Sustaining the Youth‐Leader Program in Baltimore City Recreation Centers: Formative Research Findings
Authors: Trude Angela , Steeves Elizabeth Anderson , Shipley Cara , Ruiz Maria Jose Mejía , Priscila Sato , Lachenmayr Lisa , Gittelsohn Joel 
Published: November 2023

Peer‐led interventions may be an effective means of addressing the childhood obesity epidemic, however few studies have looked at long‐term sustainability of such programs. In July 2014, we initiated wave 1 of a multi‐level, multi‐component obesity prevention intervention in Baltimore, USA ‐B'More Healthy Communities for Kids (BHCK). We trained 16 Baltimore college students as youth leaders to deliver a nutrition education and cooking skills curriculum to low income African‐American children (10–14 years old). They successfully delivered the program and achieved over 1600 interactions with youth (some repeats), an average of 10 youth in our target age range per session, during 98 sessions in after‐school programs held at seven recreation centers. Based on the successful first wave of implementation, we conducted a multiple‐methods formative evaluation to inform future capacity building and sustainability of the youth leader program in all recreation centers in Baltimore City. We conducted in‐depth interviews with recreation center directors (n=7) and BHCK youth‐leaders (n=12), and focus groups with youth leaders and teens from the community (n=15). Recreation center directors perceived many benefits of the program for children and their families related to improved nutrition knowledge and behaviors, such as the ability to read nutrition facts labels, and how to prepare foods in a healthier way. Directors identified children's low engagement as a key initial challenge, but noted a greater commitment throughout the implementation of the program. Youth leaders perceived improvements in their own eating behaviors and leadership skills. Communication within the youth leader group, absenteeism due to transportation issues, and time commitment were key challenges for leaders. The need for continuity of the program was a theme that emerged from both groups. High school students living close to the centers were identified as possible champions of the program to improve mentorship capacity in the community. Our findings indicate that the youth‐leader program was successfully implemented in seven recreation centers. Thus, we are expanding the program from wave 1 and developing a sustainable version for implementation within Baltimore City recreation centers utilizing a train the trainer approach. Youth Leaders from wave 1 will mentor high school students during wave 2 to empower and improve student's skills so they can deliver the nutrition curriculum in the after school programs. A recreation center director nutrition training will be also implemented prior wave 2 to improve director and staff buy‐in, and consequently, impact children's program engagement.Support or Funding InformationResearch supported by the Student‐Community Small Grant Award from the Urban Health Institute, the Northeast Regional Nutrition Education and Obesity Prevention Center of Excellence (NE‐RNECE), and the Global Obesity Prevention Center (GOPC) at Johns Hopkins, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the Office of the Director, National Institutes of Health (OD) under award number U54HD070725. Authors would like to thank the support from the Science without Borders, CNPq award number 249316/2013‐7.