Effect of School-Based Home-Collaborative Lifestyle Education on Reducing Subjective Psychosomatic Symptoms in Adolescents: A Cluster Randomised Controlled Trial

Abstract

In this study, we aimed to assess the effectiveness of a school-based home-collaborative lifestyle education program for adolescents (PADOK) in reducing poor subjective psychosomatic symptoms (SPS). The study was designed as a two-armed parallel cluster randomised controlled trial and the study population comprised adolescent students (aged 12–14 years, n = 1,565) who were recruited from 19 middle schools in Japan. The PADOK intervention or usual school programme was provided in schools to all eligible participants. The primary outcome was the SPS score at 6 months, while secondary outcomes included lifestyle factors, BMI, and dietary intakes. Analyses were undertaken on an intention to treat (ITT) basis accounting for the clustered design. Nineteen schools were randomised to the PADOK group (10 schools) and control group (9 schools). The numbers of students used for analysis were 1,509 for ITT and 1,420 (94.1%) for PPS. At 6 months, the crude mean change from baseline of the SPS scores by ITT analysis showed a significantly greater reduction in the PADOK group compared to that in the control group (−0.95, 95% CI −1.70 to −0.20, P = 0.016), while those for baseline-adjusted and multivariate-adjusted values showed similar directionality but were not significant (P = 0.063 and P = 0.130). The results indicated that the PADOK program may improve poor SPS scores among adolescents.

Self-perception of physical activity and fitness is related to lower psychosomatic health symptoms in adolescents with unhealthy lifestyles

“…Thus, the present study adds to the knowledge that health education programs combining traditional topics such as development of emotional or social skills might benefit from adding lifestyle – related topics such as physical activity and healthy nutrition, prevention of alcohol and smoking. There is some evidence that this approach might be promising [40].…”

Effect of acceptance and commitment therapy on body image flexibility and body awareness in patients with psychosomatic disorders: a randomized clinical trial

“…The treatment plan was designed using the model proposed based on the theoretical model of acceptance and commitment therapy for body image dissatisfaction and improvement in mindfulness skills, which had been developed by Pearson et al ( 10 ). This model involved 10 weekly 90-minute sessions ( 41 ) ( Table 1 ).…”

School-based lifestyle education involving parents for reducing subjective psychosomatic symptoms in Japanese adolescents: study protocol for a cluster randomised controlled trial

“… 17 19 PADOK had been assessed by a cluster randomised controlled trial (cRCT), and the results indicated that PADOK was effective in reducing SPS and promoting a healthy lifestyle for adolescents although the effect was statistically significant only in the crude model. 18 Study findings indicated that SPS and chronic stress are prevalent among today’s adolescents and that there is a critical need to develop effective and practical measures for minimising SPS and its potential influence among adolescents.…”

“…We had developed a school-based home-collaborative lifestyle education programme to improve poor SPS scores in adolescents Programme for adolescent of lifestyle education in Kumamoto (PADOK) based on our previous studies, 8 17 and we proved the effectiveness of PADOK, though weakly. 18 PADOK aimed to change adolescents’ lifestyles in a non-compulsory way and to provide feedback on their dietary habits by assessments using the Food Frequency Questionnaire with 82 food items (FFQW82). 19 The FFQW82 was developed to assess habitual dietary intake by evaluating nutritional intake at each meal.…”

“…Therefore, to establish a more effective programme, we have developed a school-based lifestyle education involving parents for reducing SPS in adolescents (SPRAT), an improved version of PADOK, which was used in the previous study. 18 …”