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Research Project: Childhood Obesity Prevention

Location: Children's Nutrition Research Center

Title: Assessing the sustained impact and mediators of health behavior change of the "Healthy Habits, Healthy Girls – Brazil" clustered randomized controlled trial for Brazilian adolescents

Author
item Barco Leme, Ana - Children'S Nutrition Research Center (CNRC)
item Baranowski, Tom - Children'S Nutrition Research Center (CNRC)
item Thompson, Deborah - Debbe
item Nicklas, Theresa - Children'S Nutrition Research Center (CNRC)
item Philippi, Sonia - Universidad De Sao Paulo

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 5/4/2018
Publication Date: 6/5/2018
Citation: Barco Leme, A.C., Baranowski, T., Thompson, D.J., Nicklas, T., Philippi, S.T. 2018. Assessing the sustained impact and mediators of health behavior change of the "Healthy Habits, Healthy Girls – Brazil" clustered randomized controlled trial for Brazilian adolescents: Do we need to re-think the primary outcome of obesity prevention interventions? [abstract]. International Society of Behavioral Nutrition and Physical Activity (ISBNPA) Annual Conference. June 3-6, 2018; Hong Kong, China. Oral presentation O.21.3.

Interpretive Summary:

Technical Abstract: Pediatric obesity is a major public health concern in low- and middle-income countries (LMIC) such as Brazil. There is an urgent need for preventive programs for adolescents, the assessment of their sustained impact, as well as identification of the mediators of effects on body composition. This study evaluated the 12-month impact of the Healthy Habits, Healthy Girls –Brazil school-based obesity prevention program on body composition and tests behavior mediators of change. A cluster randomized controlled trial with 253 adolescent girls [mean (se) age = 15.6 (0.87) years] from 10 public schools (i.e., 5 pairs) in the city of São Paulo, Brazil. Body mass index (BMI), waist circumference (WC), dietary intake, physical activity (PA) and sedentary behaviors (SB) during the weekdays and weekends were assessed at baseline, 6-month (post-test) and 12-month (follow-up). ANCOVA and mediation analyses were performed using intention to treat principles. There was no intervention effect on BMI, the primary outcome. Alternatively a significant effect was found on waist circumference (F=3.314, p=0.03). This effect was mediated by hours of TV/week (AB =0.14 (se 0.10), 95%CI 0.01 to 0.44), total SB/week (0.27 (0.15), 0.04 to 0.64) and total SB/weekend (0.21 (0.13), 0.01 to 0.56). The largest mediator total time on SB/week, explained 12% of the variance in WC. Conclusion: H3G-Brazil had a significant but weak effect on WC but not on BMI, the primary outcome. Since WC is more strongly related to metabolic health, future obesity prevention intervention studies may wish to use WC as a primary indicator for improvements in body composition. SB mediated the intervention effect on WC at 12-month follow-up. These findings might have implications for future obesity prevention research with girls from LMIC.