Rosenkranz et al. BMC Public Health 2010, 10:81 http://www.biomedcentral.com/1471-2458/10/81 modules were designed to require 60-90 minutes to deli- ver, with flexibility allowed for specified program activ- ities and module order. Troop leaders underwent two hours of training by the first author prior to interven- tion commencement. Regular and ongoing email and phone support took place throughout the intervention time period. Target behaviors of the intervention included: 1) Fre- quent FM; 2) Parent-child shared PA; 3) Elimination of TV during mealtime; 4) Drinking water instead of SSB at mealtime; 5) Including FV in FM; 6) Practicing good manners during FM; 7) Helping parents prepare FM and cleaning up afterwards. Troop meeting policies included: 1) Providing 15 min- utes per meeting for physically active recreation; 2) Troop leaders participating in physically active recrea- tion with girls; 3) Provision of a FV snack prepared by girls; 4) Troop leaders eating FV snack with girls; 5) Troop leaders verbally promoting PA, FV consumption in troop meetings and for home, and verbally promoting FM for home; and 6) Prohibition of SSB, candy, and TV watching during meetings. Process Measures Evaluation Procedures Over the course of the intervention period (October 2007 to April 2008) on seven occasions, a research assis- tant attended Girl Scout troop meetings. From the beginning to end of each meeting, the research assistant continuously directly observed aspects of the troop environment and activities, recording observations in a customized logbook. Curriculum implementation was evaluated via obser- ver reports (observation forms, described below) and troop leader self-evaluation forms. Troop leaders self- rated the degree of implementation for eight compo- nents of each troop meeting. Leaders responded on a three-point scale (zero to two), indicating no, partial, or full implementation for each curricular component. Troop Environmental Observations For each meeting, a trained research assistant recorded details of meeting context on a customized SNAP Ses- sion Form. This session form was patterned off SOPLAY, with observers noting the condition of the physical area for each session [40]. Session was defined as a period of time that the majority of girls were engaged in one activity. Transition to a new session began when 51% or more of the girls moved to a new activity. During snack, the research assistant completed a customized SNAP Snack Observation Form, noting all foods and drinks accessible to girls and troop leaders, including the number of girls and adults actually con- suming each food product. If food or drink was accessi- ble and consumed at periods outside the snack session, Page 5 of 13 details were also noted on this snack form. Throughout the troop meeting, the research assistant used a custo- mized SNAP Troop Observation Form to record the general structure, general content, knowledge content, and leader behavior relevant to promotion of PA and healthful eating. The research assistant used a portable timing device with vibrating alert to determine presence or absence of each condition and behavior every 60 sec- onds, for the duration of the troop meeting. The beha- vioral and environmental observation system and form were developed according to recommended guidelines for behavioral observation and patterned off SOFIT methodology [41,42]. Two research assistants were care- fully trained to use all forms and observation techni- ques, and adequate inter-rater reliability (>90% agreement) was obtained prior to actual data collection. Reliability estimates Table 2 displays our study’s reliability checks, where most variables achieved adequate reliability. The three PA promotion behaviors and three healthful eating pro- motion behaviors were later collapsed into “any physical activity promotion” and “any healthful eating promo- tion”, which improved reliability substantially (percent agreement > 90). Individual-Level Outcome Measures Evaluation Procedures For the time 1 (early October 2007) and time 2 (April 2008) assessments, a research assistant travelled to troop meetings where girls were assessed on height, weight, self-reported psychosocial influences, and health behaviors. Girls’ height and weight assessments were carried out in semi-private settings without shoes or heavy clothing. Height was measured to the nearest millimeter, using a portable stadiometer (Seca Corp, Model #214 Road Rod, Hanover, MD). Weight was measured to the nearest 0.1 kg with high-precision electronic scales (Seca Corp, Model #770, Hanover, MD). For reliability, duplicate height and weight mea- surements were taken, and third measurements were taken if the first two differed by more than 5 mm or 0.5 kg. Girls completed identical questionnaires at times 1 and 2, administered according to a standar- dized script read by the first author. Parents completed a questionnaire outside of troop meeting times, before and after the intervention period. Anthropometry Body mass index (BMI) was calculated by dividing body weight (kg) by height (m) squared. BMI scores were converted to percentiles and z-scores (our primary out- come variable) using the age- and sex-specific LMS parameters from the CDC growth charts [43]. Partici- pants were classified as overweight or obese, respec- tively, if their BMI equalled or exceeded the age- and