Evaluating the Safety and Efficacy of a Non-Weight-Centric Approach to Obesity Prevention in Rural and Urban Female Adolescents: Quasi-Experimental Study.

Furthermore, when this effectiveness was examined based on school type, it was found that in urban schools, the intervention (Green Apple) group showed marginally nonsignificant improvement at postintervention, with an adjusted mean difference of 1.86 (95% CI –0.08 to 3.81; P =.06), and nonsignificant improvement at follow-up, with an adjusted mean difference of 1.22 (95% CI –0.82 to 3.25; P =.44).

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The direction of the difference at follow-up favored the enhanced intervention (Green Apple+MNCD) group (mean difference 0.73, SE 0.49, 95% CI –0.24 to 1.71), suggesting a possible trend that may warrant further investigation in larger or longer-duration trials.

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For instance, in the intervention (Green Apple) group, the overall mean difference from baseline to follow-up across all schools was –0.26 (95% CI –0.67 to 0.14; P =.35), suggesting a modest improvement in body image perception that did not reach statistical significance.

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