Pro-Change LifeSyle Management Suite, 2009 URAC Gold Award Winner
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Page current as of: July 2010

Youth Obesity Prevention

Multi-Media and Multiple Behavior Energy Balance Program for Adolescents

Our evidence-based Health in Motion energy balance program is targeted for adolescents and focuses on three areas critical for obesity prevention:

  • Increasing physical activity
  • Eating more fruits and vegetables
  • Reducing TV time

This online program includes voice-overs read by adolescents, ten full-motion videos of adolescents encouraging and motivating each other to exercise, eat healthy, and limit TV time, and interactive Flash animations to keep youths’ interest.

Youth Obesity Sample Screen
View sample screens

Background

Development of this program was supported by grant R43 HL074482 from the National Institutes of Health (NHLBI). An effectiveness trial conducted in schools in Tennessee, New York, Massachusetts, and Rhode Island was completed in December 2007. Results of the trial demonstrate the effectiveness of the program to initiate behavior change for all three behaviors, to reduce overall behavioral risk, and to treat multiple risks simultaneously. More details on the outcomes data is available.

Over 15 presentations on this work have been made at: the Cooper Institute; the Society of Behavioral Medicine; the American Public Health Association; the Alliance for Health, Physical Education, Recreation and Dance; and the National Association of School Psychologists. Two young investigator awards were received for abstracts presented at the Cooper Institute in 2004 and 2005. In 2009 two presentations made at the Society of Behavioral Medicine received Meritorious Student Awards and one received a Citation Award from the Multiple Health Behavior Special Interest Group.

Outcome Presentations

Castle, P.H., Paiva, A.L., Mauriello, L.M., Sherman, K.J. & Prochaska, J.M. (2009). Multiple behavior risk reduction and risk acquisition: Results from an adolescent obesity prevention program. Paper presented at the annual conference of the Society of Behavioral Medicine, Montreal, Canada.

Sherman, K.J., Mauriello, L.M., Paiva, A.L., Driskell, M.M. & Castle, P.H. (2009). Co-variation of multiple behavior change: Synergistic effects of an obesity prevention program. Paper presented at the annual conference of the Society of Behavioral Medicine, Montreal, Canada.

Mauriello, L.M., Sherman, K.J., Paiva, A.L., Ciavatta (Driskell), M.M., Castle, P.H., Johnson, J.J. & Prochaska, J.M. (2009). 12-month outcomes of a multimedia obesity prevention program for adolescents. Paper presented at the annual conference of the Society of Behavioral Medicine, Montreal, Canada.

Publications

Driskell, M.M., Dyment, S.J., Mauriello, L.M., Castle, P.H., & Sherman, K.J. (2008). Relationships among multiple behaviors for childhood and adolescent obesity prevention. Preventive Medicine, 46, 209-215. abstract

Abstract:
Background: Curbing the epidemic of childhood and adolescent obesity requires impacting multiple behaviors. This article examines the interrelationships of physical activity, fruit and vegetable consumption, and limiting television time among elementary, middle, and high school students.

Methods: Nationwide samples of students in grades 4 through 12 (n=4,091) completed self-administered questionnaires assessing Transtheoretical Model (TTM) constructs and behavioral indicators for physical activity, fruit and vegetable consumption, and limiting television time. Analyses were conducted to compare the prevalence of students at-risk for the target behaviors across the age groups and to examine the interrelationships of the target behavior risks.

Results: Across the three age groups, physical activity and fruit and vegetable consumption declined, while limiting TV time increased. In addition, high school students had the greater number of behavioral risks. Across all three samples, being at-risk for one behavior almost always significantly increased the odds of being at-risk for another behavior.

Conclusion: The findings of this study provide further evidence for the need for early promotion of healthy lifestyle behaviors. The relationships among the target behaviors in three samples strongly support a multiple behavior approach for obesity prevention. TTM-based tailored interventions are now being used to address multiple behaviors without overwhelming students.

Mauriello, L.M., Sherman, K.J., Driskell, M.M., & Prochaska, J.M. (2007). Using interactive behavior change technology to intervene on physical activity and nutrition with adolescents. Adolescent Medicine: State of the Art Reviews, 18, 383-399. abstract

Abstract: Interactive technologies have emerged as a promising means for developing and disseminating health behavior change interventions. Interactive health behavior change programs are most often computer-delivered via the World Wide Web, a CD-ROM/DVD, or a stand-alone kiosk. There are many benefits of programs using these technologies. They allow the incorporation or rich media such as audio, animated graphics, and video. On-screen assessments and programming allow for immediate feedback with extensive opportunities for tailoring to participant responses. The embedded interactivity gives the user an active role with more control over their participation. Users enjoy the appeal these features offer and the flexibility of engaging in the program at their convenience. Researchers and program implementers appreciate the fidelity to treatment offered with consistent and reliable feedback delivered to participants. With improved program retention, wider reach, and less reliance on staff for delivery, interactive technologies offer a cost-effective means of delivering behavior change interventions. They are acclaimed by researchers to be an innovative, powerful, and promising way of improving the efficacy and dissemination of behavior change intervention.
Mauriello, L.M., Driskell, M.M., Sherman, K.J., Johnson, S.S., Prochaska, J.M., & Prochaska, J.O. (2006). Acceptability of a school-based intervention for the prevention of adolescent obesity. Journal of School Nursing, 22, 269-277. abstract
Abstract: This article describes the development and pilot testing of a computer-based, multiple-behavior obesity prevention program for adolescents. Using the Transtheoretical Model as a framework, this intervention offers individualized feedback based on readiness to engage in physical activity, to consume fruits and vegetables, and to limit television viewing. Focus groups and interviews with students, teachers, school administrators, and experts guided the development. Forty-five students participated in a baseline intervention session and completed a 16-item acceptability measure. Ratings were positive, with item means ranging from 3.60-4.75 on a 5-point scale. Student responses to open-ended questions aided in the enhancement of the intervention, for which an effectiveness trial begins in September 2006. This formative work demonstrated the acceptability of this school-based intervention approach, which can be promoted and prescribed by school nurses. Further, if found effective, it can be disseminated as an efficient, low-cost, population-based approach designed to address the epidemic of obesity.

Obesity Prevention at the Elementary School Level

Assessments

Assessments of the Transtheoretical Model constructs (stage of change, pros and cons, self-efficacy, and processes of change) have been developed and validated for elementary school students for physical activity, fruit and vegetable consumption, and limited TV viewing. These assessments are available for purchase.

Family Guide

This short guide offers parents and guardians information on critical behaviors for promoting energy balance and preventing obesity among youth including physical activity, fruit and vegetable consumption, and limited TV viewing. Family members are offered guidance on assessing how ready their child is to meet national guidelines for these behaviors. Tips for encouraging healthy lifestyles at home are offered.

Training

Pro-Change staff is available to conduct half day trainings on incorporating the Transtheoretical Model of Behavior Change into youth wellness programs and curriculum. Background on the model, information on assessing the stage of readiness of the youth to do the target behaviors, and ideas for incorporating stage-matched messages and activities into your program are offered.