Evaluating the Safety and Efficacy of a Non–Weight-Centric Approach to Obesity Prevention in Rural and Urban Female Adolescents: Quasi-Experimental Study
Notice bibliographique
Résumé
BACKGROUND: Obesity is increasing among Saudi adolescents, with rural females disproportionately underserved due to limited health education, sociocultural barriers, and scarce resources. While most school programs emphasize weight, global recommendations call for non-weight-centric approaches to avoid stigma. The Green Apple program is a school-based, weight-neutral intervention focusing on energy metabolism, nutrient balance, and dietary sources. Its enhanced version adds a unit on metabolic non-communicable disease (MNCD) prevention, grounded in the health belief model. Although previously tested in urban settings, it has not yet been evaluated among rural female students. OBJECTIVE: This study aimed to examine the effectiveness of the Green Apple educational intervention in improving knowledge about MNCDs, while also assessing its safety, defined as the absence of adverse psychological (body image discrepancy, disordered eating symptoms) and behavioral (increased sedentary behavior) outcomes. METHODS: This quasi-experimental study included 105 participants from urban and rural female schools in Saudi Arabia. Two classes within each school were assigned to one of two program versions: (1) enhanced intervention (Green Apple + MNCD): a three-unit, non-weight-centric educational program that included content on the prevention of MNCDs. (2) intervention (Green Apple only): a two-unit, non-weight-centric educational program without MNCD content. The intervention was delivered once per week over two consecutive weeks (two sessions), while the enhanced intervention included an additional third session. Linear mixed-effects models assessed intervention effects across three time points: baseline, post-intervention, and one-month follow-up. RESULTS: The mean age across participants was 16.42 years (SD = 0.66), with a significant difference between groups: 15.97 years (SD = 0.41) in the enhanced intervention group and 17.00 years (SD = 0.42) in the intervention group (P < .001). Both interventions significantly improved knowledge across schools. The enhanced intervention (Green Apple + MNCD) group demonstrated an increase of 1.65 (95% CI [0.61, 2.70], P < .001) from baseline to follow-up, while the intervention (Green Apple) group showed an increase of 1.26 (95% CI [0.10, 2.43], P = .02). However, no significant between-group differences were observed at baseline (mean difference = 0.20, P = .65), post-intervention (mean difference = 0.79, P = .08), or follow-up (mean difference = 0.73, P = .13). Although sedentary behavior did not significantly decrease across all schools, a significant reduction was observed in rural schools receiving the Green Apple intervention (-3.12, 95% CI [-5.67, -0.56], P = .02). CONCLUSIONS: The Green Apple program shows promise as a culturally tailored, weight-neutral intervention to enhance metabolic health literacy and reduce sedentary behavior among Saudi female adolescents without adverse effects on body image or disordered eating. By targeting a uniquely underserved population, this study addresses a critical gap in health promotion research and responds to global recommendations for inclusive, stigma-free interventions. Further studies across diverse regions of Saudi Arabia are needed to evaluate the broader applicability and long-term impact of such interventions.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,007 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».