Skip to main content

Table 1 Intervention components, description, dose and expected behavior change

From: PAAPPAS community trial protocol: a randomized study of obesity prevention for adolescents combining school with household intervention

Intervention components

Description

Dose per month

Expected behavior change

School

 1) Healthy eating

Definition of healthy eating and food choices using two educational games.

2 × 30 min

To improve the choices when eating and purchasing foods at supermarkets and fairs.

Main message: reduction of cookies, sodas, and sugar-sweetened beverages.

 2) Culinary classes

First activity- students assemble salads at school choosing from a large variety of greens and fruits. In the second, they prepare vegetarian pizzas.

1 × 50 min

To develop cooking skills increasing healthy eating choices, to discuss sensory aspects of food and to stimulate teamwork.

 3) Water exchange with sugar sweetened beverage

Measuring the amount of sugar in different drinks. Sugar intake and prevention of diseases.

2 × 30 min

To increase water consumption.

A squeeze with the PAAPPAS logo will be provide to the students and teachers.

To develop a critical view about the consumption of sugar sweetened beverages.

 4) Physical activity and sedentary behavior

How many Olympic games they have heard of. What exercises they do and would like to do. Class games related to the Olympic games and time spend sedentary.

2 × 30 min

To stimulate exercise.

 5) Fruit consumption

Group discussion and games about of fruits. What they like and dislike. Diversity of fruits from Brazil. How buy fruit al affordable prices and the importance of eating fruits.

2 × 30 min

To exchange cookies consumption by fruit.

 6) Mindful eating and self-control strategies

Activity regarding hunger and satiety cues; how to combine foods to make a healthy dishes.

2 × 30 min

To develop eating awareness regarding hunger and satiety physiological signs. To facilitate choices of healthy dishes.

Household

CHA activities

 1) Health eating habits and anthropometry

Measure weight and waist of the adolescent and mother.

30 min

To improve eating habits.

Encourage adolescents and family to: 1) Keep regular mealtimes; 2) Eat with the family at the table; 3) No television, computer or mobile phone during meals; 4) Eating meal slowly (about 20 min); 5) Serve the dish once, except for vegetables.

 2) Reduce soft drinks and sugar sweetened juices

Show pictures of the amount of sugar in sodas and popular drinks negotiating reduction strategies: 1) Avoiding buying; 2) Replace soft drinks and juices by water and flavored waters; 3) Facilitate adolescent access to fruits; 4) Buy season fruits.

20 min

To reduce soft drinks and sweetened juices and prompt specific strategies to achieve this target.

 3) Physical activity and sedentary behavior

Discuss that lifestyle modification are strong allies to lose weight. Provide a list of facilities free of charge in the neighborhood with physical activities such as churches and NGOs. Sedentary reduction strategies: 1) Reduce one hour time in computer games and TV; 2) Encourage the use of physical activity mobile app. 3) Encourage standing or walk during the interval of TV programs or in the game phase shift.

20 min

To increase physical activity and reduce sedentary behavior.

 4) Biscuits and sweets

How to read nutritional labels using as example cookies, candy and other high sugar products. Negotiate: 1) Reducing intake of cookies, biscuits and sweets and also avoiding buying them; 2) Replace cookies with homemade popcorn, fresh coconut; peanuts and corn; 3) Substitute processed sweets, with homemade marmalades and jams low in sugar; 4) Add milk to coffee to reduce sugar.

20 min

To reduce biscuits and sweets consumption and prompt specific strategies to achieve this target.

 5) Industrialized products

Identify dyes, preservatives and flavor enhance substances in labels avoid buying those high-energy industrialized products. Stimulate: 1) Replacement of noodles; processed sausage and hamburger for homemade burger /ground beef /egg; 2) Clean salads and vegetables in advance for consumption during the week (ask adolescent for help); 3) Keep always in the refrigerator fresh or frozen vegetables and beans; 4) Use spices and make attractive and colorful raw salads and vegetables. 5) Make shopping list to avoid buying unnecessary foods.

20 min

Provide information to reduce the consumption of industrialized products and prompt specific strategies to achieve this target.