance from 10% to 20% in 1997 and from 20% to 30% in 2003 in order to curb unnecessary visits to medical institutions. Since the aging of the Japanese population is inevitable, a suitable method to contain medical expenditure may be to screen individuals who are likely to develop lifestyle-related diseases and conduct early intervention programs for them to prevent the development of diseases such as myocardial infarction or stroke that are costly to treat. If this goal is attained, it may contribute to the containment of medical expenditure as well as to improving the quality of life of the elderly. Therefore, the Japanese Ministry of Health, Labor and Welfare has decided to introduce a nationwide health screening and intervention program specifically targeting the metabolic syndrome commencing April 2008. Here, we discuss (1) the background of the Japanese healthcare system and the problems facing it, (2) the underlying objective and details of the new screening program, and (3) the expected impact of the program.

A 24-Month Prospective Outcome Study of First-Episode Schizophrenia and Schizoaffective Disorder Within an Early Psychosis Intervention Program

Within the schizophrenia spectrum disorders, schizoaffective disorder is conventionally considered to have a better prognosis compared to schizophrenia. We tested the hypothesis that patients with first-episode schizoaffective disorder had better clinical and functional outcomes compared to patients with first-episode schizophrenia. The study population consisted of consecutive subjects with first-episode schizophrenia or first-episode schizoaffective disorder (diagnosed according to DSM-IV criteria) enrolled in the national Early Psychosis Intervention Program at the Institute of Mental Health/Woodbridge Hospital in Singapore from March 2001 to March 2003. The subjects' level of psychopathology, insight, socio-occupational functioning, and quality of life were assessed using the Positive and Negative Syndrome Scale (PANSS), the Scale to Assess Unawareness of Mental Disorder, the Global Assessment of Functioning scale, and the World Health Organization Quality of Life-BREF scale, respectively, at baseline and at 6, 12, 18, and 24 months. At baseline, patients with schizo-affective disorder (N = 24) were more likely to be employed (OR = 3.38, 95% CI = 1.27 to 9.02, p < .05), had a shorter duration of untreated psychosis (z = -3.30, p < .005), but had greater general psychopathology subscale scores on PANSS (z = -2.69, p < .01) compared to patients with schizophrenia (N = 254). Patients with schizophrenia had better insight into their psychiatric illness (z = -3.93, p < .001) at 6 months and expressed a better level of quality of life in the psychological health domain (z = -3.83, p < .001) at 12 months compared to patients with schizoaffective disorder. At 18 months, patients with schizoaffective disorder continued to have higher general psychopathology subscale scores on PANSS (z = -3.89, p < .001) compared to patients with schizophrenia. Patients with first-episode schizoaffective disorder do not necessarily have less severe psychopathology or better longitudinal outcomes compared to patients with first-episode schizophrenia, a finding that warrants attention in the clinical management of these patients.

Antecedents and outcomes of intervention program participation and task priority change among school psychology counselors: A latent variable growth framework

A three-year national intervention program introduced into the School Psychology Service (SPS) in Norway with the aim of increasing systemic level work among SP counselors was investigated. Latent variable growth models based on longitudinal data from 195 SP counselors gave no significant mean level change in systemic level work. This concurred with GLM analyses based on data from a sample of 20 schools. However, retrospective self-reported significant positive mean level change for systemic level work was detected among the SP counselors. Intervention program participation was associated with individual change in systemic level work. Self-efficacy beliefs about systemic level work, and school-related etiology beliefs predicted individual change to a certain degree. Comparison of two rival models gave no support for a hypothesized interaction among intervention program participation and beliefs in their effects on systemic level work. Open-ended questions indicated that individual level workload and the perceived expectations from the schools may have concern for a successful effect of the intervention program in addition to the hypothesized ones. Individual change in systemic level work was positively associated with individual change in job satisfaction.

The Action Plan—A New Instrument to Collect Data on Interventions in Secondary Prevention in Adolescents

It is difficult to draw causal conclusions about the effectiveness of secondary prevention programs for adolescents at risk, when the programs use a variety of different interventions. The Action Plan is an instrument that is designed to make collection of such data possible. This allows calculating different kinds of intervention patterns for each participant and program, which, in combination with outcome measures, gives an estimate of successful vs. less successful interventions. The study compared intervention patterns from 12 different sites in a national intervention program in Switzerland. The program, called supra-f (www.supra-f.ch), started in 1999 and will end in 2005. Results are presented from the ongoing study with approximately 600 adolescents. We calculated effect sizes (ES) to compare interventions with outcome measures. Effect sizes (ES) are presented on well being, coping, self-esteem, delinquency, and substance use (cigarettes, alcohol, cannabis) in relation to intervention packages, risk groups (low, moderate, high), and age (two groups: 11–15 and 16–20 years of age) using data collected from 1999–2002.

Prevalence of overweight and obesity in 7–9‐year‐old Portuguese children: Trends in body mass index from 1970–2002

The aim of this study was to assess the prevalence of overweight and obesity in Portuguese children age 7-9 years and to analyze trends in body mass index (BMI) from 1970-2002. Data were collected from October 2002 to June 2003 in a random sample of Portuguese children. Height and weight were measured and BMI (Kg/m(2)) was calculated. The International Obesity TaskForce (IOTF) cutoffs to define overweight and obesity were used. In the total sample we found 20.3% of overweight children and 11.3% of obese children. These results indicate a prevalence of overweight/obesity of 31.5%. Girls presented higher percentages of overweight than boys except at age 7.5. Girls also showed a higher percentages of obesity than boys except at age 9. From 1970 to 1992 and 1992 to 2002, height, weight, and BMI increased at different velocities: weight increased faster than height, and, consequently, BMI increased more in the last period than in the first one, leading to an increase in obesity values. Compared to published data by IOTF on other European countries, who applied the same methods to define overweight and obesity, Portuguese children showed the second-highest mean values in overweight/obesity. Italy showed the highest values (36%). The present study shows a very high prevalence of overweight/obesity (31.5%) in Portuguese children compared to other European countries. Portugal followed the trend of other Mediterranean countries like Spain (30%), Greece (31%), and Italy (36%). These high values require a national intervention program to control childhood obesity.