Get Fruved: Obesity Prevention for Older Adolescents
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Obesity Weight Loss |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | Any - 24 |
| Updated: | 10/17/2018 |
| Start Date: | August 2014 |
| End Date: | July 2019 |
"Get Fruved:" A Peer-led, Train-the-trainer Social Marketing Intervention to Increase Fruit and Vegetable Intake and Prevent Childhood Obesity.
This program is a non-diet approach to obesity prevention for older adolescents which does
not promote following a special diet to manage weight; instead, it promotes healthy behavior
associated with obesity prevention. This approach is especially important with youth and
older adolescent populations so as to avoid impairment in emotional well-being associated
with body dissatisfaction. Healthy weight status will be achieved by improving dietary intake
patterns, increasing physical activity, and improving stress management.
Fall of year 01 was devoted to the recruitment of student partners (intense intervention
group) and the development of partnerships. In the spring of year 01, recruited students were
enrolled in two newly developed undergraduate courses across four intervention state
partners, became collegiate 4-H members, planned a social marketing campaign, and/or learned
to be peer mentors or student researchers. In year 02, first year college students were
recruited, peer mentors were matched with a group of first year students, and the developed
social marketing campaign was pilot tested on four college campuses (diffuse intervention) by
the collegiate 4-H teams. In year 02, a toolkit with 24 weeks of intervention activities was
also refined. In year 03, the collegiate 4-H team (intense intervention group) will use the
refined toolkit to test and implement the intervention on college campuses. In year 03, the
assessment process for high school 4-H students (intense intervention group) will be pilot
tested and college students will work with the high school students on adapting the toolkit
for use in the implementation of the social marketing campaign in high school settings in
year 04 (diffuse intervention). In year 04, the college tool kit will be disseminated to
additional college campuses. In year 05, the program will be disseminated to additional high
schools.
The nine month interactive, social marketing environmental intervention will aid older
adolescents in effectively managing weight through increasing healthfulness of diet,
increased physical activity, and improved stress management behavior as compared to a control
group. On all measures it is anticipated that participants in the intensive intervention
group will have greater improvements than those in the diffuse intervention group and both
intensive and diffuse intervention groups will have improvements over those in the control
groups.
not promote following a special diet to manage weight; instead, it promotes healthy behavior
associated with obesity prevention. This approach is especially important with youth and
older adolescent populations so as to avoid impairment in emotional well-being associated
with body dissatisfaction. Healthy weight status will be achieved by improving dietary intake
patterns, increasing physical activity, and improving stress management.
Fall of year 01 was devoted to the recruitment of student partners (intense intervention
group) and the development of partnerships. In the spring of year 01, recruited students were
enrolled in two newly developed undergraduate courses across four intervention state
partners, became collegiate 4-H members, planned a social marketing campaign, and/or learned
to be peer mentors or student researchers. In year 02, first year college students were
recruited, peer mentors were matched with a group of first year students, and the developed
social marketing campaign was pilot tested on four college campuses (diffuse intervention) by
the collegiate 4-H teams. In year 02, a toolkit with 24 weeks of intervention activities was
also refined. In year 03, the collegiate 4-H team (intense intervention group) will use the
refined toolkit to test and implement the intervention on college campuses. In year 03, the
assessment process for high school 4-H students (intense intervention group) will be pilot
tested and college students will work with the high school students on adapting the toolkit
for use in the implementation of the social marketing campaign in high school settings in
year 04 (diffuse intervention). In year 04, the college tool kit will be disseminated to
additional college campuses. In year 05, the program will be disseminated to additional high
schools.
The nine month interactive, social marketing environmental intervention will aid older
adolescents in effectively managing weight through increasing healthfulness of diet,
increased physical activity, and improved stress management behavior as compared to a control
group. On all measures it is anticipated that participants in the intensive intervention
group will have greater improvements than those in the diffuse intervention group and both
intensive and diffuse intervention groups will have improvements over those in the control
groups.
The goal of the research is to develop a novel strategy to promote healthy behaviors
associated with obesity prevention in older adolescent populations. A community based
participatory research (CBPR) approach is used with partnerships among older adolescents,
university researchers and faculty, and Extension partners. The objective is to test the
effectiveness of a peer-led, train-the-trainer intervention. The intervention is an
interactive, non-traditional social marketing, online media, and environmental change
approach seeking to promote healthy behavior with communities of college and high school
students. Specific health behaviors targeted include increasing intakes of fruits and
vegetables, decreasing foods high in saturated fats and added sugars, managing stress, and
increasing physical activity. This project uniquely 1) increases participant engagement
through creative interactions, participant-created content, and incorporation of
age-appropriate technology; 2) incorporates social environments and peer-led strategies; and
3) simultaneously addresses changes in environments to support participant-driven behavior
change efforts.
This project is a Pretest-Posttest, Control Group Trial using a nested cohort design with
three conditions (intense intervention, diffuse intervention, and control), four control
universities and four intervention universities in years 01- 03, one high school as control
and one as intervention at each of the four intervention university towns in years 03-04, and
disseminated to four additional university and high school pairs in years 04-05.
A CBPR, peer-led approach is used in that upper level college students mentor freshmen 4-H
college students through the development of the intervention. The CBPR, peer-led approach
continues when the now sophomore 4-H college students implement the intervention with
incoming college freshmen in the following year. The train-the-trainer approach is utilized
when the now junior level 4-H college students mentor 4-H high school students in the
modification of the intervention for high schools. The approach continues when 4-H high
school students implement the intervention with incoming freshmen in high schools.
In the fall of year 01, 283 freshman students were recruited from general/survey nutrition
courses at the four intervention universities to participate in a special undergraduate
spring course (the intense intervention group). 94 freshman students were also recruited from
general/survey nutrition courses at the four control universities. During the fall,
researchers at the intervention schools worked with nutrition (graduate and undergraduate)
students to identify and develop partnerships with student organizations for the development
of a social marketing health promotion campaign. Researchers and student partners also worked
with local high schools (including student organizations, school food service, Parent Teacher
Associations, school wellness committees, and administration) and school boards to formalize
research agreements and relationships.
In the spring of year 01, as a part of the newly developed undergraduate course, the freshman
students (the intense intervention group) from each intervention university joined their
collegiate 4-H program. The courses were offered as independent studies or as a newly
developed course through the respective University's PI. The course covered principals of
social marketing for health behavior change. University researchers and Extension faculty
collaborated and taught in-person classes with their respective collegiate 4-H students.
Collegiate 4-H students were co-taught (by all four University's research and Extension
faculty) and had the opportunity to interact with the other collegiate 4-H students from all
four intervention universities through web-based technologies. Throughout the course, the
collegiate 4-H students developed and planned a social marketing campaign. Following a
peer-led approach, the 4-H students partnered with and were mentored by upper-level nutrition
students and student organizations (student partners) in the development and planning of the
campaign.
In year 02, the now sophomore collegiate 4-H students in the intense intervention group
(receiving hourly compensation) worked with student partners to implement the developed
nine-month social marketing campaign. The campaign centered around five costumed characters
(Spinach, Carrot, Banana, Grapes, and Tomato). Characters interacted with students on campus
in freshmen residence halls, dining halls/cafeterias and highly trafficked public areas on
campus. Photos and videos of interactions were put on the website (www.fruved.com), Facebook,
twitter, YouTube, Snap Chat, and Instagram. Online educational modules (focused on healthy
diet patterns, physical activity, and stress management) will also become available on the
website. Student participants from the general freshman population were asked to set weekly
healthy goals related to diet, physical activity, and stress management throughout the
campaign and receive email and/or text messages with goal-specific written and video health
promotion messages. Extension faculty and staff partnered with the collegiate 4-H student
teams throughout the intervention process to educate and give advice on the content of health
promotion messages. Throughout the campaign, collegiate 4-H students worked with researchers
to assess the healthiness of their campus environments using a previously developed Healthy
Campus Audit and advocated for changes to the physical and food environment.
In year 02, a random sample of 1,153 freshmen (the diffuse intervention group), determined by
screening to be at increased health risk were recruited from the eight universities (four
intervention and four control). The collegiate 4-H students (the intense intervention group)
and the same students from the control schools recruited in year 01 were reassessed.
In year 03, the collegiate 4-H team (intense intervention group) will use the refined toolkit
to test and implement the intervention on college campuses. The sustainability of observed
changes at the individual and environmental college level will be assessed by conducting
follow-up assessments with the students in the intervention (the diffuse intervention group)
and control sites at colleges in year 03. The collegiate 4-H students (the intensive
intervention group) leading the project at the high school level and the same students from
the control schools recruited in year 01 will be reassessed at the beginning of fall year 03,
and end of spring year 03. Also in year 03, the assessment process for high school 4-H
students (intense intervention group) will be piloted tested and college students will work
with the high school students on adapting the toolkit for use in the implementation of the
social marketing campaign in high school settings (diffuse intervention).
In year 04, two high schools in each of the four intervention University states will be
recruited to participate in the research process and will be randomized to control and
intervention. High schools in each state will be matched by size and community composition
and geographically separated to prevent potential exposure to the campaign. Following the
train-the-trainer model, teams of now junior collegiate 4-H students (the intense
intervention group) will mentor teams of high school 4-H students (the intense intervention
group) at each of the intervention sites in the development and implementation of the Fruved
campaign in the high school environment. In the fall, collegiate students will work with the
high school students (the intense intervention group) to modify the campaign to meet the age
and cultural needs of a high school audience and plan the specific campaign components. The
high school 4-H teams will partner with their school's food service, Parent Teacher
Association (PTA), school Wellness committee, and school administration throughout the
campaign development, implementation, and evaluation. The campaign will be conducted in the
intervention high schools over the remaining nine-month school year.
In year 04, a random sample of 331 freshman high school students (the diffuse intervention
group) will be recruited from the intervention high schools and a random sample of 331
freshman high school students (the control group) from the control high schools in each of
the four intervention University town areas. Assessments will take place in early fall and
late spring. The 4-H high school students (intensive intervention group) recruited to
participate in the design and implementation phases of the project will also be assessed in
early fall/late spring in year 04.
Also in year 04, to continue to assess the sustainability of observed changes at the
individual and environmental high school level, participants will be assessed by conducting
follow-up assessments with the students in the intensive intervention group and control sites
in high schools. The collegiate 4-H students (the intensive intervention group) that lead the
project at the high school level and the same students from the control schools recruited in
year 01 will be reassessed at the beginning of fall year 04 and end of spring year 04.
In year 04-05, materials will be developed allowing the project to be further disseminated to
other college and high school environments. Four additional college and high school pairs
will be recruited to participate in the dissemination phase. In year 04 the college students
will receive training materials, study manual, costumes, cameras, and a small implementation
budget but will not receive support for incentives or student 4-H compensation. The campaign
will be developed and implemented over one school year. A modified project assessment will be
required to be completed by the collegiate student 4H groups. In year 05 the collegiate 4-H
students will work with high school 4-H students to develop and implement the project in high
schools. The high school 4-H student group will complete the modified project assessments.
The nine month interactive, social marketing environmental intervention will aid older
adolescents in effectively preventing obesity through increasing healthfulness of diet,
increased physical activity, and improved stress management behavior as compared to a control
group. On all measures it is anticipated that participants in the intensive intervention
group will have greater improvements than those in the diffuse intervention group and both
intensive and diffuse intervention groups will have improvements over those in the control
groups. Students participating in the intervention will more effectively manage their weight
than those in the non-intervention control condition; those participating in the intervention
will improve intermediary outcomes related to diet, physical activity, and improved stress
management to a greater extent than those in the control condition; and environments at
intervention sites will show health behavior-supportive changes as compared to control sites.
Since there are more than two time intervals in the design, General Linear Modeling will be
used to analyze for changes in physical assessments, specifically a mixed-model Analysis of
variance and covariance (ANCOVA) if the group-specific slopes are homogeneous. A wide range
of analyses will be employed to analyze the influence of the intervention on secondary
outcomes, including multivariate analyses of variance (MANOVA), ANOVAs, and logistic
regression. Significant ANOVAs will be followed up with tests of simple and main effects as
appropriate. The intervention group-by-occasions interaction test will assess the impact of
the intervention in the treatment group relative to the control group across time on the
secondary outcome measures.
associated with obesity prevention in older adolescent populations. A community based
participatory research (CBPR) approach is used with partnerships among older adolescents,
university researchers and faculty, and Extension partners. The objective is to test the
effectiveness of a peer-led, train-the-trainer intervention. The intervention is an
interactive, non-traditional social marketing, online media, and environmental change
approach seeking to promote healthy behavior with communities of college and high school
students. Specific health behaviors targeted include increasing intakes of fruits and
vegetables, decreasing foods high in saturated fats and added sugars, managing stress, and
increasing physical activity. This project uniquely 1) increases participant engagement
through creative interactions, participant-created content, and incorporation of
age-appropriate technology; 2) incorporates social environments and peer-led strategies; and
3) simultaneously addresses changes in environments to support participant-driven behavior
change efforts.
This project is a Pretest-Posttest, Control Group Trial using a nested cohort design with
three conditions (intense intervention, diffuse intervention, and control), four control
universities and four intervention universities in years 01- 03, one high school as control
and one as intervention at each of the four intervention university towns in years 03-04, and
disseminated to four additional university and high school pairs in years 04-05.
A CBPR, peer-led approach is used in that upper level college students mentor freshmen 4-H
college students through the development of the intervention. The CBPR, peer-led approach
continues when the now sophomore 4-H college students implement the intervention with
incoming college freshmen in the following year. The train-the-trainer approach is utilized
when the now junior level 4-H college students mentor 4-H high school students in the
modification of the intervention for high schools. The approach continues when 4-H high
school students implement the intervention with incoming freshmen in high schools.
In the fall of year 01, 283 freshman students were recruited from general/survey nutrition
courses at the four intervention universities to participate in a special undergraduate
spring course (the intense intervention group). 94 freshman students were also recruited from
general/survey nutrition courses at the four control universities. During the fall,
researchers at the intervention schools worked with nutrition (graduate and undergraduate)
students to identify and develop partnerships with student organizations for the development
of a social marketing health promotion campaign. Researchers and student partners also worked
with local high schools (including student organizations, school food service, Parent Teacher
Associations, school wellness committees, and administration) and school boards to formalize
research agreements and relationships.
In the spring of year 01, as a part of the newly developed undergraduate course, the freshman
students (the intense intervention group) from each intervention university joined their
collegiate 4-H program. The courses were offered as independent studies or as a newly
developed course through the respective University's PI. The course covered principals of
social marketing for health behavior change. University researchers and Extension faculty
collaborated and taught in-person classes with their respective collegiate 4-H students.
Collegiate 4-H students were co-taught (by all four University's research and Extension
faculty) and had the opportunity to interact with the other collegiate 4-H students from all
four intervention universities through web-based technologies. Throughout the course, the
collegiate 4-H students developed and planned a social marketing campaign. Following a
peer-led approach, the 4-H students partnered with and were mentored by upper-level nutrition
students and student organizations (student partners) in the development and planning of the
campaign.
In year 02, the now sophomore collegiate 4-H students in the intense intervention group
(receiving hourly compensation) worked with student partners to implement the developed
nine-month social marketing campaign. The campaign centered around five costumed characters
(Spinach, Carrot, Banana, Grapes, and Tomato). Characters interacted with students on campus
in freshmen residence halls, dining halls/cafeterias and highly trafficked public areas on
campus. Photos and videos of interactions were put on the website (www.fruved.com), Facebook,
twitter, YouTube, Snap Chat, and Instagram. Online educational modules (focused on healthy
diet patterns, physical activity, and stress management) will also become available on the
website. Student participants from the general freshman population were asked to set weekly
healthy goals related to diet, physical activity, and stress management throughout the
campaign and receive email and/or text messages with goal-specific written and video health
promotion messages. Extension faculty and staff partnered with the collegiate 4-H student
teams throughout the intervention process to educate and give advice on the content of health
promotion messages. Throughout the campaign, collegiate 4-H students worked with researchers
to assess the healthiness of their campus environments using a previously developed Healthy
Campus Audit and advocated for changes to the physical and food environment.
In year 02, a random sample of 1,153 freshmen (the diffuse intervention group), determined by
screening to be at increased health risk were recruited from the eight universities (four
intervention and four control). The collegiate 4-H students (the intense intervention group)
and the same students from the control schools recruited in year 01 were reassessed.
In year 03, the collegiate 4-H team (intense intervention group) will use the refined toolkit
to test and implement the intervention on college campuses. The sustainability of observed
changes at the individual and environmental college level will be assessed by conducting
follow-up assessments with the students in the intervention (the diffuse intervention group)
and control sites at colleges in year 03. The collegiate 4-H students (the intensive
intervention group) leading the project at the high school level and the same students from
the control schools recruited in year 01 will be reassessed at the beginning of fall year 03,
and end of spring year 03. Also in year 03, the assessment process for high school 4-H
students (intense intervention group) will be piloted tested and college students will work
with the high school students on adapting the toolkit for use in the implementation of the
social marketing campaign in high school settings (diffuse intervention).
In year 04, two high schools in each of the four intervention University states will be
recruited to participate in the research process and will be randomized to control and
intervention. High schools in each state will be matched by size and community composition
and geographically separated to prevent potential exposure to the campaign. Following the
train-the-trainer model, teams of now junior collegiate 4-H students (the intense
intervention group) will mentor teams of high school 4-H students (the intense intervention
group) at each of the intervention sites in the development and implementation of the Fruved
campaign in the high school environment. In the fall, collegiate students will work with the
high school students (the intense intervention group) to modify the campaign to meet the age
and cultural needs of a high school audience and plan the specific campaign components. The
high school 4-H teams will partner with their school's food service, Parent Teacher
Association (PTA), school Wellness committee, and school administration throughout the
campaign development, implementation, and evaluation. The campaign will be conducted in the
intervention high schools over the remaining nine-month school year.
In year 04, a random sample of 331 freshman high school students (the diffuse intervention
group) will be recruited from the intervention high schools and a random sample of 331
freshman high school students (the control group) from the control high schools in each of
the four intervention University town areas. Assessments will take place in early fall and
late spring. The 4-H high school students (intensive intervention group) recruited to
participate in the design and implementation phases of the project will also be assessed in
early fall/late spring in year 04.
Also in year 04, to continue to assess the sustainability of observed changes at the
individual and environmental high school level, participants will be assessed by conducting
follow-up assessments with the students in the intensive intervention group and control sites
in high schools. The collegiate 4-H students (the intensive intervention group) that lead the
project at the high school level and the same students from the control schools recruited in
year 01 will be reassessed at the beginning of fall year 04 and end of spring year 04.
In year 04-05, materials will be developed allowing the project to be further disseminated to
other college and high school environments. Four additional college and high school pairs
will be recruited to participate in the dissemination phase. In year 04 the college students
will receive training materials, study manual, costumes, cameras, and a small implementation
budget but will not receive support for incentives or student 4-H compensation. The campaign
will be developed and implemented over one school year. A modified project assessment will be
required to be completed by the collegiate student 4H groups. In year 05 the collegiate 4-H
students will work with high school 4-H students to develop and implement the project in high
schools. The high school 4-H student group will complete the modified project assessments.
The nine month interactive, social marketing environmental intervention will aid older
adolescents in effectively preventing obesity through increasing healthfulness of diet,
increased physical activity, and improved stress management behavior as compared to a control
group. On all measures it is anticipated that participants in the intensive intervention
group will have greater improvements than those in the diffuse intervention group and both
intensive and diffuse intervention groups will have improvements over those in the control
groups. Students participating in the intervention will more effectively manage their weight
than those in the non-intervention control condition; those participating in the intervention
will improve intermediary outcomes related to diet, physical activity, and improved stress
management to a greater extent than those in the control condition; and environments at
intervention sites will show health behavior-supportive changes as compared to control sites.
Since there are more than two time intervals in the design, General Linear Modeling will be
used to analyze for changes in physical assessments, specifically a mixed-model Analysis of
variance and covariance (ANCOVA) if the group-specific slopes are homogeneous. A wide range
of analyses will be employed to analyze the influence of the intervention on secondary
outcomes, including multivariate analyses of variance (MANOVA), ANOVAs, and logistic
regression. Significant ANOVAs will be followed up with tests of simple and main effects as
appropriate. The intervention group-by-occasions interaction test will assess the impact of
the intervention in the treatment group relative to the control group across time on the
secondary outcome measures.
Inclusion criteria:
- Students in the intensive intervention group must be registered for a general/survey
nutrition or wellness course
- Students in the diffuse intervention group randomly selected from those who screen in
because they are at increased health risk (increased BMI and waist circumference, low
intakes of fruits and vegetables, high levels of stress, and low levels of physical
activity)
Exclusion criteria:
- There are no exclusionary criteria for students in the intensive intervention group
- Students who are not at-risk for health issues are excluded from the diffuse
intervention group
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