Girls on the Move Intervention

描述(由申请人提供)：只有3.4%的中学年龄女孩符合体力活动(PA)建议。随着中学女生从6年级到8年级的进步，中等到剧烈的体力活动(MVPA)每年下降4%，导致体重增加。这一下降在社会经济地位较低的城市少数民族女孩中尤为明显，这支持了增加MVPA对这一群体来说是一个至关重要的公共卫生优先事项。为期17周的“女孩在移动”(GOTM)干预应用了健康促进模式(HPM)和自我决定理论(SDT)，由3个部分组成。在学校时间进行的两个个人层面的活动包括：(1)与学校护士进行15分钟面对面的个性化辅导，以支持每个女孩的MVPA(0周)；(2)基于互联网的互动咨询会议，在此期间，每个女孩都会收到激励性的、个性化的反馈信息(9周)。在两次咨询中，咨询都反映了激励性面试的沟通风格，并根据每个女孩从评估对PA的想法和感受的电脑调查问卷中收集的关键回答而单独定制。组级组件，90分钟。PA俱乐部(提供4天/周)，包括MVPA，并提供一个重要的放学后场所，帮助女孩建立MVPA的行为模式。PA俱乐部的教练领导PA俱乐部(例如，来自社区的合格个人；包括体育课在内的教师；以及运动队教练)。为了弥合课后PA俱乐部和在校时间的咨询之间的差距，学校护士每月两次参加PA俱乐部，与女孩们一起进行MVPA并给予鼓励。这项为期5年的以学校为基础的小组随机试验的目的是在干预后即刻和9个月随访时评估GOTM干预在增加中学女生MVPA分钟数(主要结果)和改善心血管(CV)健康、身体质量指数和体脂百分比(次要结果)方面的效果。认知和情感中介变量包括：PA的感知收益(HPM)、PA的障碍(HPM)、PA的自我效能(HPM)、社会支持(HPM)、享受(HPM)和动机(SDT)，所有这些都与MVPA相关。除了解决所有中介变量外，每个干预成分都包含了SDT提出的促进内在动机以驱动行为的三个基本需求：能力、自主性和关联性。根据这些学校的人口统计数据，预计会出现一个SES低、种族混杂、以非裔美国人为主的样本。8所城市学校将在学年秋季被随机分配到PA干预组(n=4)或对照组(n=4)。2、3和4(总计N=8×3=24所不同的学校)。在这三年中，每所学校每年都将招收62名女孩。比较条件将包括两个90分钟的健康促进研讨会。我们的长期目标是增加MVPA，作为一种手段来解决青春期女孩超重和肥胖的高流行率，从而降低她们患不良心血管健康结局的风险。 与公共健康相关：这一新颖且以理论为导向的“流动女孩”干预措施旨在帮助城市、种族多样化、处境不利的中学女孩实现美国农业部关于中等到剧烈体育活动(MVPA)的建议，这是解决这一群体中高度超重和肥胖流行的关键公共卫生优先事项。以学校为基础的综合干预包括三个部分：1)与学校护士面对面的、个人化的激励性咨询会议；2)基于互联网的互动会议，在此期间，每个女孩都会收到励志的、个人化的反馈信息；以及3)MVPA的课后机会。这项干预措施预计将对心血管健康产生显著影响，有助于缩小健康差距，这是美国心脏协会和疾控中心青少年和学校健康部门的主要优先事项。

DESCRIPTION (provided by applicant): Only 3.4 percent of girls of middle school age meet physical activity (PA) recommendations. As middle school girls progress from 6th- to 8th- grade, moderate to vigorous physical activity (MVPA) declines 4 percent per year, contributing to weight gain. The decline is particularly evident among urban, minority girls of low socioeconomic status (SES), supporting that increasing MVPA is a vital public health priority for this group. The 17-week "Girls on the Move" (GOTM) intervention applies the Health Promotion Model (HPM) and Self- Determination Theory (SDT) and has 3 components. Two individual-level components occurring during school hours include: (1) a 15-minute face-to-face motivational, individually tailored counseling session with a school nurse to support each girl's MVPA (0 wks.), and (2) an interactive Internet-based counseling session during which each girl receives motivational, individually tailored feedback messages (9 wks.). At both sessions, counseling reflects the motivational interviewing communication style and is individually tailored based on each girl's key responses gleaned from computerized questionnaires assessing thoughts and feelings about PA. A group-level component, 90-min. PA Club (offered 4 days/wk.), includes MVPA and provides an important venue after school for assisting girls to establish a behavioral pattern of MVPA. PA Club instructors lead the PA Club (e.g., qualified individuals from community; teachers, including physical education; and sports team coaches). To bridge the gap between the after-school PA Club and the counseling during school hours, the school nurse attends the PA Club two times per month to do MVPAs with the girls and offer encouragement. The aim of the 5-year school-based group randomized trial is to evaluate the efficacy of the GOTM intervention in increasing middle school girls' minutes of MVPA (primary outcome) and improving cardiovascular (CV) fitness, body mass index, and percent body fat (secondary outcomes), immediately post-intervention and at 9- month follow-up. Cognitive and affective mediating variables include: perceived benefits of PA (HPM), barriers to PA (HPM), PA self-efficacy (HPM), social support (HPM), enjoyment (HPM), and motivation (SDT), all of which are related to MVPA. In addition to addressing all mediating variables, each intervention component incorporates three basic needs proposed by SDT for promoting intrinsic motivation to drive behavior: competence, autonomy, and relatedness. Based on demographics of the schools, a low-SES, mixed-race, predominately African American, sample is expected. Eight urban schools will be randomly assigned to the PA intervention (n = 4) or comparison condition (n = 4) in the fall of yrs. 2, 3, and 4 (total N = 8 X 3 = 24 different schools). Sixty-two girls will be recruited in each school during each of the three years. The comparison condition will include two 90-minute health-promoting workshops. Our long-term goal is to increase MVPA as a means to address the high overweight and obesity prevalence among adolescent girls, thus reducing their risk for adverse CV health outcomes. PUBLIC HEALTH RELEVANCE: The novel and theory-driven "Girls on the Move" intervention aims to assist urban, racially diverse, disadvantaged middle school girls in achieving USDHHS recommendations for moderate to vigorous physical activity (MVPA), a vital public health priority for addressing the high overweight and obesity prevalence noted in this group. The comprehensive school-based intervention includes three components; 1) a face-to-face motivational, individually tailored counseling session with a school nurse; 2) an interactive Internet-based session during which each girl receives motivational, individually tailored feedback messages; and 3) an after- school opportunity for MVPA. The intervention is expected to have a notable impact on cardiovascular health that can contribute toward reducing health disparities, a major priority of the American Heart Association and CDC's Division of Adolescent and School Health.