Adolescents Committed To Improvement Of Nutrition and Physical Activity (ACTION)

描述（由申请人提供）：肥胖已成为美国儿童和青少年的流行病。这种流行病的一个不幸的后果是最近认识到青少年的代谢综合征，这是一种历史上属于成人的疾病。拟议的R-21研究的主要目的是使用基于社区的预防性研究（CBPR）方法来创建，实施和评估主要针对超重的西班牙裔青少年的文化相关和年龄适当的肥胖干预（ACTION）。干预措施将通过阿尔伯克基公立学校的校本保健中心实施。行动有3个主要组成部分，是与SBHC供应商和学生在准备当前的建议共同确定：每两周与SBHC提供者进行一次临床接触，使用动机增强疗法帮助超重青少年采取更健康的行为（特别是增加水果和蔬菜，减少高脂肪食物，减少高糖饮料，增加体力活动和减少久坐行为），并利用社区咨询理事会制定变革阶段的具体战略，这些战略将通过印刷和DVD媒体提供。将与青少年，家长和学校工作人员进行额外的形成性研究，以探索潜在的社会，制度和政策层面的机制，可以添加到行动，以支持高中生实现更健康的生活方式。将根据社区咨询理事会的建议修改干预内容。为了在一个学期内测试ACTION干预的有效性，将招募准备改变的超重青少年。本研究将采用准实验设计，其中一个SBHC将提供干预条件，另一个SBHC将提供对照条件。学生将在两个SBHC站点进行干预前和干预后测量，以评估与对照条件下的学生相比，干预条件下的青少年是否会改善代谢综合征的风险因素，改善营养和改善体力活动。分析方法将包括每个时间点的横断面分析、每组内的前后比较以及干预组和对照组之间变化的比较。本研究将提供有关潜在的社会、机构和政策层面机制的形成性数据，以支持高中生实现更健康的生活方式，并提供有关已开发干预措施有效性的试点数据，这些数据将用于规划和设计R34/R 01提交的全面干预措施。公共卫生相关性：最近估计，美国12-19岁的超重和肥胖青少年占11%。《2010年健康人》的目标是将超重或肥胖的青少年比例降至5%。拟议的研究，行动，将大大有助于解决这一关键的公共卫生问题的儿童肥胖症通过创新机制，利用学校为基础的健康中心。

DESCRIPTION (provided by applicant): Obesity has become epidemic in U.S. children and adolescents. An unfortunate consequence of this epidemic is the recent recognition of the metabolic syndrome in adolescents, a condition that was historically an adult entity. The main purpose of the proposed R-21 study is to use Community Based Participatory Research (CBPR) methodology to create, implement and evaluate a culturally relevant and age-appropriate obesity intervention (ACTION) for primarily Hispanic adolescents who are overweight. The intervention will be implemented through Albuquerque Public Schools' School-Based Health Centers (SBHCs). ACTION has 3 primary components that were jointly determined with SBHC providers and students in preparing the current proposal: biweekly clinical encounters with SBHC providers, use of Motivational Enhancement Therapy to help overweight adolescents adopt healthier behaviors (specifically increase fruits and vegetable, decrease high fat foods, decrease high sugar beverages, increase physical activity and decrease sedentary behavior), and use of a community advisory council to develop strategies specific to the Stages of Change which will be delivered by print and DVD media. Additional formative research with teens, parents, and school staff will be conducted to explore the potential social, institutional and policy level mechanisms that can be added to ACTION to support high school students in achieving a healthier lifestyle. Intervention components will be modified as suggested by the community advisory council. To test efficacy of the ACTION intervention in one semester, overweight adolescents who are ready to change will be recruited. The study will employ a quasi-experimental design in which one SBHC will deliver the intervention condition and another SBHC will deliver the control condition. Students will have pre- and post- intervention measurements at both SBHC sites to assess if adolescents in the intervention condition will have improved risk factor profile for metabolic syndrome, improved nutrition and improved physical activity when compared with students in the control condition. Analytical approaches will include both cross-sectional analyses at each point in time, pre-post comparisons within each group and comparison of change between the intervention and control groups. This study will provide formative data on potential social, institutional and policy level mechanisms to support high school students in achieving a healthier lifestyle and pilot data on the efficacy of the developed intervention which will be used to plan and design a full-scale intervention for an R34/R01 submission. PUBLIC HEALTH RELEVANCE: Recent estimate of overweight and obese adolescents, ages 12-19 years, in the U.S. is 11%. Healthy People 2010 has set an objective to reduce the proportion of adolescents who are overweight or obese to 5%. The proposed study, ACTION, will contribute greatly to addressing this critical public health problem of childhood obesity through the innovative mechanism of using School-Based Health Centers.