A 2-year young adult obesity prevention trial in the US: Process evaluation results.

Our objective was to conduct a process evaluation of the CHOICES (Choosing Healthy Options in College Environments and Settings) study, a large, randomized, controlled trial designed to prevent unhealthy weight gain in young adults (aged 18-35) attending 2-year community colleges in the USA. The 24-month intervention consisted of participation in an academic course and a social networking and support website. Among intervention participants, completion rates for most course activities were >80%, reflecting a high level of dose received. Course retention and participant satisfaction were also high. Engagement results, however, were mixed with less than half of participants in the online and hybrid sections of the course reporting that they interacted with course materials ≥3 h/week, but 50-75% reporting that they completed required lessons 'all/very thoroughly'. Engagement in the website activities was also mixed with more than half of intervention participants logging onto the website during the first month, but then declining to 25-40% during the following 23 months of the intervention. Intervention engagement is a challenge of online interventions and a challenge of working with the young adult age group in general. Additional research is needed to explore strategies to support engagement among this population, particularly for relatively long intervention durations.

Translating a health behavior change intervention for delivery to 2-year college students: the importance of formative research.

Young adults are at risk for weight gain in the transition to independent adulthood; 2-year college students are at greater risk and understudied relative to 4-year students. This project conducted formative research for a randomized controlled weight gain prevention trial among 2-year college students, to ensure appropriateness of content and delivery of a curriculum originally developed for 4-year college students. Data were collected from community college students, faculty, and staff from October 2009 to August 2011. Work included focus groups and key informant interviews, curriculum pilot testing, and social network and support website beta testing. Based on focus groups and interviews, program content, course delivery modes, and communication channels were adjusted to meet population interests and preferences. The course was delivered successfully in pilot testing, and the website was received well by beta testers. Formative work successfully guided program adaptations to address population needs.

New moves-preventing weight-related problems in adolescent girls a group-randomized study.

BACKGROUND: Weight-related problems are prevalent in adolescent girls. PURPOSE: To evaluate New Moves, a school-based program aimed at preventing weight-related problems in adolescent girls. DESIGN: School-based group-randomized controlled design. SETTING/PARTICIPANTS: 356 girls (mean age=15.8±1.2 years) from six intervention and six control high schools. More than 75% of the girls were racial/ethnic minorities and 46% were overweight or obese. Data were collected in 2007-2009 and analyzed in 2009-2010. INTERVENTION: An all-girls physical education class, supplemented with nutrition and self-empowerment components, individual sessions using motivational interviewing, lunch meetings, and parent outreach. MAIN OUTCOME MEASURES: Percentage body fat, BMI, physical activity, sedentary activity, dietary intake, eating patterns, unhealthy weight control behaviors, and body/self-image. RESULTS: New Moves did not lead to significant changes in the girls' percentage body fat or BMI but improvements were seen for sedentary activity, eating patterns, unhealthy weight control behaviors, and body/self-image. For example, in comparison to control girls, at 9-month follow-up, intervention girls decreased their sedentary behaviors by approximately one 30-minute block a day (p=0.050); girls increased their portion control behaviors (p=0.014); the percentage of girls using unhealthy weight control behaviors decreased by 13.7% (p=0.021); and improvements were seen in body image (p=0.045) and self-worth (p=0.031). Additionally, intervention girls reported more support by friends, teachers, and families for healthy eating and physical activity. CONCLUSIONS: New Moves provides a model for addressing the broad spectrum of weight-related problems among adolescent girls. Further work is needed to enhance the effectiveness of interventions to improve weight status of youth.

'Ready. Set. ACTION!' A theater-based obesity prevention program for children: a feasibility study.

This study examined the feasibility of implementing an innovative theater-based after-school program, 'Ready. Set. ACTION!', to reach ethnically diverse and low-income children and their parents with obesity prevention messages. The study population included 96 children and 61 parents. Children were in fourth to sixth grade and 41% were overweight at baseline. Program impact was evaluated with a pre/post-randomized controlled study design, but a major focus was placed on the process evaluation conducted in the intervention schools. Intervention children and parents reported high program satisfaction and that they had made changes or intended to make positive changes in their behaviors due to program participation. However, few meaningful differences between the intervention and control conditions were found at follow-up. Thus, the combined process and impact evaluation results suggest that the intervention was effective in leading to increased awareness of the need for behavioral change, but was not powerful enough on its own to lead to behavioral change. From this feasibility study, we concluded that Ready. Set. ACTION! offers promise as a creative intervention strategy. The next research step may be to incorporate theater-based programs into more comprehensive school-based interventions, with both educational and environmental components, and evaluate program impact.

Dietary approaches to healthy weight management for adolescents: the New Moves model.

This article describes the dietary component of New Moves, a school-based obesity-prevention program for adolescent girls. New Moves is a multicomponent intervention that integrates nutrition, social support, and physical activity sessions within an all-girls physical education high school class. New Moves also includes individual counseling sessions that use motivational interviewing techniques, follow-up group lunch meetings, and parent outreach activities. The nutrition component focuses on avoiding dieting and unhealthy weight-control behaviors and adopting lifelong healthy eating behaviors such as increasing fruit and vegetable intake, decreasing sweetened beverage intake, eating breakfast daily, and paying attention to internal signs of hunger and satiety.