LA Sprouts: The Impact of Gardening and Nutrition Education on Childhood Obesity in Latino Youth

Study Overview
=================
Brief Summary
-----------------
The overall goal of this project is to conduct a randomized controlled 12-week after school, gardening, nutrition and cooking program (called LA Sprouts) to improve dietary intake and reduce obesity in 3rd, 4th and 5th grade students (ages 8-12 years) in Los Angeles. Approximately 400 3rd - 5th grade students participating in the LA's Best after school program will participate. Four elementary schools in Los Angeles will be selected to participate in the study. Schools will be randomized by region to either receive the intervention (LA Sprouts; 2 schools, n=200 students) or serve as controls (received a delayed intervention program one school semester later; 2 schools, n=200 students). The LA Sprouts intervention will take place at the elementary schools, with gardens on campus specially designed and built for this project. The program will be held once a week for 12 weeks and will consist of a 45-minute gardening lesson, taught by Master Gardeners from the University of California Cooperative Extension (supervised by Nicole Gatto, MPH, PhD), and a 45-minute nutrition education and cooking lesson, taught by USC a Nutrition Educator (supervised by Jaimie Davis, PhD, RD). Measures of childhood obesity (i.e., body mass index (BMI) and body fat percentages), blood pressure, metabolic function (fasting blood glucose, insulin and lipids), dietary intake and related behaviors, and school performance will be measured before and after the implementation of the program in both intervention and control participants. Approximately 10 additional students of the same age will be asked to participate in a focus group to evaluate the questionnaire developed for this study. In addition, approximately 20 additonal students of the same age will be asked to participate in a test-retest session to validate the reliability of the questionnaire.

Official Title
-----------------
LA Sprouts: The Impact of Gardening and Nutrition Education on Childhood Obesity in Latino Youth

Conditions
-----------------
Pediatric Obesity

Intervention / Treatment
-----------------
* Behavioral: LA Sprouts intervention


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Normal, Overweight and Obese Children: Investigators will attempt to obtain a natural selection of normal weight children (age- & sex-specific BMI < 85th percentile based on CDC BMI growth charts (40) and overweight and obese children (BMI ≥ 85th percentile). Based on preliminary data from these areas, investigators expect that at least 50% of the sample will be overweight or obese. There will not be an upper BMI limit. Gender & Age: Investigators will attempt to enroll equal numbers of female and male students in 3rd through 5th grades (8-12 years of age). Latino origin: This study will include all ethnicities, however the selected schools are >90% Latino. Exclusion Criteria: The following criteria are exclusionary: presently taking medication(s) or diagnosed with any disease that could influence dietary intake or body composition; previously diagnosed with any major illness since birth (e.g. chronic birth asphyxia, cancer, etc.); any physical, cognitive, or psychological disability that would prevent participation in the study. Participants testing positive for diabetes (as determined from the fasting blood draw) will be referred for treatment. (Note: subjects with pre-diabetes will be eligible for the study). Although participant data may be excluded based on the above exclusion criteria, participation in the program classes may be allowed. Individual cases will be reviewed as they arise.

Ages Eligible for Study
-----------------
Minimum Age: 8 Years
Maximum Age: 12 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: LA Sprouts intervention<br>The intervention classes will be taught during a 90-minute session once a week for 12 weeks. Participants will receive a 45-minute gardening lesson, taught by a Master Gardener (supervised by Dr. Gatto). This lesson will include learning how to plant, maintain and harvest various fruits and vegetables. Supplementing the gardening lesson, a USC nutrition educator, with help from various graduate students (supervised by PI Dr. Davis), will lead a 45-minute cooking activity and nutrition education lesson. Every participant will participate in the cooking activity and sample the food. The program will include lessons on growing crops that have cultural significance to Latino youth such as nopales, beans, corn and squash (the latter three crops are commonly referred to as the three sisters). | Behavioral: LA Sprouts intervention<br>* see arm 1 description<br>|
| No Intervention: control<br>Approximately 200 students in the second region who are enrolled in LA's Best will serve as control participants. After the 12-week intervention is conducted and all post-testing measures are collected on controls, a vegetable/fruit garden will be built at both control schools and the LA Sprouts program will be taught to all 3rd, 4th and 5th graders in LAs Best and their parents at the control school as a delayed intervention. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in adiposity | measured by BMI, waist circumference, and body fat percentages (via Tanita scale) | baseline and 12 weeks | 
| change in blood pressure |  | baseline and 12 weeks | 
| change in metabolic function | measured by fasting glucose, insulin and lipids | baseline and 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in dietary intake | measured via screener, specifically fruits, vegetables, fiber | basline and 12 weeks | 
| change in determinants of fruit and vegetable intake | measured via LA Sprouts questionnaire (developed for this study), ie knowledge, preferences, self-efficacy, motivation | basline and 12 weeks | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
gardening, cooking, nutrition education, Hispanic Americans