Girls on the Move Intervention

描述（由申请人提供）：只有3.4%的中学适龄女孩符合体育活动（PA）的建议。随着中学女生从六年级到八年级的进步，中等到剧烈的体育活动（MVPA）每年下降4%，导致体重增加。这种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，这表明增加最低生活津贴是这一群体的一项重要公共卫生优先事项。为期17周的“运动中的女孩”（GOTM）干预采用健康促进模型（HPM）和自我决定理论（SDT），有3个组成部分。两个个人层面的组成部分包括：(1)与学校护士进行15分钟面对面的激励性个性化定制咨询会议，以支持每个女孩的MVPA（0周）；(2)基于互联网的交互式咨询会议，在此期间每个女孩都会收到激励性的个性化定制反馈信息（9周）。在这两个课程中，咨询反映了动机性访谈的沟通风格，并根据每个女孩从电脑调查问卷中收集的关键回答进行个性化定制，评估她们对PA的想法和感受。一个小组级别的部分，90分钟。PA俱乐部（每周四天），包括MVPA，是帮助女生建立MVPA行为模式的重要场所。PA Club的指导员领导PA Club（例如，来自社区的合格个人；教师，包括体育教师；和运动队教练）。为了弥补课后辅导和上课辅导之间的差距，学校护士每月两次参加辅导俱乐部，与女孩们一起做MVPAs，并给予鼓励。这项为期5年的以学校为基础的随机分组试验的目的是评估GOTM干预在增加中学女生MVPA分钟（主要结局）和改善心血管（CV）健康、体重指数和体脂率（次要结局）方面的疗效，这些干预在干预后立即和9个月的随访中进行。认知和情感的中介变量包括：个人行为的感知利益（HPM）、个人行为的障碍（HPM）、个人行为的自我效能（HPM）、社会支持（HPM）、享受（HPM）和动机（SDT），这些变量都与MVPA有关。除了解决所有中介变量之外，每个干预组件都包含SDT提出的三个基本需求，以促进驱动行为的内在动机：能力、自主性和相关性。根据这些学校的人口统计数据，预计将有一个低社会经济地位、混血儿、主要是非裔美国人的样本。8所城市学校将在秋季被随机分配到PA干预组（n = 4）或比较组（n = 4）。2、3、4（总N = 8 × 3 = 24所不同的学校）。在三年的每一年里，每所学校将招收62名女生。比较条件将包括两个90分钟的健康促进讲习班。我们的长期目标是增加MVPA作为解决青春期女孩高超重和肥胖患病率的一种手段，从而降低她们不良心血管健康结局的风险。

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.