Obesity Prevention in African American Schoolchildren

描述(由申请人提供)： 在美国，肥胖是第二大可预防的疾病和死亡原因。低社会经济地位(SES)和少数民族受到的影响不成比例。预防儿童和青少年肥胖是公共卫生的优先事项。学校已被确定为预防肥胖的关键场所；然而，大多数健康教育干预措施对体重只有适度的效果。我们提出了一项随机干预试验(初步研究)，以测试以学校为基础的、在城市低SES非裔美国学生中开展的环境肥胖预防计划的可行性和有效性。学校、学生及其家庭和当地社区将参与促进健康饮食和体育活动(HEPA)，以预防儿童肥胖。六所芝加哥公立学校将被随机分配为干预学校(4所)和对照学校(2所)。焦点小组研究将评估推广HEPA的需要和障碍，并指导干预。干预组将接受一项旨在改善学校物理和社会环境的学校环境丰富计划(SEE)，旨在改善学校的物理和社会环境，目标是餐饮服务、课间休息、体育课(PE)和学校氛围；以及一项社区支持和环境修改(CSEM)计划，涉及当地街角和连锁杂货店，以促进学生及其家庭的健康饮食。将包括5年级和6年级学生的家庭参与，他们将被跟踪两年，以测试改善家庭环境的方法。为了评估干预的有效性，将从学校(如食品服务、课间休息和体育)、学生(如体重、饮食和体力活动)、家长(如家庭食品购买习惯)和社区(如当地商店可供选择的零食)收集多层次的数据。此外，还将收集过程评估数据，以评估目标受众对各种干预内容的可行性和接受度(参与度和满意度)。主要结果变量是学生体重状况的变化；次要结果包括学生饮食行为和身体活动的变化以及目标环境因素的变化。此外，还将确定干预的成本效益。如果干预被证明有效，将开展一项全面的研究。这项研究的发现将为在低收入家庭和少数族裔学生中预防肥胖提供见解。

DESCRIPTION (provided by applicant): Obesity is the second leading preventable cause of disease and death in the United States. Low socioeconomic status (SES) and minorities are disproportionately affected. Obesity prevention among children and adolescents is a public health priority. Schools have been identified as key settings for obesity prevention; however, most health education interventions have had only a moderate effect on body weight. We propose a randomized intervention trial (pilot study) to test the feasibility and effectiveness of a school-based, environmental obesity prevention program in urban Iow-SES African American students. Schools, students and their families, and local communities will be involved to promote healthy eating and physical activity (HEPA) for prevention of childhood obesity. Six Chicago public schools will be randomly assigned as intervention (4 schools) and controls (2 schools). Focus group studies will assess needs and barriers for promotion of HEPA and guide the intervention. The intervention group will receive a School Environment Enrichment (SEE) program to modify the school physical and social environment, targeting food service, recess, physical education (PE) and school climate, and a Community Support & Environment Modification (CSEM) program, involving local corner and chain grocery stores to promote healthy eating among students and their families. Family involvement will be included for 5th and 6th graders, who will be followed for two years, to test ways to modify family environment. To assess the intervention effectiveness, multilevel data will be collected from schools (eg, food service, recess and PE), students (eg, body weight, eating and physical activity), parents (eg, family food purchasing practices) and communities (eg, available choices of snack foods in local stores). In addition, process evaluation data will be collected to assess the feasibility and acceptance (participation and satisfaction) of various intervention components by the target audience. The primary outcome variable is change in students' body weight status; secondary outcomes include changes in students' eating behavior and physical activity and changes in target environmental factors. In addition, cost-effectiveness of the intervention will be determined. If the intervention proves effective, a full-scale study will be developed. Findings from this study will provide insights into the prevention of obesity among Iow-SES and minority students.