Location: Children's Nutrition Research Center2012 Annual Report
1a. Objectives (from AD-416):
Objective 1. Develop and evaluate the effectiveness of a culturally appropriate, web-based, dietary and physical activity intervention for preventing obesity in high school students. Sub-objective 1.A. Complete the development of the intervention and control websites. Sub-objective 1.B. Evaluate the effect of the intervention on anthropometric, dietary and physical activity behaviors and psychosocial – mediating variables. Sub-objective 1.C. Conduct process evaluation of the intervention. Sub-objective 1.D. Determine the long-term impact of the intervention on body weight and dietary and physical activity behaviors in youth. Sub-objective 1.E. Determine the impact of the intervention on body weight and dietary and physical activity behaviors in the control condition youth who gain access to the intervention condition website at 12 months post baseline. Objective 2. Develop and evaluate the effectiveness of novel, multi-media, diet and/or physical activity interventions for preventing obesity in youth. Sub-objective 2.A. Evaluate a 10-episode videogame promoting increased fruit and vegetable consumption to elementary-aged youth. Sub-objective 2.B. Evaluate and refine a hypothesized theoretical model of youth physical activity behavior. Once developed, this model and its validated scales will be used to develop multi-media interventions to help youth become more physically active. Sub-objective 2.C. Validate a scale measuring youth physical activity problem solving ability and examine the relationship between physical activity problem solving ability, physical activity self efficacy, and physical activity. Once developed, this validated scale will be used to develop multi-media interventions to help youth become more physically active.
1b. Approach (from AD-416):
For objective 1, we will develop and evaluate the effectiveness of a culturally appropriate, web-based, dietary and physical activity intervention for preventing obesity in high school students. Weight, dietary and physical activity behaviors, and psychosocial mediating variables will be measured and compared between intervention and control condition participants at baseline and immediate post (post 1) after the 8-week intervention, and at 6- (post 2) and 12-months (post 3) after baseline. A complete process evaluation will be conducted. For the second objective, we will evaluate a 10-episode videogame promoting increased fruit and vegetable consumption to elementary-aged youth. Fruit and vegetable consumption, goal attainment, and psychosocial variables will be measured at baseline, immediate post (post 1), and 6 months later (post 2). A corresponding website for parent/guardians will be developed. We will also evaluate and refine a hypothesized theoretical model of youth physical activity behavior and validate a scale measuring youth physical activity problem solving ability. Once developed, the model and validated scales will be used to guide the development of multi-media interventions to help youth become more physically active.
3. Progress Report:
For Objective 1, the 8-week Teen Choice: Food and Fitness intervention was completed with 408 participants consented, 390 enrolled, and 291 completing both baseline and the post test (25% attrition). More adolescents in the treatment group reported eating 3 or more servings of vegetables per day in the past week at post compared with the control group. Regardless of group, there were statistically significant increases at post for the percentage of adolescents who reported being physically active at least 60 minutes per day on all 7 days in the past week. Fewer adolescents reported watching 3 or more hours of TV per day in the last 7 days. Approximately 75% of the participants logged in at least once a week for the 8-week intervention period. When asked to give the Teen Choice website a grade, 91% of participants gave it an A or B. A manuscript is being prepared on these results. The participants are able to access the website for an additional 18 months after completing the post test. They will complete the questionnaires every 6 months. In objective 2 of evaluating a 10-episode videogame promoting increased fruit and vegetable (FV) consumption, 400 4th and 5th grade children and 400 parents were enrolled in the study and completed baseline data collection. Of these, 96% of children and 97% of parents completed post 1 data collection, 90% of children and 90% of parents completed post 2 data collection, and almost all children (99%) participated in post 1 interviews. Participation was high - 91% of children played all 10 episodes of the videogame; they met an average of 8.2 out of 9 recipe goals and 8.7 out of 9 FV goals. Preliminary analyses of our primary hypotheses were completed, and secondary analyses are currently underway. Qualitative data analysis was completed. Analysis of the remaining data (parent data, mediation/moderation) will begin at the end of this FY or early FY 2012. Compared to baseline, children who only set goals and those who also created an action or coping plan ate more FV after playing the game; however, only children who created an action plan continued to eat more FV 3 months later. As part of the game, children set two types of goals in the game: a recipe goal and a FV consumption goal. A highly significant interaction was observed for recipe goal attainment; for the children who created action plans, as the number of recipe goals attained increased, so did FV consumption. A similar effect was found for FV goal attainment; for children who created action or coping plans, as the number of FV goals attained increased, so did FV consumption. When the research subjects were asked to describe the game, the most common description was that it was an educational game that informed them of healthy behaviors and FV consumption. Most described the game as a positive experience. The most popular components were Virtual Kitchen (video clips that demonstrated how to make recipes) and Mini Games (casual games that reinforced key knowledge, such as portion sizes and "real FV" vs. "FV imposters"). Most children (92%) appeared satisfied with the game and graded it an A or B. When asked to describe a person who eats at least 5 servings of FV a day, most described this person as living a healthy lifestyle which included being healthy, energetic, and active. Responses suggested children were able to transfer knowledge from the virtual world to the real world. Four manuscripts are being prepared for submission. Recruitment for the main validation study with objectively measured physical activity was also initiated; 102 teens completed the validation study. The manuscript on the initial validation study with self-report physical activity was resubmitted. A manuscript on the development and validation of the video on how to wear the activity monitor was published [Thompson D, Abdelsamad D, Cantu D, Gillum A. Instructional physical activity monitor video in English and Spanish. American Journal of Preventive Medicine. 2012. 42(3):e29-30]
1. Ask the audience. Online obesity prevention programs should be designed to meet the needs of the intended participants to increase the likelihood of intervention success. Researchers at the Children's Nutrition Research Center at Houston, Texas conducted formative research with 12-17 year old adolescents to enlist their help in the design of an online program focused on healthy eating and physical activity. The participants provided information on the design of the website, characters, and the different components of the website, like goal setting and recipes. This research will enable other researchers to more fully understand the benefits of asking for input from intervention targets as online intervention programs are designed. These results may influence how nutritional intervention research is designed and developed.
2. Let the games begin! Fruit and vegetable intake has been associated with a decreased risk of chronic disease, yet children eat fewer fruit and vegetables than what is recommended. Because fruit and vegetable intake during childhood is associated with fruit and vegetable intake in adulthood, it is important to help children learn to eat more fruit and vegetables. Children's Nutrition Research Center researchers in Houston, Texas, have found that video games may offer a solution to this concern. Fourth and 5th graders who created a plan of how to meet their fruit and vegetable goals while playing a 10-epsidode video game entitled Squire’s Quest! II increased their fruit and vegetable intake and maintained this pattern three months later. This research has identified a potentially important way to not only increase fruit and vegetable consumption among youth, but maintain those increases over time.