A psychosocial approach to smoking prevention for urban black youth. Motivational Interviewing as an intervention to increase adolescent self-efficacy and promote weight loss: Methodology and design A prospective study of parentally bereaved youth, caregiver depression, and body mass index. Influence of physical training on plasma leptin in obese youths. Psychological and behavioral risk factors for obesity onset in adolescent girls: a prospective study. Overweight and obesity prevention for adolescents: a cluster randomized controlled trial in a school setting. School-based health center-based treatment for obese adolescents: feasibility and body mass index effects. Overweight and Obesity as Predictors of Absenteeism in the Working Population of the Netherlands Physical fitness and physical activity in obese and nonobese Flemish youth. Improvements in fitness reduce the risk of becoming overweight across puberty. Evaluation of the Living 4 Life project: a youth-led, school-based obesity prevention study. The Nutrition and Enjoyable Activity for Teen Girls (NEAT girls) randomized controlled trial for adolescent girls from disadvantaged secondary schools: rationale, study protocol, and baseline results Rationale and study protocol for the 'active teen leaders avoiding screen-time' (ATLAS) group randomized controlled trial: an obesity prevention intervention for adolescent boys from schools in low-income communities. Challenge! Health Promotion/Obesity Prevention Mentorship Model Among Urban, Black Adolescents Go!: results from a quasi-experimental obesity prevention trial with hospital employees HOME Plus: Program design and implementation of a family-focused, community-based intervention to promote the frequency and healthfulness of family meals, reduce children’s sedentary behavior, and prevent obesity Trial of prevention and reduction of obesity through active living in clinical settings: a randomized controlled trial. Early Childhood Obesity Prevention in Low-Income, Urban Communities Mobile technology for obesity prevention: a randomized pilot study in racial- and ethnic-minority girls. Efficacy trial of a selective prevention program targeting both eating disorders and obesity among female college students: 1- and 2-year follow-up effects. Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Promoting healthful family meals to prevent obesity: HOME Plus, a randomized controlled trial Enhancing self-regulation as a strategy for obesity prevention in Head Start preschoolers: the growing healthy study
Despite the high rates of smoking-related cancers among black Americans , little is known about the type of smoking prevention program that might be effective with black youth . The current study pilot-tested a promising smoking prevention approach to determine its feasibility , acceptability , and effectiveness .  A total of 608 students in nine predominantly black urban junior high schools were stratified by community and r and omly assigned to treatment and control conditions . Students in the treatment condition participated in a 12-session smoking prevention program which taught resistance skills and general life skills . Process data indicated that this prevention approach was feasible and acceptable to students , teachers , and administrators . Outcome data indicated that this program reduced the proportion of children who smoked in the past month by 56 percent , and it increased knowledge of the adverse consequences of smoking and normative expectations concerning adult and peer smoking . These results are discussed in terms of their implication s for prevention and modifications which might further strengthen the efficacy of this approach for urban black adolescents Background Childhood obesity is associated with serious physiological and psychological consequences including type 2 diabetes , higher rates of depression and low self-esteem . With the population of overweight and obese youth increasing , appropriate interventions are needed that speak to the issue of readiness to change and motivation to maintain adherence to healthy behavior changes . Motivational Interviewing ( MI ) is a method of therapy found to resolve ambivalence , enhance intrinsic motivation and promote confidence in a person 's ability to make behavior changes . While MI has shown promise in the adult obesity literature as effecting positive lifestyle change , little is known about the effectiveness of MI with overweight and obese youth . This study aims to : 1 ) demonstrate that MI is an effective intervention for increasing a person 's self-efficacy ; 2 ) demonstrate that exposure to MI will facilitate healthy behavior changes ; 3 ) explore psychological changes related to participation in MI and 4 ) compare physiological and anthropometric outcomes before and after intervention . Methods / Design The current investigation is a prospect i ve study conducted with ongoing participants who regularly attend an outpatient pediatric care center for weight-loss . Overweight youth ( BMI > 85th % ile ) between the ages of 10 and 18 who meet eligibility criteria will be recruited . Participants will be r and omly assigned to a control group ( social skills training ) or a treatment group ( MI ) . Participants will meet with the therapist for approximately 30 minutes prior to seeing the dietician , over the course of 6 months . Participants will also undergo a full day assessment at the beginning and end of psychology intervention to evaluate body fat , and metabolic risk ( screening for diabetes , high cholesterol , high blood pressure and fitness level ) . The paper and pencil portions of the assessment s as well as the clinical testing will occur at baseline and at the conclusion of the intervention ( 6 months ) with a repeat assessment 6 months following the completion of the intervention . Discussion Results from this study are expected to enhance our underst and ing of the efficacy of  MI with children and adolescents who are overweight or obese . Trial registration Current Controlled Trials # NCT00326404 OBJECTIVE To examine the relationship between body mass index ( BMI ) in bereaved youth and nonbereaved controls 5 years after a parent 's death . The study was conducted from August 9 , 2002 , through December 31 , 2013 . DESIGN A prospect i ve , longitudinal , controlled study of the effects of sudden parental death on youth . SETTING Bereaved families were recruited through coroner records and by advertisement .  Nonbereaved families were recruited using r and om-digit dialing and by advertisement . PARTICIPANTS 123 parentally bereaved offspring were compared with 122 nonbereaved control offspring , all of whom were aged 11 - 25 years at the 5-year assessment . MAIN EXPOSURE Bereavement status , type of parental death ( accident , suicide , or sudden natural death ) , and history of depression in caregivers prior to parental death . OUTCOME MEASURES BMI categories ( normal , overweight , and obese ) , according to International Obesity Task Force guidelines for adults and Centers for Disease Control and Prevention guidelines for children , and DSM-IV psychiatric disorder in offspring and caregivers before and after time of parental death . RESULTS Bereaved offspring were more likely to have a BMI in the obese range compared to nonbereaved controls ( χ2(2 ) = 7.13 , P < .01 ) . There were no differences in BMI category by death type among bereaved offspring . Caregiver history of depression was a significant correlate of offspring obesity in nonbereaved youth but had a protective effect on the BMI of bereaved youth . CONCLUSIONS Bereaved youth were more likely to be obese than nonbereaved youth 5 years after parental death , and caregiver history of depression was associated with increased risk for obesity in nonbereaved youth only . Future studies are necessary to identify mechanisms that increase risk for obesity in parentally bereaved youth Little is known about the effects of different intensities of physical training on plasma leptin . This study examined the effect of two intensities of physical training on leptin in obese teenagers , and explored correlates at baseline and in response to 8 months of physical training . The participants were 55 obese youths 12 - 16 years of age who completed both baseline and posttesting . The youths were r and omized to engage in lifestyle education only ( LSE ) , moderate-intensity physical training and LSE , or high-intensity physical training and LSE .  Baseline leptin was positively associated with fat mass . Girls had higher leptin levels at lower levels of fasting insulin than boys . The 8-mo physical training doses prescribed to obese teenagers did not result in significant group differences in mean change in leptin , although there was large variability in individual response . The change in leptin was inversely associated with baseline leptin and change in cardiovascular fitness . Diet , physical activity level , visceral adiposity , and glucose concentrations were not associated with leptin , neither at baseline nor in response to physical training . At baseline , total fat mass rather than visceral adiposity was associated with higher leptin levels . Over the 8-mo intervention period , regardless of group membership , youths who had the lowest increase in cardiovascular fitness tended to have the highest increase in leptin Because little is known about risk factors for obesity , the authors tested whether certain psychological and behavioral variables predicted future onset of obesity . The authors used data from a prospect i ve study of 496 adolescent girls who completed a baseline assessment at age 11 - 15 years and 4 annual follow-ups .  Self-reported dietary restraint , radical weight-control behaviors , depressive symptoms , and perceived parental obesity -- but not high-fat food consumption , binge eating , or exercise frequency-predicted obesity onset . Results provide support for certain etiologic theories of obesity , including the affect regulation model . The fact that self-reported , weight-control behaviors  identified girls at risk for obesity implies that high-risk youths are not engaging in effective weight-control methods and suggests the need to promote more effective strategies BACKGROUND Given the increasing prevalence of obesity among youth over the past decade , prevention has become an international public health priority . PURPOSE To evaluate the 2-year effectiveness of three strategies aim ed at preventing overweight and obesity among adolescents in a high school setting . DESIGN PRomotion de l'ALIMentation et de l'Activité Physique ( PRALIMAP ) is a school-based RCT . Each study high school was assigned to receive or not , over a 2-year period ( Grade s 10 and 11 ) , each of three prevention strategies according to a 2 × 2 × 2 factorial school r and omization . Data were collected in 2006 - 2009 and analyzed in 2009 - 2011 . SETTING / PARTICIPANTS A total of 3538 adolescents ( aged 15.6±0.7 years at baseline ) in 24 public high schools in Lorraine ( northeastern France ) completed the PRALIMAP trial . INTERVENTIONS The prevention strategies were education ( development of nutritional knowledge and skills ) ; environment ( creation of a favorable environment by improving availability of " healthy " dietary items and physical activity ) ; and screening and care ( detection of overweight/obesity and , if necessary , adapted care management ) . MAIN OUTCOMES MEASURES The main outcome of interest was BMI ; BMI z-score and prevalence of overweight/obesity were considered as secondary outcomes . RESULTS Adolescents who completed the PRALIMAP trial were younger , less often suspected of having eating  disorders and depression , and came from a higher socioeconomic class than those who did not . The 2-year change of outcomes was more favorable in the 12 screening and care high schools compared to the no-screening ones : a 0.11 lower increase in BMI ( p=0.0303 ) ; a 0.04 greater decrease in BMI z-score ( p=0.0173 ) ; and a 1.71 % greater decrease in overweight/obesity prevalence ( p=0.0386 ) . Education and environment strategies were not more effective than no strategy intervention . CONCLUSIONS Although the screening and care strategy is an effective way to prevent , at 2 years , overweight and obesity among adolescents in a high school setting , its effects over and above no strategy intervention were small . TRIAL REGISTRATION This study is registered at www . clinical trials.govNCT00814554 BACKGROUND School-based health centers ( SBHCs ) may be an ideal setting to address obesity in adolescents because they provide increased access to a traditionally difficult-to-reach population . The study evaluated the feasibility of adding a health educator ( HE ) to SBHC teams to provide support and increase the delivery of preventive services for overweight or obese adolescents . METHODS Adolescents with BMI ≥85 % recruited from two SBHCs were r and omized to a control group ( CG ) or an  intervention group ( IG ) . Both groups received preventive services , including physical examinations and laboratory screening in the SBHC . The educator met with the IG during the academic year , utilizing motivational interviewing techniques to set lifestyle goals . Text messaging was used to reinforce goals between visits . RESULTS Eighty-two students ( 15.7±1.5 years of age ; BMI , 31.9±6.2 kg/m(2 ) ) were enrolled in the IG and 83 in the control group ( 16.0±1.5 years of age ; BMI , 31.6±6.5 kg/m(2 ) ) . Retention was 94 % in the IG and 87 % in the CG . A total of 54.5 % of the IG and 72.2 % of the CG decreased or maintained BMI z-score ( less than 0.05 increase ; p=0.025 ) . Sports participation was higher in the CG ( 47 % vs. 28 % in the IG ; p=0.02 ) . Mean BMI z-score change was -0.05±0.2 for students participating in sports vs. 0.01±0.2 for those not ( p=0.09 ) . CONCLUSIONS This SBHC intervention showed successful recruitment and retention of participants and delivery of preventive services in both groups . Meeting with an HE did not improve BMI outcomes in the IG . Confounding factors , including sports participation and SBHC utilization , likely contributed to BMI outcomes Objective : To determine the relation between body mass index ( BMI ) and  absenteeism . Methods : Data were collected in a prospect i ve cohort study ( n = 1284 ) . Multilevel analyses ( linear mixed model with r and om intercept ) with two levels ( employee and company ) were used to test whether BMI was related to duration and frequency of absenteeism and whether this relation was influenced by sports participation . Results : Obese employees were absent 14 days a year more than normal-weight employees . Also the frequency of absenteeism of more than 7 days was significantly higher . The differences in absenteeism between obese and normal-weight employees were larger for employees who did not practice sport regularly . Conclusions : Obese employees are more often absent and are absent longer , especially when they do not practice sport regularly . An active company policy to prevent obesity is needed , both from a health and a business efficiency perspective OBJECTIVE To assess different aspects of physical fitness and physical activity in obese and nonobese Flemish youth . RESEARCH METHODS AND PROCEDURES A r and om sample of 3214 Flemish schoolchildren was selected and divided into an " obese " and " nonobese " group based on body mass index and sum of skinfolds . Physical fitness was assessed by the European physical fitness test battery . Physical activity  was estimated by a modified version of the Baecke Question naire . RESULTS Obese subjects had inferior performances on all tests requiring propulsion or lifting of the body mass ( st and ing-broad jump , sit-ups , bent-arm hang , speed shuttle run , and endurance shuttle run ) compared with their nonobese counterparts ( p < 0.001 ) . In contrast , the obese subjects showed greater strength on h and grip ( p < 0.001 ) . Both groups had similar levels of leisure-time physical activity ; however , nonobese boys had a higher sport index than their obese counterparts ( p < 0.05 ) . DISCUSSION Results of this study show that obese subjects had poorer performances on weight-bearing tasks , but did not have lower scores on all fitness components . To encourage adherence to physical activity in obese youth , it is important that activities are tailored to their capabilities . Results suggest that weight-bearing activities should be limited at the start of an intervention with obese participants and alternative activities that rely more on static strength used PURPOSE Information about factors related to overweight development in early stages of life is needed for design ing useful strategies to prevent overweight and related diseases . Longitudinal studies can contribute to this goal . The present study aim ed to identify factors in childhood that determine the development of overweight/obesity in adolescence . METHODS A prospect i ve study in 598 normal-weight Estonian and Swedish children age 9.5 ± 0.4 yr from the European Youth Heart Study , who were followed during 6 yr , was conducted . Weight and height were measured at baseline and follow-up , and weight status was ascertained according to the international criteria for body mass index . Cardiorespiratory fitness  ( expressed as  VO(2max ) ( mL·kg(-1)·min(-1 ) ) ) was assessed by a maximal bike test . Parents reported their weight , height , and educational level . RESULTS Being male ( vs female ) and Estonian ( vs Swedish ) was related to higher risk for incident overweight/obesity . Change in fitness was a stronger predictor of incident overweight/obesity than childhood fitness , parental overweight , or parental education . The risk of developing overweight/obesity was reduced 10 % every 1 mL·kg(-1)·min(-1 ) of VO(2max ) increase ( odds ratio = 0.90 and 95 % confidence interval = 0.84 - 0.95 ) after adjustment for a set of confounders including baseline body mass index and without differences by gender . CONCLUSIONS Our results suggest that improvements in fitness from childhood to adolescence are associated with a lower risk of becoming overweight/obese in adolescence . The current findings highlight the importance of promoting fitness through physical exercise from early stages in life , as a promising strategy to fight against overweight and obesity . Gender and country differences observed in this study require social and political attention The Living 4 Life study was a  youth-led  ,  school-based intervention  to reduce obesity in New Zeal and . The study design was quasi-experimental , with comparisons made by two cross-sectional sample s within schools . Student data were collected at baseline ( n=1634 ) and at the end of the 3-year intervention ( n=1612 ) . A r and om-effects mixed model was used to test for changes in primary outcomes ( e.g. anthropometry and obesity-related behaviours ) between intervention and comparison schools . There were no significant differences in changes in anthropometry or behaviours between intervention and comparison schools . The prevalence of obesity in intervention schools was 32 % at baseline and 35 % at follow-up and in comparison schools was 29 % and 30 % , respectively . Within-school improvements in obesity-related behaviours were observed in three intervention schools and one comparison school . One intervention school observed several negative changes in student behaviours . In conclusion , there were no significant improvements to anthropometry ; this may reflect the intervention 's lack of intensity , insufficient duration , or that by adolescence changes in anthropometry and related behaviours are difficult to achieve . School-based obesity prevention interventions that actively involve young people in the design of interventions may result in improvements in student behaviours , but require active support from leaders within their schools Background Child and adolescent obesity predisposes individuals to an increased risk of morbidity and mortality from a range of lifestyle diseases . Although there is some evidence to suggest that rates of pediatric obesity have leveled off in recent years , this has not been the case among youth from low socioeconomic background s. The purpose of this paper is to report the rationale , study design and baseline findings of a school-based obesity prevention program for low-active adolescent girls from disadvantaged secondary schools . Methods / Design The Nutrition and Enjoyable Activity for Teen Girls ( NEAT Girls ) intervention will be evaluated using a group r and omized controlled trial . NEAT Girls is a 12-month multi-component school-based intervention developed in reference to Social Cognitive Theory and includes enhanced school sport sessions , interactive seminars , nutrition workshops , lunch-time physical activity ( PA ) sessions , PA and nutrition h and books , parent newsletters , pedometers for self-monitoring and text messaging for social support . The following variables were assessed at baseline and will be completed again at 12- and 24-months : adiposity , objective ly measured PA , muscular fitness , time spent in sedentary behaviors , dietary intake , PA and nutrition social-cognitive mediators , physical self-perception and global self-esteem . Statistical analyses will follow intention-to-treat principles and hypothesized mediators of PA and nutrition behavior change will be explored . Discussion NEAT Girls is an innovative intervention targeting low-active girls using evidence -based behavior change strategies and nutrition and PA messages and has the potential to prevent unhealthy weight gain and reduce the decline in physical activity and poor dietary habits associated with low socio-economic status . Few studies have reported the long-term effects of school-based obesity prevention programs and the current study has the potential to make an important contribution to the field . Trial registration Australian New Zeal and Clinical Trials Registry No : INTRODUCTION The negative consequences of unhealthy weight gain and the high likelihood of pediatric obesity tracking into adulthood highlight the importance of targeting youth who are ' at risk ' of obesity . The aim of this paper is to report the rationale and study protocol for the ' Active Teen Leaders Avoiding Screen-time ' ( ATLAS ) obesity prevention intervention  for adolescent boys living in low-income communities . METHODS / DESIGN The ATLAS intervention will be evaluated using a cluster r and omized controlled trial in 14 secondary schools in the state of New South Wales ( NSW ) , Australia ( 2012 to 2014 ) .  ATLAS is an 8-month multi-component , school-based program informed by self-determination theory and social cognitive theory . The intervention consists of teacher professional development , enhanced school-sport sessions , research er-led seminars , lunch-time physical activity mentoring sessions , pedometers for self-monitoring , provision of equipment to schools , parental newsletters , and a smartphone application and website . Assessment s were conducted at baseline and will be completed again at 9- and 18-months from baseline . Primary outcomes are body mass index ( BMI ) and waist circumference . Secondary outcomes include BMI z-scores , body fat ( bioelectrical impedance analysis ) , physical activity ( accelerometers ) , muscular fitness ( grip strength and push-ups ) , screen-time , sugar-sweetened beverage consumption , resistance training skill competency , daytime sleepiness , subjective well-being , physical self-perception , pathological video gaming , and aggression . Hypothesized mediators of behavior change will also be explored . DISCUSSION ATLAS is an innovative school-based intervention design ed to improve the health behaviors and related outcomes of adolescent males in low-income communities OBJECTIVES : The objective of this study was to evaluate a 12-session home/community-based health promotion/obesity prevention program ( Challenge ! ) on changes in BMI status , body composition , physical activity , and diet . METHODS : A total of 235 black adolescents ( aged 11–16 years ; 38 % overweight/obese ) were recruited from low-income urban communities . Baseline measures included weight , height , body composition , physical activity ( PA ) , and diet . PA was measured by 7-day play-equivalent physical activity ( ≥1800 activity counts per minute ) . Participants were r and omly assigned to health promotion/obesity prevention that is anchored in social cognitive theory and motivational interviewing and was delivered by college-aged black mentors or to control . Postintervention ( 11 months ) and delayed follow-up ( 24 months ) evaluations were conducted . Longitudinal analyses used multilevel models with r and om intercepts and generalized estimating equations , controlling for baseline age/gender . Stratified analyses examined baseline BMI category . RESULTS : Retention was 76 % over 2 years ; overweight/obese status declined 5 % among intervention adolescents and increased 11 % among control adolescents . Among overweight/obese youth , the intervention reduced total percentage of body fat and fat mass and increased fat-free mass at delayed follow-up and increased play-equivalent physical activity at postintervention but not at delayed follow-up . Intervention adolescents declined significantly more in snack/dessert consumption than control adolescents at both follow-up evaluations . CONCLUSIONS : At postintervention , there were intervention effects on diet and PA but not BMI category or body composition . At delayed follow-up , dietary changes were sustained and the intervention prevented an increase in BMI category . Body composition was improved for overweight/obese youth . Changes in body composition follow changes in diet and PA and may not be detected immediately after intervention Background Worksite obesity prevention interventions using an ecological approach may hold promise for reducing typical weight gain . The purpose of this study was to examine the effectiveness of Go ! , an innovative 12-month multi-component worksite obesity prevention intervention . Methods A quasi-experimental non-equivalent control group design was utilized ; 407 eligible hospital employees ( intervention arm ) and 93 eligible clinic employees ( comparison arm ) participated . The intervention involved pedometer distribution , labeling of all foods in the worksite cafeteria and vending machines ( with calories , step equivalent , and a traffic light based on energy density signaling recommended portion ) , persuasive messaging throughout the hospital , and the integration of influential employees to reinforce healthy social norms .  Changes in weight , BMI , waist circumference , physical activity , and dietary behavior after 6 months and 1 year were primary outcomes . Secondary outcomes included knowledge , perceptions of employer commitment to employee health , availability of information about diet , exercise , and weight loss , perceptions of coworker support and frequency of health discussion s with coworkers . A process evaluation was conducted as part of the study . Results Repeated measures ANCOVA indicated that neither group showed significant increases in weight , BMI , or waist circumference over 12 months . The intervention group showed a modest increase in physical activity in the form of walking , but decreases in fruit and vegetable servings and fiber intake . They also reported significant increases in knowledge , information , perceptions of employer commitment , and health discussion s with peers . Employees expressed positive attitudes towards all components of the Go ! intervention . Conclusions This low-intensity intervention was well-received by employees but had little effect on their weight over the course of 12 months . Such results are consistent with other worksite obesity prevention studies using ecological approaches . Implementing low-impact physical activity ( e.g. , walking , stair use ) may be more readily incorporated into the worksite setting than more challenging behaviors of altering dietary habits and increasing more vigorous forms of physical activity . Trial Registration This study was registered with clinical trials.gov ( NCT01585480 ) on April 24 , 2012 Background Involvement in meal preparation and eating meals with one ’s family are associated with better dietary quality and healthy body weight for youth . Given the poor dietary quality of many youth , potential benefits of family meals for better nutritional intake and great variation in family meals , development and evaluation of interventions aim ed at improving and increasing family meals are needed . This paper presents the design of key intervention components and process evaluation of a community-based program ( Healthy Home Offerings via the Mealtime Environment ( HOME ) Plus ) to prevent obesity . Methods The HOME Plus intervention was part of a two-arm ( intervention versus attention-only control ) r and omized-controlled trial . Ten monthly , two-hour sessions and five motivational/ goal - setting telephone calls to promote healthy eating and increasing family meals were delivered in community-based setting s in the Minneapolis/St . Paul , MN metropolitan area . The present study included 81 families ( 8 - 12 year old children and their parents ) in the intervention condition . Process surveys were administered at the end of each intervention session and at a home visit after the intervention period . Chi-squares and t-tests were used for process survey analysis . Results The HOME Plus program was successfully implemented and families were highly satisfied . Parents and children reported that the most enjoyable component was cooking with their families , learning how to eat more healthfully , and trying new recipes/foods and cooking tips . Average session attendance across the ten months was high for families ( 68 % ) and more than half completed their home activities . Conclusions Findings support the value of a community-based , family-focused intervention program to promote family meals , limit screen time , and prevent obesity . Trial registration BACKGROUND The efficacy of physical activity with a healthful diet to reduce obesity is established ; however , little is known about the translation of effective lifestyle strategies for obesity reduction in primary care setting s. METHODS We assessed the effectiveness of a 2-year behaviorally based physical activity and diet program implemented entirely within clinical practice s to reduce obesity . A total of 490 sedentary , obese adults were r and omized to usual care ( n = 241 ) or to the behavioral intervention ( n = 249 ) . The usual care group received advice from their physicians about lifestyle as a strategy for obesity reduction . The behavioral intervention included individual counseling from health educators to promote physical activity with a healthful diet . The primary outcome was change in waist circumference ( WC ) . RESULTS A total of 396 participants completed the trial ( 80.8 % ) . A significant main effect was observed for WC change within the intervention compared with usual care ( P < .001 ) that was sustained at 24 months ( mean [ SE ] , -0.9 [ 0.4 ] vs 0.2 [ 0.4 ] cm ; P = .05 ) . Secondary analyses revealed significant main effects for change in WC in men ( P = .009 ) and women ( P = .02 ) . In men , the mean ( SE ) reduction in WC at 24 months was greater with behavioral intervention compared with usual care ( -1.6 [ 0.6 ] vs 0.1 [ 0.6 ] cm ; P = .049 ) . In women , the behavioral intervention was associated with differences in WC compared with usual care at 6 and 12 months ( P ≤ .01 ) but not at 24 months ( P = .10 ) . CONCLUSIONS Behavioral intervention in clinical setting s is associated with modest reductions in WC during a 2-year study in obese patients . However , the effectiveness of the intervention is restricted to men . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00665158 Given the disproportionately high rates of obesity-related morbidity among low-income , ethnic minority youth , obesity prevention in this population is critical . Prior efforts to curb childhood obesity have had limited public health impact . The present study evaluates an innovative approach to obesity prevention by promoting foundational parenting and child behavioral regulation . This pre – post intervention study evaluated an enhanced version of ParentCorps with 91 families of pre-Kindergarten students in low-income , urban communities . Assessment s included tests of knowledge and parent report . Consistent with findings from two r and omized controlled trials of ParentCorps , parent knowledge and use of foundational parenting practice s increased and child behavior problems decreased . Child nutrition knowledge and physical activity increased and television watching decreased ; for boys , sleep problems decreased . Comparable benefits occurred for children at high risk for obesity based on child dysregulation , child overweight , and parent overweight . Results support a “ whole child , ” family-centered approach to health promotion in early childhood BACKGROUND Mobile technologies have wide-scale reach and disseminability , but no known studies have examined mobile technologies as a st and -alone tool to improve obesity-related behaviors of at-risk youth . PURPOSE To test a 12-week mobile technology intervention for use and estimate effect sizes for a fully powered trial . METHODS Fifty-one low-income , racial/ethnic-minority girls aged 9 - 14 years were r and omized to a mobile technology ( n=26 ) or control ( n=25 ) condition . Both conditions lasted 12 weeks and targeted fruits/vegetables ( FVs ; Weeks 1 - 4 ) ; sugar-sweetened beverages ( SSBs ; Weeks 5 - 8 ) , and screen time ( Weeks 9 - 12 ) . The mobile intervention prompted real-time goal setting and self-monitoring and provided tips , feedback , and positive reinforcement related to the target behaviors . Controls received the same content in a written manual but no prompting . Outcomes included device utilization and effect size estimates of FVs , SSBs , screen time , and BMI . Data were collected and analyzed in 2011 - 2012 . RESULTS Mobile technology girls used the program on 63 % of days and exhibited trends toward increased FVs ( + 0.88 , p=0.08 ) and decreased SSBs ( -0.33 , p=0.09 ) . The adjusted difference between groups of 1.0 servings of FVs ( p=0.13 ) and 0.35 servings of SSBs ( p=0.25 ) indicated small to moderate effects of the intervention ( Cohen 's d=0.44 and -0.34 , respectively ) . No differences were observed for screen time or BMI . CONCLUSIONS A st and -alone mobile app may produce small to moderate effects for FVs and SSBs . Given the extensive reach of mobile devices , this pilot study demonstrates the need for larger-scale testing of similar programs to address obesity-related behaviors in high-risk youth OBJECTIVE Evaluate the effects of a prevention program targeting both eating disorders and obesity at 1- and 2-year follow-ups . METHOD Female college students at risk for these outcomes because of body image concerns ( N = 398 ) were r and omized to the Healthy Weight 2 group-based 4-hr prevention program , which promotes lasting healthy improvements to dietary intake and physical activity and nutrition science health behavior change principles , or an educational brochure control condition . RESULTS Intervention participants showed significantly less body dissatisfaction and eating disorder symptoms and lower eating disorder onset through 2-year follow-up versus controls , but the former 2 effects were small . There were no main effects for body mass index ( BMI ) , depressive symptoms , dieting , caloric intake , physical activity , or obesity onset . Moderator analyses revealed stronger eating disorder symptom effects for youths with initially elevated symptoms and lower pressure to be thin , stronger BMI effects for youths with initially elevated symptoms and BMI scores , and weaker eating disorder symptom effects for youths with initially elevated pressure to be thin . CONCLUSIONS The 60 % reduction in eating disorder onset over the 2-year follow-up was clinical ly significant and a novel effect for a prevention program , but the main effects on continuous outcomes were small , suggesting that adding nutrition science principles weakened the intervention efficacy . Effects on both eating disorder symptoms and BMI were greater for those with elevated eating disorder symptoms and BMI at pretest , implying that it might be useful to target these individuals in future trials OBJECTIVE To evaluate the impact of a school-based health behavior intervention known as Planet Health on obesity among boys and girls in grade s 6 to 8 . DESIGN R and omized , controlled field trial with 5 intervention and 5 control schools . Outcomes were assessed using preintervention ( fall 1995 ) and follow-up measures ( spring 1997 ) , including prevalence , incidence , and remission of obesity . PARTICIPANTS A group of 1295 ethnically diverse grade 6 and 7 students from public schools in 4 Massachusetts communities . INTERVENTION Students participated in a school-based interdisciplinary intervention over 2 school years . Planet Health sessions were included within existing curricula using classroom teachers in 4 major subjects and physical education . Sessions focused on decreasing television viewing , decreasing consumption of high-fat foods , increasing fruit and vegetable intake , and increasing moderate and vigorous physical activity . MAIN OUTCOME MEASURES Obesity was defined as a composite indicator based on both a body mass index and a triceps skinfold value greater than or equal to age- and sex-specific 85th percentiles . Because schools were r and omized , rather than students , the generalized estimating equation method was used to adjust for individual-level covariates under cluster r and omization . RESULTS The prevalence of obesity among girls in intervention schools was reduced compared with controls , controlling for baseline obesity ( odds ratio , 0.47 ; 95 % confidence interval , 0.24 - 0.93 ; P = .03 ) , with no differences found among boys . There was greater remission of obesity among intervention girls vs. control girls ( odds ratio , 2.16 ; 95 % confidence interval , 1.07 - 4.35 ; P = .04 ) . The intervention reduced television hours among both girls and boys , and increased fruit and vegetable consumption and result ed in a smaller increment in total energy intake among girls . Reductions in television viewing predicted obesity change and mediated the intervention effect . Among girls , each hour of reduction in television viewing predicted reduced obesity prevalence ( odds ratio , 0.85 ; 95 % confidence interval , 0.75 - 0.97 ; P = .02 ) . CONCLUSION Planet Health decreased obesity among female students , indicating a promising school-based approach to reducing obesity among youth Background Family meal frequency has been shown to be strongly associated with better dietary intake ; however , associations with weight status have been mixed . Family meals-focused r and omized controlled trials with weight outcomes have not been previously conducted . Therefore , this study purpose was to describe weight-related outcomes of the HOME Plus study , the first family meals-focused r and omized controlled trial to prevent excess weight gain among youth . Methods Families ( n = 160 8 - 12-year-old children and their parents/guardians ) were r and omized to intervention ( n = 81 ) or control ( n = 79 ) groups . Data were collected at baseline ( 2011–2012 ) , post-intervention ( 12-months post-baseline ) and follow-up ( 21-months post-baseline ) . The intervention included ten monthly group sessions ( nutrition education ; h and s-on meal and snack planning , preparation , and skill development ; screen time reductions ) and five motivational , goal - setting phone calls . The main outcome was child body mass index ( BMI ) z-score . Results General linear models , adjusted for baseline values and demographics , showed no significant treatment group differences in BMI z-scores at post-intervention or follow-up ; however , a promising reduction in excess weight gain was observed . Post-hoc stratification by pubertal onset indicated prepubescent children in the intervention group had significantly lower BMI z-scores than their control group counterparts . Conclusions The study used a strong theoretical framework , rigorous design , quality measurement and a program with high fidelity to test a family meals-focused obesity prevention intervention . It showed a modest decrease in excess weight gain . The significant intervention effect among prepubescent children suggests the intervention may be more efficacious among relatively young children , although more research with appropriately powered sample s are needed to replicate this finding . Trial registration This study is registered at www . clinical trials.gov NCT01538615 . Registered 01/17/2012 Background Nearly one in five 4-year-old children in the United States are obese , with low-income children almost twice as likely to be obese as their middle/upper-income peers . Few obesity prevention programs for low-income preschoolers and their parents have been rigorously tested , and effects are modest . We are testing a novel obesity prevention program for low-income preschoolers built on the premise that children who are better able to self-regulate in the face of psychosocial stressors may be less likely to eat impulsively in response to stress . Enhancing behavioral self-regulation skills in low-income children may be a unique and important intervention approach to prevent childhood obesity . Methods / design The Growing Healthy study is a r and omized controlled trial evaluating two obesity prevention interventions in 600 low-income preschoolers attending Head Start , a federally-funded preschool program for low-income children . Interventions are delivered by community-based , nutrition-education staff partnering with Head Start . The first intervention ( n = 200 ) , Preschool Obesity Prevention Series ( POPS ) , addresses evidence -based obesity prevention behaviors for preschool-aged children and their parents . The second intervention ( n = 200 ) comprises POPS in combination with the Incredible Years Series ( IYS ) , an evidence -based approach to improving self-regulation among preschool-aged children . The comparison condition ( n = 200 ) is Usual Head Start Exposure . We hypothesize that POPS will yield positive effects compared to Usual Head Start , and that the combined intervention ( POPS + IYS ) addressing behaviors well-known to be associated with obesity risk , as well as self-regulatory capacity , will be most effective in preventing excessive increases in child adiposity indices ( body mass index , skinfold thickness ) . We will evaluate additional child outcomes using parent and teacher reports and direct assessment s of food-related self-regulation . We will also gather process data on intervention implementation , including fidelity , attendance , engagement , and satisfaction . Discussion The Growing Healthy study will shed light on associations between self-regulation skills and obesity risk in low-income preschoolers . If the project is effective in preventing obesity , results can also provide critical insights into how best to deliver obesity prevention programming to parents and children in a community-based setting like Head Start in order to promote better health among at-risk children . Trial registration number Clinical trials.gov Identifier :
It is unclear from these results whether sports programs , as currently offered , protect youth from becoming overweight or obese .
Sport is a promising setting for obesity prevention among youth , but little is known about whether it prevents obesity .