Children First Study II: an educational programme on cardiovascular prevention in public schools can reduce parents' cardiovascular risk

Pinto, Cristiano J. M.; Fornari, Luciana S.; Oyama, Silvia M. R.; Rodrigues, Maria M. D.; Davanço, Taciana; Caramelli, Bruno

doi:10.1590/1806-9282.66.9.1217

Brasil

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Original Article • Rev. Assoc. Med. Bras. 66 (9) • Sept 2020 • https://doi.org/10.1590/1806-9282.66.9.1217 linkcopy

Children First Study II: an educational programme on cardiovascular prevention in public schools can reduce parents' cardiovascular risk

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE: The aim of this study was to analyze whether the implementation of a multidisciplinary educational programme for cardiovascular prevention in public schools can contribute to reducing the Fram INGHAM CARDIOVASCULAR RISK SCORE OF THE CHILDREN'S PARENTS AFTER ONE YEAR.

METHODS: This was a prospective, community-based, case-control study carried out in public schools in Sao Paulo, Brasil. Students were randomized to receive healthy lifestyle recommendations by two different approaches. The control group received written cardiovascular health educational brochures for their parents. The intervention group received the same brochures for the parents, and the children were exposed to a weekly educational programme on cardiovascular prevention with a multidisciplinary health team for one year. Clinical and laboratorial data were collected at the onset and end of the study.

RESULTS: We studied 265 children and their 418 parents. At the baseline, the rate of parents with intermediate or high Framingham scores (risk of cardiovascular disease over the next 10 years greater than 10%) was 6.9% in the control group and 13.3% in the intervention group. After one year, the rate of parents with intermediate or high Framingham risk score was reduced by 22.2% in the intervention group and increased by 33.3% in the control group (p=0.031). The cardiovascular risk factors that improved in the intervention group were blood pressure, LDL-cholesterol (low-density lipoprotein cholesterol), and glucose levels.

CONCLUSION: An educational programme on cardiovascular prevention for school-age children in public schools can reduce the cardiovascular risk of their parents.

KEYWORDS: Cardiovascular diseases/prevention & control; Child; Parents; Education; Schools

	Groups
Variables	Control	Intervention	p^a a Statistical significance according to Wilcoxon test for comparisons of continuous variables between two independent groups at the baseline.
Age (years)	37.9 (8.6)	39.5 (8.8)	0.070
BMI (kg/m²)	27.4 (5.5)	27.6 (5.1)	0.692
Systolic blood pressure (mmHg)	118.8 (15.4)	122.4 (13.8)	0.004
Diastolic blood pressure (mmHg)	76.2 (10.2)	84.6 (10.4)	< 0.001
Smoking	20 (9.3)	21 (10.4)	0.695
Total cholesterol (mg/dl)	184.2 (38.4)	192.7 (37.2)	0.009
Triglycerides (mg/dl)	120.0 (98.9)	128.2 (89.9)	0.109
HDL-cholesterol (mg/dl)	52.0 (18.6)	52.6 (15.2)	0.145
LDL-cholesterol (mg/dl)	108.3 (35.6)	115.0 (30.9)	0.017
Glucose (mg/dl)	85.6 (25.2)	85.8 (26.6)	0.847

	Groups
	Control			Intervention
	Before	After	p a	Before	After	p a
BMI (kg/m2)	27.4 (5.5)	27.5 (5.4)	0.012	27.6 (5.1)	27.7 (5.2)	0.052
Systolic blood pressure (mmHg)	118.8 (15.4)	118.4 (16.7)	0.552	122.4 (13.8)	118.4 (12.9)	<0.001
Diastolic blood pressure (mmHg)	76.2 (10.2)	77.5 (10.1)	0.091	84.6 (10.4)	80.1 (8.9)	<0.001
Total cholesterol (mg/dl)	184.2 (38.4)	181.5 (40.8)	0.058	192.7 (37.2)	189.6 (37.8)	0.348
Triglycerides (md/dl)	120.0 (98.9)	137.4 (159.3)	0.003	128.2 (89.9)	137.6 (117.0)	0.071
HDL-cholesterol (mg/dl)	52.0 (18.6)	46.9 (11.4)	<0.001	52.6 (15.2)	46.4 (12.5)	<0.001
LDL-cholesterol (mg/dl)	108.3 (35.6)	114.7 (50.6)	0.766	115.0 (30.9)	122.1 (50.4)	0.008
Glucose (mg/dl)	85.6 (25.2)	83.8 (30.6)	0.003	85.8 (26.6)	80.3 (21.8)	<0.001
Average Framingham risk (%)	3.7 (4.9)	4.1 (5.7)	0.001	5.0 (6.3)	4.9 (6.2)	0.227

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Statistical significance according to Wilcoxon test for comparisons of continuous variables between two independent groups at the baseline.