Middle School Physical Activity Intervention for Girls

描述(申请人提供)：在美国，超过150万的中学女生超重或有超重的风险。为期10年的NHLBI生长与健康研究表明，女孩身体质量指数(BMI)和肥胖症的增加与中等到剧烈体育活动(MVPA)的减少有关。女孩的MVPA在中学期间急剧下降。Cochrane Collaboration 2005年对预防儿童肥胖干预措施的审查强调了在增加MVPA的干预措施中同时处理个人行为变化和环境的必要性。本研究的目的是在健康促进模式和社会认知理论的指导下，检验为期6个月的“流动女孩”干预的可行性，并获得初步的有效性证据。这项干预包括激励性的、量身定做的咨询加上课后体育活动(PA)，以增加MVPA和心血管(CV)健康，并改善六年级女孩的身体成分和与MVPA相关的认知和情感反应。具体地说，它包括一个90分钟的课后PA俱乐部，其中包括MVPA和6个每月一对一的每月激励、个别定制的咨询课程，在上学期间与注册(学校)护士一起支持每个女孩持续的MVPA。运用激励性访谈沟通方式，学校护士将根据每个女孩从评估与MVPA相关的认知和情感变量的计算机化问卷中收集的关键回答，单独定制咨询。一所中学将被随机分配接受干预，另一所中学作为注意力控制。到目前为止，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取关于护士咨询的基本证据，作为帮助女孩增加和维持MVPA的一种手段。如果成功，这种干预可以转化为其他项目(例如，糖尿病教育和减肥)。具体目标是：1.评估干预措施的可行性：(1)女孩参与；(2)遵守协议；(3)使用者和提供者(护士和PA俱乐部教练)满意度。2.探索干预组的参与者是否比对照组的参与者在6个月时在MVPA分钟数(通过加速计测量)的主要结果以及MVPA自我报告、CV健身、BMI、体脂百分比和腰围的次要结果方面有改善。3.探索初级结果是否由认知变量(PA的感知收益、PA的感知障碍、PA的自我效能、社会支持、规范、模型)和情感变量(PA的享受)中介。4.探索干预组的参与者是否比对照组的参与者在7个月时有更多的MVPA分钟。公共卫生相关性：我们为中学女生提供的新颖、全面和理论驱动的干预措施包括学校护士提供的激励性、个性化的咨询，以及在她们的学校进行体育活动的机会。这一办法针对2010年健康人的目标，即通过协助女孩实现适中至剧烈体育活动的国家建议，改善青年的健康。

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.