Nurse and Teacher Led Adolescent Healthy Weight Classes to Improve Health Behaviors.

摘要

Problem Statement: Weight management is a public health problem affecting adolescents across the United States that negatively impacts their current and future physical, social, and behavioral health. Rapid implementation of efficient and sustainable interventions is necessary to manage the problem.;Purpose: The purpose of this study was to examine the feasibility and initial efficacy of using a weight management intervention that was school-based, evidence-based, and developmentally appropriate to help adolescents develop and maintain healthy nutrition and physical activity behaviors and improve their adiposity and weight status.;Methods: This feasibility and initial efficacy study used a single group repeated measures design. The sample consisted of African American, non-Hispanic white and bilingual Hispanic adolescents enrolled at the Just Right Academy in Durham, North Carolina. The participants received a healthy nutrition and physical activity education and exercise intervention. The intervention included a 7-week series of a 45-60 minute, nurse-led and classroom teacher assisted, evidence-based, and developmentally appropriate nutrition and physical activity education and exercise classes offered twice a week, for a total of 14 classes. Data were collected before the intervention started at Time 1 (baseline), at Time 2 (after completion of the intervention), and Time 3 (after three months without contact from the study staff). Data collected included height, weight, body mass index (BMI) percentiles, and adiposity (waist circumference and triceps and subscapular skinfolds). Health behavior information and changes were collected using the Child Health Behavior Survey, physical activity logs, and parental and schoolteachers' interviews.;Analysis: Descriptive data analyses and correlations were conducted but interpreted conservatively, considering the small sample size and methodology as a feasibility and initial efficacy study. Paired t-tests were run on weight, adiposity, nutrition and physical activity data from Time 1 to Time 2 and Time 1 to Time 3 to examine changes in weight, adiposity and health behaviors across time.;Results: As expected participants mean height increased from Time 1 to Time 2. However, at Time 3 mean height decreased, which was most likely secondary to several students who were quite tall left the school, and we were unable to contact them for the Time 3 data collection. There was a significant increase in weight and BMI percentile at both Time 2 and Time 3. The BMI percentile measurements indicated that during the Time 1 measurement 1 of 15 students was underweight, 6 of 15 students were normal weight, 4 of 15 students were overweight, and 4 of 15 were obese. During the Time 2 measurement 7 of 14 students were normal weight, 3 of 14 students were overweight, and 4 of 15 were obese. During Time 3 measurement 1 of 12 students was underweight, 3 of 12 students were normal weight, 3 of 12 students were overweight, and 5 of 12 were obese. There was no significant decrease in triceps or subscapular skinfolds at Time 2 or Time 3. There was a significant decrease in waist circumference at Time 2 and Time 3. Interview feedback, low cost, and successful completion of all planned activities indicated that students, parents, and school staff believed that the project was beneficial and suitable for their school. The intervention faced no notable barriers and had no cost for the school. The cost for the researcher included only printing (;Significance: The results of this study suggest that an evidence-based and developmentally appropriate weight management intervention is acceptable and feasible in a non-traditional school setting. Management of adiposity and weight in adolescents may improve their physical, social, and health behaviors and contribute to their overall wellness. Further study is needed to determine efficacy towards behavior change and weight management more accurately.