Working hypothesis of the scientific study:
‘The acquisition of healthy habits in childhood reduces the risks of cardiovascular disease and improves the quality of life in adulthood”
The design of the SI! Programme is based on scientific evidence that supports its effectiveness, such as the inclusion of the child’s immediate circle, also intervening in the families and the teaching staff, covering the entire school environment. As well as being an intervention at different levels, with the classic components of health promotion programmes such as nutrition and physical activity, the components of body and health and emotional management have also been incorporated, thereby achieving a holistic vision of health that connects the 4 components directly with cardiovascular health.
By using the acquisition of skills, the intention is to succeed in achieving a change in attitudes that can translate into the adoption of healthy habits that will stand the test of time. The evaluation will therefore be carried out in these three lines, with a final expectation of an impact in the physical parameters of health that are evaluated by using the indicators established in the scientific literature, such as body mass index, waist measurement or folds of subcutaneous fat.
The effectiveness of the SI! Programme is evaluated using randomised and controlled trials.
In order to evaluate the effectiveness of the SI! Programme at Infant Education level, a randomised and controlled trial was carried out in 24 schools in Madrid (12 interventions and 12 controls) during the school years 2011-2012 and 2013-2014. The school environment and skills, attitudes and cardiovascular health habits of families, teaching staff and schoolchildren were evaluated. In addition, children were measured using a series of cardiovascular health parameters, such as blood pressure, waist measurement, height, weight and folds of subcutaneous fat.
The final results showed that after three school years, the skills, attitudes and habits regarding cardiovascular health had improved significantly more in the group of children that had taken part in the SI! Programme, the physical activity component being the one where the greatest difference was noticed. It could also be demonstrated that the acquisition of health-related skills by children translated into adherence to healthy lifestyles and then into a modification of the physical parameters of cardiovascular health, due to the fact that at the end of the study it was found that overweight or obese children who had followed the SI! Programme from the age of 3 had reduced their cardiovascular health indicators, such as percentage of fat and waist measurement, more.
2015 ‘The SI! Program for cardiovascular health promotion in early childhood: A cluster randomized trial’ Peñalvo JL, Santos-Beneit G, Sotos-Prieto M, Bodega P, Oliva B, Òrrit X, Rodríguez C, Fernández-Alvira J, Redondo J, Vedanthan R, Bansilal S, Gómez E, Fuster V. J Am Coll Cardiol 66 (14): 1525-1534
2015 ‘Association between anthropometry and high blood pressure in a representative sample of preschoolers in Madrid’ Santos-Beneit G, Sotos-Prieto M, Pocock S, Redondo J, Fuster V, Peñalvo JL. Rev Esp Cardiol (English ed) 68(6):477-484
2014 ‘Parental and self-reported dietary and physical activity habits in preschoolers and their socio-economic determinants’ Sotos-Prieto M, Santos-Beneit G, Pocock S, Redondo J, Fuster V, Peñalvo JL. Public Health Nutr 3:1-11
2013 ‘A cluster randomized trial to evaluate the efficacy of a school-based behavioral intervention for health promotion among children aged 3 to 5’ Peñalvo JL, Santos-Beneit G, Sotos-Prieto M, Martínez R, Rodríguez C, Franco M, López-Romero P, Pocock S, Redondo J, Fuster V. BMC Public Health 13: 656
2013 ‘The Program SI! intervention for enhancing a healthy lifestyle in preschoolers: first results from a cluster randomized trial’ Peñalvo JL, Sotos-Prieto M, Santos-Beneit G, Pocock S, Redondo J, Fuster V. BMC Public Health 13: 1208.
As the Infant programme had produced such good results, the SI! Primary Programme study started with the inclusion of a follow-up of the children who began their school life with the SI! Programme (3 years), in the hope that the very positive trend obtained in this first stage of Infant Education would be confirmed. The study will extend over a total of 6 school years (the whole of Primary Education), from October 2014 to June 2020.
The evaluation system is similar to that of the Infant programme, adapting the questionnaires on the skills, attitudes and habits to the new age group (from 6 to 11 years) and retaining the same anthropometric measures and blood pressure. To evaluate the effects of the SI! Programme at different educational stages, 48 newly signed-up schools (Madrid-South) and 21 schools that completed the SI! Infant Programme (Madrid-Capital) are participating in the programme. This will enable the impact of the intervention in schools that apply the SI! Programme at Primary level only, at Infant level only, or both levels – Infant and Primary – to be evaluated. The intervention at Primary level has been designed in two stages, the first covering the first 3 years and the second the last 3; the schools will be randomised in 4 groups and will act as control schools or intervention schools at different times during the study and the effectiveness of the programme will be evaluated at various times and over different periods.
2015 ‘Development and validation of a questionnaire to evaluate lifestyle-related behaviors in elementary school children’ Santos-Beneit G, Sotos-Prieto M, Bodega P, Rodríguez C, Òrrit X, Pérez-Escoda N, Bisquerra R, Fuster V, Peñalvo JL. BMC Public Health 15: 901-907.
The SI! Secondary Programme is currently under development and the aim is to begin the pilot study prior to randomisation in the school year 2016-2017. Working groups have already been set up in 6 schools in Catalonia and the first focus groups and tests of materials established. Both the intervention and evaluation will be adapted to the corresponding age group (12 to 16 years) and the physiological parameter measurements associated with obesity and blood cholesterol levels extended, because at this age it is expected that a higher prevalence of certain cardiovascular risk factors will start to appear.