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

描述（由申请人提供）：在过去的20年里，美国儿童和青少年的肥胖率飙升。全国性研究表明，在少数种族/族裔和低收入人群超重或肥胖风险较高的地方存在差异。有效的学校预防计划的设计、实施和传播对于解决肥胖流行中的这些差异至关重要，但成功的模式很少。由社区合作伙伴使用CBPR方法提供信息的综合干预措施，以及包括个人融入的干预措施。（体力活动行为），社会（体育教师课程培训活动）和环境（改善学校体育设备）因素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）。由于与加州大学洛杉矶分校护理学院，洛杉矶联合学区（LAUSD）的合作伙伴关系，我们建议评估的影响，以中学为基础的环境和课程干预的身体活动和健身行为和标准化的成绩测试成绩之间的MUA/P青年。这项研究还审查了干预措施的效果是否因性别和种族而异。拟议的环境和课程，协调学校健康计划将包括三个组成部分：（1）SPARK中学体育和营养（M-SPAN）计划，2）体育教师的专业发展（PD）和课程培训; 3）提供优质体育设备。本研究采用整群随机对照试验设计，在LAUSD的24所MUA/P中学进行重复测量（计划前，计划中，计划后立即）并随机分配干预措施。M-SPAN是一项循证计划，由CDC推荐，以减少儿童肥胖。为了加强M-SPAN，SPARK创造了PE设备来匹配M-SPAN中的活动。课程干预需要结合SPARK主动娱乐和LAUSD体育标准课程，并将在两个干预年（共22个月）的11个月内每月提供一次。项目设计将分两波实施。第一波（每种研究条件6个研究中心）将从第1 - 3年开始运行，第二波（每种研究条件6个研究中心）将从第2 - 4年开始运行。将使用客观和主观活动指标评价研究目的，包括SOP10（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（BMI和皮褶厚度降低）测量）、有氧健身（1英里跑）和肌肉力量/耐力（卷曲和引体向上）以及标准化成绩测试分数。还将通过改良的青年危险行为调查（YRBSS），在干预前、干预中期和干预后立即对干预学校的一小部分青年（n = 3，960）进行身体活动评估。对于第一波，第1年、第2年和第3年;对于第二波，第2年、第3年和第4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.