Challenge! Health Promotion/obesity Prevention Mentorship Model Among Urban, Black Adolescents

• Published in: Pediatrics (Evanston) 2010-08, Vol.126 (2), p.280-288
• Main Authors: BLACK, Maureen M, HAGER, Erin R, TREUTH, Margarita S, YAN WANG, LE, Katherine, ANLIKER, Jean, SONIA ARTEAGA, S, DICLEMENTE, Carlo, GITTELSOHN, Joel, MAGDER, Laurence, PAPAS, Mia, SNITKER, Soren
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent obesity; Biological and medical sciences; Black or African American - statistics & numerical data; Body Mass Index; Catchment Area, Health; Child; Disease prevention; Female; General aspects; Health Promotion; Humans; Male; Medical sciences; Mentoring programs; Mentors; Metabolic diseases; Miscellaneous; Motivation; Motor Activity; Obesity; Obesity - ethnology; Obesity - prevention & control; Obesity in adolescence; Pediatrics; Prevalence; Prevention; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retention, Psychology; Socioeconomic Factors; Surveys and Questionnaires; Teenagers; United States - epidemiology; Urban Population - statistics & numerical data; Weight control
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2009-1832

The objective of this study was to evaluate a 12-session home/community-based health promotion/obesity prevention program (Challenge!) on changes in BMI status, body composition, physical activity, and diet. A total of 235 black adolescents (aged 11-16 years; 38% overweight/obese) were recruited from low-income urban communities. Baseline measures included weight, height, body composition, physical activity (PA), and diet. PA was measured by 7-day play-equivalent physical activity (> or =1800 activity counts per minute). Participants were randomly assigned to health promotion/obesity prevention that is anchored in social cognitive theory and motivational interviewing and was delivered by college-aged black mentors or to control. Postintervention (11 months) and delayed follow-up (24 months) evaluations were conducted. Longitudinal analyses used multilevel models with random intercepts and generalized estimating equations, controlling for baseline age/gender. Stratified analyses examined baseline BMI category. Retention was 76% over 2 years; overweight/obese status declined 5% among intervention adolescents and increased 11% among control adolescents. Among overweight/obese youth, the intervention reduced total percentage of body fat and fat mass and increased fat-free mass at delayed follow-up and increased play-equivalent physical activity at postintervention but not at delayed follow-up. Intervention adolescents declined significantly more in snack/dessert consumption than control adolescents at both follow-up evaluations. At postintervention, there were intervention effects on diet and PA but not BMI category or body composition. At delayed follow-up, dietary changes were sustained and the intervention prevented an increase in BMI category. Body composition was improved for overweight/obese youth. Changes in body composition follow changes in diet and PA and may not be detected immediately after intervention.