Challenge in Schools: Adolescent Overweight Prevention

描述（由申请人提供）：儿童超重是一个严重的公共卫生问题，其患病率正在上升，特别是在低收入家庭的少数民族儿童中。虽然很多人都把注意力集中在学校管理的预防超重项目上，但大多数项目在阻止青春期身体脂肪的积累方面都没有效果。这项申请的目标是制定和实施一项多层次的小组和全校范围的干预措施，通过增加健康食品（水果和蔬菜）的消费和增加体育活动的时间，防止青春期女性超重。该应用程序扩展了最近完成的家庭和社区健康促进/超重预防计划（挑战计划）的随机试验，该计划通过分配大学导师给低收入的城市非裔美国青少年进行。在18个月的研究期间，参与干预的青少年比对照组的青少年更不容易超重。在拟议的项目中，以发展生态学和社会认知理论为基础的挑战计划已经扩展到一个小组形式，并在学校进行试点测试。拟议的项目保留了原项目的许多元素，包括大学导师、家庭和社区模块，以及与两个城市基督教青年会的合作。该项目的主要目的是使用因子设计来比较来自10所中学的800名低收入、城市、少数民族12- 13岁女孩的身体成分、饮食和体育活动方面的多层次（学校和小组）干预与仅学校干预、仅小组干预或不干预。第二个目的是检查干预对身体组成、饮食和身体活动的影响是否因以下因素而异：1)家庭和同伴对采用健康饮食和参与身体活动的支持或2)饮食和身体活动的改变阶段。本研究的最终目的是检验干预对青少年身体成分、饮食和体育活动的影响是否通过自我效能感的变化介导。除了评估干预措施外，拟议研究的结果将增强我们对家庭和同伴支持、变化阶段、青少年饮食和体育活动的自我效能感与身体组成变化的关系的理解。

DESCRIPTION (provided by applicant): Pediatric overweight is a serious public health problem that is increasing in prevalence, particularly among minority children from low-income families. Although there has been much attention directed toward overweight prevention programs administered through the schools, most programs have not been effective in halting the accumulation of body fat that occurs during adolescence. The objectives of this application are to develop and implement a multilevel small group and school-wide intervention to prevent overweight among adolescent females by increasing consumption of healthy foods (fruits and vegetables) and time spent in physical activity. This application extends a recently completed randomized trial of a home and community-based health promotion/overweight prevention program (the Challenge Program), conducted by assigning college mentors to low-income, urban African-American adolescents. Adolescents enrolled in the intervention were statistically less likely to become overweight than adolescents in the control group over the 18-month study period. In the proposed project, the Challenge Program, which is based on developmental-ecological and social cognitive theory, has been extended to a small group format and pilot tested in schools. The proposed program retains many of the elements of the original program, including the college mentors, family and community modules, and collaboration with two urban YMCAs. The primary aim of the proposed project is to use a factorial design to compare a multi-level (school and small group) intervention with school-only, small group-only, or no intervention on body composition, diet, and physical activity among 800 low-income, urban, minority 12- 13 year old girls from 10 middle schools. The second aim is to examine whether the impact of the intervention on body composition, diet, and physical activity varies by: 1) family and peer support for adopting a healthy diet and engaging in physical activity or 2) stage of change for diet and physical activity. The final aim is to examine whether the impact of the intervention on adolescents' body composition, diet, and physical activity is mediated by changes in self-efficacy. In addition to evaluating the intervention, findings from the proposed study will enhance our understanding of how family and peer support, stage of change, and adolescents' self-efficacy for diet and physical activity are related to changes in body composition. Public Health Relevance: The objective of this application is to evaluate whether small group and school-wide interventions among 12-13 year old females in urban middle schools are effective in increasing consumption of healthy foods (fruits and vegetables) and time spent in physical activity. The 12-session small group intervention will be implemented by college mentors in collaboration with the YMCA and the school-wide intervention is a partnership among school personnel, students, parents, community members, and university representatives. Positive findings would suggest that interventions to prevent overweight among middle- school females should include school-wide and small group components with family, school, and community involvement.