Case study: Behavior changes in the family-focused obesity prevention HOME Plus program.

OBJECTIVE: The purpose of this case study is to describe two successful HOME Plus participants and highlight how an intervention with individual and group components can help families make lifestyle changes that result in improvements in child weight status. DESIGN: One hundred and sixty families participated in the HOME Plus study, and were randomized to either a control or intervention group. SAMPLE: Two successful HOME Plus participants were chosen because of their healthful changes in weight status and behavior and high engagement in the program. MEASUREMENTS: Data were collected at baseline and postintervention, 1 year later. Data included height, weight, home food inventory, dietary recalls, and psychosocial surveys. INTERVENTION: Families in the intervention group participated in cooking and nutrition education sessions, goal-setting activities, and motivational interviewing telephone calls to promote behavioral goals associated with meal planning, family meal frequency, and healthfulness of meals and snacks. RESULTS: Analysis of the families' behaviors showed that Oliver (fictitious name) experienced changes in nutritional knowledge and cooking skill development while Sophia's (fictitious name) changes were associated with healthful food availability and increased family meal frequency. CONCLUSION: These cases show that offering a multicomponent, family-focused program allows participants to select behavior strategies to fit their unique family needs.

The researchers have left the building: what contributes to sustaining school-based interventions following the conclusion of formal research support?

BACKGROUND: This study examined the sustainability of New Moves, a school-based program aimed at decreasing weight-related problems in adolescent girls. The National Cancer Institute recognizes New Moves as a research-tested intervention program that produced positive behavioral and psychosocial outcomes. METHODS: Ten schools participated in the sustainability study. Teachers completed a survey and interview, and research staff observed 1 physical education (PE) class within 2 years of the study's completion. Qualitative data were grouped by themes. Frequencies were calculated using quantitative data. RESULTS: All schools continued all-girls PE classes using New Moves components following the study period. Fewer schools continued the nutrition and social support classroom modules and individual coaching sessions while no schools continued lunch get-togethers. Program components were sustained in both New Moves intervention schools and control schools. CONCLUSIONS: Programs are most likely to be sustained if they (1) fit into the current school structure, (2) receive buy-in by teachers, and (3) require minimal additional funds or staff time. Providing control schools with minimal training and intervention resources was sufficient to continue program components if staff perceived the program was important for students' health and compatible within the school's existing infrastructure.

Parental role modeling of fruits and vegetables at meals and snacks is associated with children's adequate consumption.

Research has shown that parental role modeling of healthful eating behaviors is positively correlated to children's dietary intake and fruit and vegetable (F&V) preferences. The purpose of this study is to (1) examine associations between parent and child report of parental role modeling of F&V consumption at snacks and dinner and (2) determine whether parental role modeling is associated with children meeting daily F&V recommendations. Parent-child dyads (N = 160) participating in the HOME Plus study completed baseline surveys on parental role modeling of F&V at snacks and dinner. Children also completed 24-hour dietary recalls. Spearman correlations and chi-square/Fisher's exact tests were used to examine relationships between parent and child report of parental role modeling of F&V at snacks and dinner and whether children met daily recommendations. On average, children consumed less than three daily servings of F&V with only 23% consuming the recommended servings. Statistically significant correlations were seen between parent and child report of parental role modeling fruit at dinner and green salad at dinner. Children who reported parental role modeling of vegetables at snack and salad at dinner were significantly more likely, than those who did not, to meet daily F&V recommendations. Parents who reported role modeling fruit at snack were significantly more likely to have children who met daily F&V recommendations. Results indicate that children are aware of their parents' eating behaviors and on occasion report this behavior similarly to their parents. Parents should be encouraged to utilize the opportunity to role model healthful dietary intake, especially at snacks, where consumption of F&V appears low.

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.