Ethnic Dance and Screen Time Reduction to Prevent Weight Gain in Latina Girls
Condition: Obesity; Overweight; Excessive Weight Gain
MeSH terms: Overweight; Body Weight; Weight Gain
Study type: Interventional

Summary: 
      A randomized controlled trial to test the efficacy of an after school ethnic dance program
      plus a culturally-tailored, home-based screen time reduction intervention to reduce weight
      gain (body mass index) among lower socioeconomic status, pre-adolescent Latina girls.
    

Detailed description: 
      We propose a 2-arm, parallel group, randomized controlled trial to test the efficacy of an
      after school ethnic dance program plus a culturally-tailored, home-based screen time
      reduction intervention to reduce weight gain (body mass index) among lower socioeconomic
      status, pre-adolescent Latina girls. The control group will receive an "active-placebo"
      information-based health education intervention. A total of 240 7-9 year old girls will be
      randomized to the two conditions, and both interventions will last for the full 2-year period
      of the study for each girl.

      Latina girls are at increased risk of obesity and obesity-related morbidities. However,
      effective and generalizable obesity prevention programs for this rapidly growing population
      are not available. After school ethnic dance programs are highly motivating, and an
      innovative approach to providing a large "dose" of moderate-to-vigorous physical activity for
      Latina girls. After school programs may also indirectly reduce sedentary behavior and improve
      diet. Dance is fun for pre-adolescent girls, it plays an important social and cultural role
      in Latino communities, and after school dance classes are a potentially generalizable
      "environmental" intervention strategy. Our past pilot studies and ongoing trials of ethnic
      dance interventions demonstrate that (1) dance is a highly attractive and feasible form of
      activity for pre-adolescent girls and (2) a dance intervention can result in reduced weight
      gain (BMI) and increased fitness among girls.

      Latina girls are also heavy consumers of screen-based media, television, videotapes/DVDs and
      video games. Excessive screen time is considered one of the most modifiable causes of
      childhood obesity. We propose a culturally-tailored, home-based screen time reduction
      intervention, delivered by bilingual, Latina, Community Health Advisors (CHAs). Our prior and
      ongoing studies demonstrate the feasibility and potential efficacy of (1) reducing children's
      screen time to reduce weight gain and (2) providing home-based behavior change interventions
      to low-income Latino families using CHAs. All interventions will be further developed,
      revised, and pilot-tested with Latina girls and their families through formative research.

      240 girls Latina girls will be recruited over 18 months from six public elementary schools
      serving low-income Latino communities in northern CA. Measures will be collected in girls'
      homes at baseline, 6, 12, 18 and 24 months, including height and weight, waist circumference,
      triceps skinfold thickness, blood pressure and resting heart rate, physical activity
      monitoring by accelerometry, media use, 24-hour dietary recalls, weight concerns, depressive
      symptoms, school performance, sexual maturation, and demographics. Body Mass Index (BMI) is
      the primary outcome measure. The primary outcome analysis will compare individual
      trajectories of change in BMI in the treatment and control groups over the entire two-year
      course of the trial, using random regression models. The study is powered (90%) to detect a
      clinically-significant effect. Specific Aims include:

        1. To test the efficacy of a combined, after school ethnic dance and home-based screen time
           reduction intervention to reduce weight gain (BMI) over 2 years.

           Primary hypothesis: Compared to controls, girls in the treatment group will
           significantly reduce their weight gain (BMI) over the two-year study period.

        2. To test the effects of a combined, after school ethnic dance and home-based screen time
           reduction intervention on secondary outcomes over two years.

           Secondary hypotheses: Compared to controls, girls in the treatment group will
           significantly reduce their waist circumference, triceps skinfold thickness, systolic and
           diastolic resting blood pressures, resting heart rate, television, videotape/DVD and
           video game use, meals eaten with TV, daily dietary energy intake, percent of energy from
           fat, weight concerns and depressive symptoms, and significantly increase their daily
           physical activity, daily moderate to vigorous physical activity, liking for physical
           activity, and school performance.

        3. To evaluate potential demographic, cultural, psychological, and biological moderators
           and mediators of intervention effects on BMI and secondary outcomes, to evaluate
           correlates and risk factors for change in BMI and secondary outcomes, and to evaluate
           intervention delivery variables and their relationships to outcomes.
    

Intervention name(s): after school ethnic dance program - ballet folklorica; culturally-tailored, home-based screen time reduction; culturally-tailored health and nutrition education
Intervention type(s): Behavioral; Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: obesity; prevention; girls; Latina/Hispanic; Dance; television; screen time