Middle School Physical Activity Intervention for Girls

描述（由申请人提供）：美国有超过150万的中学女生超重或有超重的危险。这项为期10年的NHLBI生长与健康研究表明，女孩身体质量指数（BMI）和肥胖的增加与中度至剧烈体育活动（MVPA）的减少有关。女生的MVPA在中学时期急剧下降。2005年Cochrane Collaboration对预防儿童肥胖的干预措施的回顾强调了在干预措施中同时处理个体行为改变和环境的必要性，以增加MVPA。本研究的目的是检验在健康促进模式和社会认知理论指导下进行为期6个月的“运动中的女孩”干预的可行性，并获得初步的有效性证据。干预包括动机性、个体化辅导和课后体育活动（PA），以提高六年级女生的MVPA和心血管（CV）健康，并改善与MVPA相关的身体成分和认知以及情感反应。具体来说，它包括一个90分钟的课后PA俱乐部，包括MVPA和6个一对一的月度激励，在上学期间由注册（学校）护士为每个女孩提供量身定制的咨询课程，以支持每个女孩持续的MVPA。采用动机性访谈沟通方式，学校护士将根据每个女孩从计算机调查问卷中收集的关键回答，评估与MVPA相关的认知和情感变量，为每个女孩量身定制咨询。一所中学将被随机分配接受干预，另一所作为注意力控制。迄今为止，学校护士对以学校为基础的PA干预的参与有限。我们的研究提供了一种创新的方法来获得关于护士咨询作为帮助女孩增加和维持MVPA的手段的必要证据。如果成功，这种干预可以转化为其他项目（如糖尿病教育和减肥）。具体目标是：1.；评估与(1)女孩参与有关的干预措施的可行性；(2)遵守协议；(3)使用者和提供者（护士和PA俱乐部指导员）满意度。2. 探讨干预组的参与者，与对照组相比，是否在MVPA分钟（由加速度计测量）的主要结局，以及6个月时MVPA自我报告、CV健康、BMI、体脂百分比和腰围的次要结局方面表现出改善。3. 探索主要结果是否受认知变量（自我护理的感知利益、自我护理的感知障碍、自我护理自我效能、社会支持、规范、模式）和情感变量（自我护理的享受）的调节。4. 探讨干预组的参与者在7个月时是否比对照组的参与者有更长的MVPA分钟。公共卫生相关性：我们针对中学女生的新颖、全面和理论驱动的干预措施包括由学校护士提供的动机性、量身定制的咨询，以及在学校进行体育活动的机会。这一方法通过协助女孩实现关于中度至剧烈体育活动的国家建议，实现了2010年健康人口目标，即改善青年健康。

DESCRIPTION (provided by applicant): Over 1.5 million middle school girls in the U.S. are overweight or at risk for becoming overweight. The 10-year NHLBI Growth and Health Study showed that increases in girls' body mass index (BMI) and adiposity were related to a decrease in moderate to vigorous physical activity (MVPA). A sharp decline in girls' MVPA occurs during middle school. The Cochrane Collaboration 2005 review of interventions for preventing obesity in children underscored the need to simultaneously address individual behavior change and the environment in interventions to increase MVPA. The purpose of this study is to test the feasibility of and obtain preliminary evidence of efficacy for a 6-month "Girls on the Move" intervention (guided by the Health Promotion Model and Social Cognitive Theory). The intervention involves motivational, individually tailored counseling plus after- school physical activity (PA) to increase MVPA and cardiovascular (CV) fitness, as well as improve body composition and cognition and affective responses related to MVPA among 6th-grade girls. Specifically, it consists of a 90-minute after-school PA Club that includes MVPA and 6 one-on-one monthly motivational, individually tailored counseling sessions with a registered (school) nurse during the school day to support each girl's continued MVPA. Applying the motivational interviewing communication style, the school nurse will individually tailor the counseling based upon each girl's key responses gleaned from computerized questionnaires assessing cognitive and affective variables related to MVPA. One middle school will be randomly assigned to receive the intervention and another to serve as attention control. School nurses have had limited involvement in school-based PA interventions to date. Our study offers an innovative approach for acquiring essential evidence regarding nurse counseling as a means for assisting girls to increase and maintain MVPA. If successful, this intervention can be translated to other programs (e.g., diabetic education and weight reduction). Specific aims are: 1. Evaluate the feasibility of the intervention related to (1) girls' participation; (2) adherence to protocols; and (3) user and provider (nurse and PA Club instructors) satisfaction. 2. Explore if participants in the intervention group, compared to those in the control group, show improvement in the primary outcome of minutes of MVPA (measured by accelerometer), and also secondary outcomes of self-report of MVPA, CV fitness, BMI, percent body fat, and waist circumference at 6 months. 3. Explore if the primary outcome is mediated by cognitive (perceived benefits of PA, perceived barriers to PA, PA self-efficacy, social support, norms, models) and affective (enjoyment of PA) variables. 4. Explore if participants in the intervention group, compared to those in the control group, have greater minutes of MVPA at 7 months. PUBLIC HEALTH RELEVANCE: Our novel, comprehensive, and theory-driven intervention for middle school girls includes motivational, individually tailored counseling from a school nurse and an opportunity for physical activity at their school. This approach addresses Healthy People 2010 objectives to improve the health of youth by assisting girls to achieve national recommendations for moderate to vigorous physical activity.