Rosenkranz et al. BMC Public Health 2010, 10:81 http://www.biomedcentral.com/1471-2458/10/81 Page 10 of 13 Figure 2 Percent of troop meeting time spent at various intensity levels by condition, based on accelerometer data. meetings. Intervention girls were less sedentary and accumulated greater levels of MVPA than control girls. This is an important result, as it demonstrates the feasi- bility of implementing enjoyable opportunities for MVPA in what otherwise could be rather inactive troop meetings. With regard to public health, more physically active troop meetings could help attending girls to reduce sedentary behavior, and perhaps over time be more likely to achieve health benefits associated with meeting PA guidelines. A major finding of this effectiveness study was that the intervention components were implemented with good fidelity in real-world settings, and resulted in troop leader health promotion behaviors and environmental opportu- nities for PA and healthful eating in the troop meetings. However, our intervention resulted in no measured impact on the behavioral influences of obesity for individual girls or parents in settings beyond the troop meeting Table 6 Individual outcomes at time 1 and time 2 by condition environment. Intervention troop meetings offered ample physically active content and FV snacks, while control condition meetings offered very little PA or healthful eat- ing opportunities. It appears that troop leaders delivered the curriculum, promoted PA, FM, and FV, discouraged SSB and eating with TV, and instituted troop policies in accordance with their training for the study. However, we saw no evidence for the hypothesized changes to BMI z- scores, habitual PA, FM, FV consumption, eating with TV, or SSB consumption. Our study’s statistical power appears to be adequate for the primary outcome, but low for PA and FV. However, in all cases, there were not any identi- fied trends in the data to suggest potential non-significant effects in these variables. The lack of detectable effects beyond the troop envir- onment may mean that the program itself was not effi- cacious outside the meetings, that the troop leaders were ineffective, or that girls failed to attend to the core messages and active learning opportunities, among numerous possibilities. It is also quite possible that our intervention had some effects that were not measured in our study. For example, improved skills, attitudes, beha- vioral intentions, empowerment, self efficacy, proxy effi- cacy, and increased knowledge of health promotion behaviors are possible outcomes that were not assessed in this study. According to a mediating variable frame- work, interventions impact mediating variables, which then act on behaviors and other outcomes [51]. Tests of mediation were beyond the scope of the paper, but further work using mediation analysis could help to answer the question as to why the intervention did not achieve measured outcomes beyond troop meetings. The intervention may have failed to impact potential Individual Outcome Variables Girl’s BMI Girl’s BMI percentile Girl’s BMI z-score Parent BMIa Family meals/weeka (scale 0-21) Girl days/week of 60 min. MVPAb (scale 0-7) Percent of parents meeting MVPA standarda Girl FV servings/dayb (scale 0-8) Parent FV Servings/daya (scale 0-8) Girl eating with TV scaleb (scale 0-4) Parent eating with TV scalea (scale 0-4) Girl days/week SSB consumptionb (scale 0-7) Parent days/week SSB consumptiona (scale 0-7) Time 1 INT Mean (SD) 20.1 (4.4) 65.2 (27.0) 0.57 (0.94) 29.1 (6.4) 11.2 (4.2) 4.2 (1.8) 46.7 5.0 (2.0) 3.9 (1.5) 1.1 (0.7) 1.8 (0.7) 3.1 (2.2) 1.8 (2.2) Time 2 INT Mean (SD) 20.4 (4.5) 64.8 (26.9) 0.55 (0.94) 29.5 (6.9) 10.9 (3.6) 3.9 (1.7) 42.0 4.9 (1.7) 4.4 (1.6) 0.8 (0.7) 1.7 (0.7) 2.3 (2.4) 2.0 (2.6) Time 1 CON Mean (SD) 19.1 (2.9) 64.5 (23.8) 0.38 (0.75) 29.1 (6.7) 11.4 (5.0) 4.5 (1.9) 33.3* 3.7 (1.9)* 3.7 (1.8) 1.1 (0.8) 2.0 (0.8) 2.6 (2.4) 2.7 (2.7) Time 2 CON Mean (SD) 19.2 (3.0) 62.2 (23.2) 0.36 (0.74) 30.0 (7.5) 12.1 (4.7) 3.5 (1.8) 36.4 3.7 (1.8)* 4.4 (1.5) 1.1 (0.7) 2.1 (0.7)* 2.2 (2.4) 2.4 (2.8) Note: Means adjusted for troop clustering, weight status, authoritarian parenting, socioeconomic status and race/ethnicity; INT = intervention; CON = control; BMI = body mass index; MVPA = moderate-to-vigorous physical activity; FV = fruits and vegetables; TV = television; SSB = sugar-sweetened beverages; aFrom Parent Report; bFrom Child Report; *Significant difference by condition within same time point; For all variables, there were no significant differences in change from time 1 to time 2 by condition, p > .05.