Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .
Adolescent smoking: effect of school and community characteristics.
BACKGROUND A substantial challenge in addressing adolescent tobacco use is that smoking behaviors occur in complex environments that involve the school setting and larger community context . PURPOSE This study provides an integrated description of factors from the school and community environment that affect youth smoking and explains variation in individual smoking behaviors both within and across schools/communities . METHODS Data were collected from 82 r and omly sample d secondary schools in five Canadian provinces ( British Columbia , Manitoba , Ontario , Quebec , Newfoundl and , and Labrador ) during the 2003 - 2004 school year . Cross-sectional data were obtained from students ; school administrators ( school-based tobacco control policies and programs ) ; and from observations in the community . In 2009 , hierarchic logistic regression was used to model the role of individual , school , and community variables in predicting student smoking outcomes . RESULTS Students who attended a school with a focus on tobacco prevention ( OR=0.87 , 95 % CI=0.81 , 0.94 ) and stronger policies prohibiting tobacco use ( OR=0.92 , 95 % CI=0.88 , 0.97 ) were less likely to smoke than students who attended a school without these characteristics . A student was more likely to smoke if a greater number of students smoked on the school periphery ( OR=1.25 , 95 % CI=1.07 , 1.47 ) . Within the community , price per cigarette ( OR=0.91 , 95 % CI=0.84 , 0.99 ) and immigrants ( OR=0.99 , 95 % CI=0.98 , 0.99 ) were inversely related to students ' smoking status . CONCLUSIONS The results suggest that school and community characteristics account for variation in smoking levels across schools . Based on the current findings , the ideal school setting that supports low student smoking levels is located in a neighborhood where the cost of cigarettes is high , provides tobacco prevention education , and has a policy prohibiting smoking
Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .