Guys/Girls Opt for Activities for Life (GOAL) Trial

摘要 体育活动不足和饮食质量差是导致超重/肥胖（OW/O）患病率高的原因 在12-19岁的青少年中，表明需要在12岁或之前进行干预。相比其他 青少年，服务不足（少数民族;社会经济地位低）城市地区的青少年表现出更多的 不健康的行为会增加他们患肥胖症和相关心血管疾病（CVD）的风险。指导 自我决定理论和信息动机行为技能模型，小说16周 男孩/女孩选择终身活动（目标）干预包括3个组成部分：1）课后目标俱乐部： 为男孩和女孩举办26次120分钟的活动（每周2天），包括体育活动和健康饮食， 烹饪; 2）三次家长-青少年二元会议，以增强二元关于体育活动和健康的能力 饮食和烹饪; 3）目标社交网站，使父母可以相互激励，以帮助他们的 青少年增加体育活动和提高饮食质量。这项为期5年的随机分组试验的目的（单位： 作业是学校）是评估GOAL对降低CVD风险因素（高%体脂， OW/O，低CV适应性），改善生活质量（QOL）;并增加动力，自我效能和社会 支持提高服务不足的青少年（5 - 7年级）的MVPA和饮食质量， ≥0。长期目标是改善服务不足的青少年的CV健康，以减少健康差距， NHLBI的一个主要优先事项。18所学校将被随机分配接受GOAL（n=9）或普通 学校提供的控制（n=9）的条件。每个学校有40对男女生（n = 20）， 每名愿意充当支助人员的青少年的父母将被招募（总共720对）。分析 将基于意向治疗原则。目的是评价目标干预的效果，比较 与对照组相比，（1）干预组和对照组之间的体脂百分比（主要结局）改善≥2.5% 从基线（0个月）至4个月（干预后即刻）BMI z评分≥0的青少年， 基线后13个月（9个月）F/U）;（2）增加青少年的次要近端结局： MVPA（通过加速计; min/hr）和饮食质量（基于3次24小时饮食回忆的健康饮食指数）， 0至4个月;（3）改善次要远端结局：CV健身（渐进式有氧CV耐力跑， [15-0 - 4个月的BMI、OW/O百分比和QOL， 13个月;（4）通过评估任何中介因素，增加社会支持，自我效能和动机 影响青少年PA和饮食质量。探索性目的（父母）是评估GOAL的任何效果， 与对照组相比，（1）改善父母的家庭营养和PA，MVPA（通过加速度计）， 和饮食质量（水果-蔬菜-纤维筛选剂）;和（2）降低父母的体脂%， BMI从0到4个月和13个月。

Abstract Inadequate physical activity and poor diet quality contribute to the high overweight/obesity (OW/O) prevalence in adolescents, aged 12-19 years, indicating a need to intervene at or before age 12. Compared with other adolescents, underserved (minority; low socioeconomic status) adolescents in urban areas exhibit more unhealthy behaviors that increase their risk for obesity and related cardiovascular disease (CVD). Guided by Self-Determination Theory and the Information-Motivation-Behavioral Skills Model, the novel 16-week Guys/Girls Opt for Activities for Life (GOAL) intervention includes 3 components: 1) After-school GOAL Club: 26 120-minute events (2 days/week) for boys and girls that incorporate physical activity and healthy eating and cooking; 2) Three parent-adolescent dyad meetings to empower dyads about physical activity and healthy eating and cooking; and 3) GOAL social networking website so parents can motivate each other to help their adolescents increase physical activity and diet quality. The purpose of this 5-yr group randomized trial (unit of assignment is school) is to evaluate the effect of GOAL on decreasing CVD risk factors (high % body fat, OW/O, low CV fitness), improving quality of life (QOL); and increasing motivation, self-efficacy, and social support to increase MVPA and diet quality among underserved adolescents (5th–7th grade) having BMI z-score ≥0. The long-term goal is to improve the CV health of underserved adolescents to decrease health disparities, a major priority of NHLBI. Eighteen schools will be randomly assigned to receive either GOAL (n=9) or usual school offerings control (n=9) condition. Forty dyads of boys (n=20) and girls (n=20) in each school and one parent per adolescent who is willing to serve as a support person will be enrolled (720 dyads total). Analysis will be based on the intention-to-treat principle. Aims are to evaluate effect of the GOAL intervention, compared to control, on: (1) Improving % body fat (primary outcome) by ≥2.5% between intervention and control adolescents with a BMI z-score ≥0 from baseline (0 months) to 4 months (immediate post-intervention) and to 13 months post-baseline (9-mon. F/U); (2) Increasing secondary proximal outcomes among adolescents: MVPA (via accelerometers; min/hr) and diet quality (healthy eating index based on 3 24-hr dietary recalls) from 0 to 4 months; (3) Improving secondary distal outcomes: CV fitness (Progressive Aerobic CV Endurance Run, [15- or 20-m shuttle run]) from 0 to 4 months; and BMI, OW/O percentage, & QOL from 0 to 4 months and to 13 months; and (4) Increasing social support, self-efficacy, and motivation with evaluation of any mediating effect on adolescent PA and diet quality. An exploratory aim (parents) is to evaluate any effect of GOAL, compared to control, on: (1) Improving parents’ perceived family nutrition and PA, MVPA (via accelerometers), and diet quality (fruit-vegetable-fiber screener) from 0 to 4 months; and (2) Reducing parents’ % body fat and BMI from 0 to 4 months and to 13 months.