• Emilie Bonsergent, Nelly Agrinier, Nathalie Thilly, Sabrina Tessier, Karine Legrand, Edith Lecomte, Evelyne Aptel, Serge Hercberg, Jean-François Collin, Serge Briançon, and PRALIMAP Trial Group.
• Laboratoire EA4360, University of Lorraine, Apemac, France.
• Am J Prev Med. 2013 Jan 1; 44 (1): 303930-9.

BackgroundGiven the increasing prevalence of obesity among youth over the past decade, prevention has become an international public health priority.PurposeTo evaluate the 2-year effectiveness of three strategies aimed at preventing overweight and obesity among adolescents in a high school setting.DesignPRomotion de l'ALIMentation et de l'Activité Physique (PRALIMAP) is a school-based RCT. Each study high school was assigned to receive or not, over a 2-year period (Grades 10 and 11), each of three prevention strategies according to a 2 × 2 × 2 factorial school randomization. Data were collected in 2006-2009 and analyzed in 2009-2011.Setting/ParticipantsA total of 3538 adolescents (aged 15.6±0.7 years at baseline) in 24 public high schools in Lorraine (northeastern France) completed the PRALIMAP trial.InterventionsThe prevention strategies were education (development of nutritional knowledge and skills); environment (creation of a favorable environment by improving availability of "healthy" dietary items and physical activity); and screening and care (detection of overweight/obesity and, if necessary, adapted care management).Main Outcomes MeasuresThe main outcome of interest was BMI; BMI z-score and prevalence of overweight/obesity were considered as secondary outcomes.ResultsAdolescents who completed the PRALIMAP trial were younger, less often suspected of having eating disorders and depression, and came from a higher socioeconomic class than those who did not. The 2-year change of outcomes was more favorable in the 12 screening and care high schools compared to the no-screening ones: a 0.11 lower increase in BMI (p=0.0303); a 0.04 greater decrease in BMI z-score (p=0.0173); and a 1.71% greater decrease in overweight/obesity prevalence (p=0.0386). Education and environment strategies were not more effective than no strategy intervention.ConclusionsAlthough the screening and care strategy is an effective way to prevent, at 2 years, overweight and obesity among adolescents in a high school setting, its effects over and above no strategy intervention were small.Trial RegistrationThis study is registered at www.clinicaltrials.govNCT00814554.Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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