COPE/Healthy Lifestyles for Teens: A School-Based RCT

描述（由申请人提供）： 预防和治疗青少年肥胖和心理健康障碍是美国的两大公共卫生问题。今天在过去的20年里，超重或肥胖的青少年发病率急剧增加，目前约有17.1%的青少年超重或肥胖。此外，美国约有1500万儿童和青少年（25%）有心理健康问题，干扰他们在家中或学校的功能，但只有不到25%的受影响者接受任何治疗。西班牙裔青少年中肥胖和心理健康问题的患病率甚至更高，研究表明这两种情况在许多青少年中往往并存。然而，尽管这两个公共卫生问题的发病率迅速增加，其相关的健康差异和不良的健康结果，一直缺乏基于理论的干预研究，在高中青少年进行，以改善他们的健康生活方式行为以及他们的身心健康结果。不幸的是，身心健康服务在很大程度上仍然是分开的，而不是在国家的医疗保健系统中整合，这往往导致这些重大的青少年健康问题的识别和治疗不足。 因此，拟定的随机对照试验的目的是检验科普的有效性（创造个人赋权的机会）/健康生活方式（思考，感觉，情绪和锻炼）计划，一个由认知行为理论指导的教育和认知行为技能建设干预，对凤凰城800名文化多样的青少年的健康生活方式行为和抑郁症状，亚利桑那州的高中这项研究的具体目标是：（1）使用随机对照试验来测试科普TEEN计划对关键结果的短期和更长期的有效性，包括健康的生活方式行为，抑郁症状和体重指数百分比，（二）检查认知信念和感知困难在引导健康生活方式中的作用，以介导科普对健康生活方式行为和抑郁的影响。症状;（3）探索可能调节干预对健康生活方式行为和抑郁症状影响的变量，包括种族/民族、性别、社会经济地位、文化适应和父母健康生活方式信念和行为。六个先前的试点研究支持这种全面的临床试验的需要，以及在促进健康的生活方式，信念，行为和青少年最佳心理健康的认知行为技能建设的使用。 这项研究与NIH的路线图和改善人们健康，预防疾病和残疾的发生以及促进弱势群体最高健康水平的目标是一致的。 公共卫生相关性： 预防和治疗青少年肥胖和心理健康障碍是当今美国的两大公共卫生问题。为了解决与肥胖和心理健康问题相关的发病率和不良健康结果的增加，一个基于理论的15个会话的干预计划，名为科普，（创造个人赋权的机会）/健康生活方式（思考、感觉、情绪和锻炼），将在高中健康课上提供，以改善800名文化多样性青少年的身心健康成果。（14至16岁）。

DESCRIPTION (provided by applicant): The prevention and treatment of obesity and mental health disorders in adolescence are two major public health problems in the United States (U.S.) today. The incidence of adolescents who are overweight or obese has increased dramatically over the past 20 years, with approximately 17.1 percent of teens now being overweight or obese. Furthermore, approximately 15 million children and adolescents (25 percent) in the U.S. have a mental health problem that is interfering with their functioning at home or at school, but less than 25 percent of those affected receive any treatment for these disorders. The prevalence rates of obesity and mental health problems are even higher in Hispanic teens, with studies suggesting that the two conditions often coexist in many youth. However, despite the rapidly increasing incidence of these two public health problems with their related health disparities and adverse health outcomes, there has been a paucity of theory- based intervention studies conducted with adolescents in high schools to improve their healthy lifestyle behaviors as well as their physical and mental health outcomes. Unfortunately, physical and mental health services continue to be largely separated instead of integrated in the nation's healthcare system, which often leads to inadequate identification and treatment of these significant adolescent health problems. Therefore, the goal of the proposed randomized controlled trial is to test the efficacy of the COPE (Creating Opportunities for Personal Empowerment)/Healthy Lifestyles TEEN (Thinking, Feeling, Emotions & Exercise) Program, an educational and cognitive-behavioral skills building intervention guided by cognitive behavior theory, on the healthy lifestyle behaviors and depressive symptoms of 800 culturally diverse adolescents enrolled in Phoenix, Arizona high schools. The specific aims of the study are to: (1) Use a randomized controlled trial to test the short- and more long-term efficacy of the COPE TEEN Program on key outcomes, including healthy lifestyles behaviors, depressive symptoms and body mass index percentage, (2) Examine the role of cognitive beliefs and perceived difficulty in leading a healthy lifestyle in mediating the effects of COPE on healthy lifestyle behaviors and depressive symptoms; and (3) Explore variables that may moderate the effects of the intervention on healthy lifestyle behaviors and depressive symptoms, including race/ethnicity, gender, SES, acculturation, and parental healthy lifestyle beliefs and behaviors. Six prior pilot studies support the need for this full scale clinical trial and the use of cognitive-behavioral skills building in promoting healthy lifestyles beliefs, behaviors and optimal mental health in teens. This study is consistent with the NIH roadmap and goals of improving people's health and preventing the onset of disease and disability as well as promoting the highest level of health in a vulnerable population. PUBLIC HEALTH RELEVANCE: The prevention and treatment of obesity and mental health disorders in adolescence are two major public health problems in the United States today. To address the increasing incidence and adverse health outcomes associated with both obesity and mental health problems, a theory-based 15 session intervention program entitled COPE (Creating Opportunities for Personal Empowerment)/Healthy Lifestyles TEEN (Thinking, Feeling, Emotions & Exercise), will be delivered within high school health classes in order to improve the physical and mental health outcomes of 800 culturally diverse adolescents (14 to 16 years of age).