Impact an Educational Multimodal Intervention to Improve Healthy Habits in Adolescents.

Primary outcomes

1. Self steem

   Time frame: 4 months

   Self-esteem was assessed with the Rosenberg Scale. consists of 10 items and is a self-report instrument for evaluating an individual's overall self-esteem. The RSES is scored using four response options, ranging from strongly agree to strongly disagree. It is a two-dimensional scale: positive self-esteem (self-confidence or personal satisfaction) and negative self-esteem (self-contempt or personal devaluation). Five items are scored positively, and five items are scored negatively. The total score ranges from 10 to 40 points, with 10 points being the lowest self-esteem score and 40 points being the highest. With respect to the total score, a score of 30 to 40 points indicates high self-esteem; a score of 26 to 29 points indicates intermediate self-esteem; and a score less than or equal to 25 points indicate low self-esteem.

2. Body image

   Time frame: 4 months

   Dissatisfaction with body image was assessed with the Body shape questionnaire. This instrument evaluates dissatisfaction with body image due to body weight and shape; participants respond to items referring to how they have felt about their body shape in the last weeks. The questionnaire contains 34 self-report items; items are scored using a six-point Likert scale ranging from 1 (never) to 6 (always), with a total possible score ranging from 34 to 204 points. The higher the score is, the greater an individual's dissatisfaction with their body. Based on their BSQ results, the participants were divided into four groups according to dissatisfaction with physical appearance using the validated model: scores ≤80 (no dissatisfaction with BI); 81 ≤ scores ≤ 110 (slight dissatisfaction with BI); 111≤ scores ≤ 140 (moderate dissatisfaction with BI); and scores ≥ 141 (severe dissatisfaction with BI).

3. self concept

   Time frame: 4 months

   self-concept was assessed with the physical self-concept questionnaire.

   The Physical Activity Questionnaire for Adolescents (PAQ-A) assesses the physical exercise of the adolescent in the last 7 days. It consists of 9 questions that measure aspects of the physical exercise performed by the adolescent. It also provides information on whether the person has been ill. It is evaluated by means of a scale of 1 to 5 points that establishes a graduation of the level of physical activity carried out. It allows us to know at what time of the day and of the week the adolescent is most active.

4. Nutrition

   Time frame: 4 months

   the quality of the diet was assessed with the kidmed questionnaire. Kidmed questionnaire assesses adherence to the Mediterranean diet as a prototype of a healthy diet. The index consists of 16 questions, of which 12 are positive and 4 are negative; individuals who answer "yes" to positive questions receive +1 point, while those who answer "yes" to negative questions receive -1 point. Points are summed at the end of the evaluation, and a score ranging from 0 to 12 is obtained. The sum of these value scores is classified into 3 levels: ≥8 points indicates the optimal Mediterranean diet (good), scores between 4 and 7 points indicate that compatibility with the Mediterranean diet should be improved (moderate), and scores ≤3 points indicate very poor diet quality (low)