Impact of a CBPR School Program on Obesity-Related Outcomes in Underserved Youth

描述(申请人提供)：在过去的20年里，美国儿童和青少年的肥胖率急剧上升。国家研究表明，在种族/族裔少数群体和低收入者超重或肥胖风险较高的地方存在差异。设计、实施和传播有效的以学校为基础的预防计划对于解决肥胖症流行中的这些差异至关重要，然而，成功的模式很少。采用CBPR方法由社区伙伴提供信息且全面的干预措施，以及包括个人(体育活动行为)、社会(体育教师课程培训活动)和环境(改进的学校体育设备)因素的干预措施，在实现对儿童肥胖相关行为和认知表现的长期影响方面取得了更大的成功，特别是在医疗服务不足的地区/人群(MUA/P)。通过与洛杉矶联合学区加州大学洛杉矶分校护理学院的合作，我们建议评估以中学为基础的环境和课程干预对MUA/P青少年的身体活动和健身行为以及标准化成就测试分数的影响。这项研究还考察了干预的效果是否因性别和种族而异。拟议的环境和课程，协调的学校健康计划将由三个部分组成：(1)星火中学体育教育和营养计划(M-SPAN)，2)体育教师的专业发展(PD)和课程培训，以及3)提供高质量的体育器材。本研究采用整群随机对照试验设计，对洛杉矶联合大学的24所MUA/P中学进行重复干预(项目前、项目中、项目后即刻)，并随机分配干预。M-SPAN是一项以证据为基础的计划，是疾控中心推荐的减少儿童肥胖症的计划。为了增强M-SPAN，斯派克创造了与M-SPAN中的活动相匹配的体育设备。课程干预需要结合Spark Active Recreation课程和洛杉矶联合大学体育标准课程，并将在两个干预年(总共22个月)的每11个月内每月提供一次。项目设计将分两波实施。第一波(每个研究条件有6个点)将从1-3年开始，第二波(每个研究条件有6个点)将从第二年到第四年进行。研究目的将用客观和主观的活动指标进行评估，包括SOPLAY(青年观察计划和休闲活动系统)，通过FitnessGram评估的身体健康，通过身体成分(减少的BMI和皮褶厚度)，有氧健康(一英里跑)，肌肉力量/耐力(卷曲和引体向上)以及标准化成绩测试分数。来自干预学校的一小部分青少年(n=3960)也将通过改进的青少年危险行为调查(YRBSS)、干预前、干预中和干预后立即进行体力活动评估。第一波为第一年、第二年和第三年，第二波为第二年、第三年和第四年。

DESCRIPTION (provided by applicant): Over the past 20 years, obesity rates in U.S. children and youth have skyrocketed. National studies show that disparities exist where racial/ethnic minorities and those from a low-income are at higher risk for being overweight or obese. Design, implementation and dissemination of effective school-based prevention programs are critical to addressing these disparities in the obesity epidemic, however few successful models exist. Interventions that are both informed by community partners using a CBPR approach and are comprehensive, and those that include the integration of individual (physical activity behaviors), social (PE teacher curriculum training activities) and environmental (improved school PE equipment) factors have greater success in achieving long-term effects on children's obesity-related behaviors and cognitive performance, especially among medically underserved areas/populations (MUA/P). Resulting from a partnership with the UCLA School of Nursing, the Los Angeles Unified School District (LAUSD) we propose to assess the impact of a middle-school based environmental and curriculum intervention on physical activity and fitness behaviors and standardized achievement test scores among MUA/P youth. This research also examines whether the effects of the intervention vary by gender and ethnicity. The proposed environment and curriculum, coordinated school health program will consist of three components: (1) the SPARK Middle School Physical Education and Nutrition (M-SPAN) Program, 2) professional development (PD) and curriculum training for PE teachers; and 3) provision of quality PE equipment. This study uses a cluster randomized controlled trial design at 24 MUA/P middle schools in the LAUSD with repeated measures (pre-program, mid-program, immediate post-program) and random assignment to the intervention. M-SPAN is an evidenced-based program and is recommended by the CDC to decrease childhood obesity. In order to enhance M-SPAN, SPARK has created PE equipment to match the activities in M-SPAN. The curriculum intervention entails the combination of SPARK Active Recreation and LAUSD PE Standards curricula and will be delivered once a month over 11 months of each of the two intervention years (total 22 months). The project design will be implemented in two waves. Wave I (with 6 sites from each study condition) will run from Years 1-3 and Wave II (with 6 sites from each study condition); will run from Years 2-4. The study aims will be evaluated with objective and subjective activity measures including SOPLAY (System for Observing Plan and Leisure Activity in Youth), physical fitness via the FitnessGram assessment, measured by body composition (decreased BMI and skinfold thickness), aerobic fitness (one mile run), and muscular strength/endurance (curl-up and pull-up) as well as standardized achievement test scores. A small subsample of youth from intervention schools (n=3,960) will also be assessed for physical activity via a modified Youth Risk Behavior Survey (YRBSS), pre-intervention, mid- intervention and immediate post-intervention. For Wave I years 1, 2, and 3 and for Wave II, years 2, 3 and 4.