Dissemination of an Adolescent Obesity Prevention Intervention to Louisiana Schools (ProudMe)

This project aims to test the effectiveness and implementation of an adolescent obesity prevention intervention called ProudMe. The study recruits 480 adolescents from 12 middle schools (cluster-randomized to 6 ProudMe schools vs 6 wait-list control schools) and expect to observe improvements of obesity-prevention behaviors and weight status in the ProudMe group compared to the control. The investigators also collect mixed-methods data from 24 school implementers at the 6 ProudMe schools and expect to observe appropriate levels of adaptation, fidelity, reach, penetration, and sustainability, with manageable time and financial cost.

Study Overview

• Status: Enrolling by invitation
• Conditions: Waitlist Control; Treatment (ProudMe)
• Intervention / Treatment: Behavioral: ProudMe; Behavioral: Waitlist Control

Detailed Description

The Louisiana-based, 12-week, multi-level, multi-component, ecological intervention is called Preventing Obesity Using Digital-assisted Movement and Eating (ProudMe). Guided by robust theories and prior work, this project involves multiple trained student researchers to address two specific aims.

Aim 1: to test the effectiveness of the ProudMe intervention in Louisiana middle schools. Informed by power analysis (80% statistical power), the study recruits 480 adolescents from 12 middle schools (cluster-randomized to 6 ProudMe schools vs 6 wait-list control schools). Quantitative data on obesity-prevention behaviors (i.e., physical activity, screen-based sedentary behavior, diet behaviors) and weight status (i.e., body mass index z score, waist circumference) are collected from all adolescent participants using validated instruments and procedures. The investigators hypothesize the multi-level modeling analyses to show improvements of obesity-prevention behaviors and weight status in the ProudMe group compared to a waist-list control, after controlling for sociodemographic factors at multiple ecological levels.

Aim 2: to test the implementation outcomes of the ProudMe intervention in Louisiana middle schools. The investigators collect mixed-methods data from 24 school implementers (i.e., teachers, administrators, and staff), 96 adolescents, and 96 parents at the 6 ProudMe schools, to capture adaptation and implementation indicators. The investigators evaluate the adaptations made across three phases (early, mid, late) of the implementation (i.e., what, at what level, when, how, why, by whom, and impact to intervention). In addition, the investigators assess reach, fidelity, penetration, sustainability, and cost of the implementation across early, mid, and late phases of the implementation. The investigators expect the ProudMe schools to show appropriate levels of adaptation, fidelity, reach, penetration, and sustainability, with manageable time and financial cost.

Building on previously funded work (e.g., R21HD090513, PI: Dr. Chen), this project is led by a strong, collaborative, transdisciplinary team with experts from kinesiology, developmental psychology, nutrition, childhood obesity, computer science, statistics, and implementation science. The project significantly strengthens the research environment of the Louisiana State University (LSU) - a primarily undergraduate student serving institution under-funded by the NIH. The project creates unique opportunities that are otherwise unavailable for LSU students who aspire to seek advanced education or careers in biomedical and health fields.

• Study Type: Interventional
• Enrollment (Estimated): 480
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Louisiana
    • Baton Rouge, Louisiana, United States, 70803
      • LSU Pedagogical Kinesiology Lab

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Students enrolled in 6th, 7th, or 8th grades in participating schools.
• Students with parental consent and child assent.

Exclusion Criteria:

• Students enrolled in grades other than 6th, 7th, or 8th grades
• Students in non-participating schools.
• Students without parental consent and child assent.
• Students without adequate readiness for physical activity.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: ProudMe; The ProudMe condition involves three key components: (a) artificial intelligence (AI)-assisted behavior management system (i.e., ProudMe Tech), (b) ProudMe physical/health education (PE) and lunchroom reform (ProudMe Cafeteria), (c) customized implementation training (ProudMe Training).	Behavioral: ProudMe; ProudMe Tech: Regular human/computer interaction (3-5 times per week) to engage in SMART goal-setting, behavior monitoring, and self-reflection as assisted by AI-enabled feedback. ProudMe Physical Education [PE]: 12 lessons to acquire knowledge, skill, and dispositions to improve physical activity, diet, screen-based sedentary behaviors. ProudMe Cafeteria: Purposely enabling policy and environmental changes in school cafeteria (recognize areas of strengths and weaknesses; set goals and action plans; make changes to improve scores assessed by the Smarter Lunchroom Scorecard). ProudMe Training: 4-hour implementation training + regular check-in and support (via motivational interviewing techniques)
Active Comparator: Waitlist Control; The waitlist control involves (a) regular physical/health education and lunchroom, (b) professional development training on the importance of quality physical/health education, health eating and foot environment. It does not involve AI-assisted behavior management system.	Behavioral: Waitlist Control; The waitlist control involves (a) regular physical/health education and lunchroom, (b) professional development training on the overall importance of quality physical/health education, health eating and foot environment. It does not involve AI-assisted behavior management system.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physical activity: NHANES physical activity recall question, Leisure-Time Exercise Questionnaire, ActiGraph accelerometers	Self-reported screen time	12 weeks
Screen time	a screen time questionnaire	12 weeks
Food environment	Parent-reported Food Frequency Questionnaire	12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Body mass index z score	Body mass index (BMI) z scores and BMI scores are converted by weight and height. Body weight is measured to the nearest 0.1kg with a calibrated Seca Model 770 scale. Raw BMI score is calculated from height and body weight as follows: BMI (kg/m2) = Body weight (kg) / Height (m)2. BMI-z score is calculated to examine how many standard deviations adolescents' BMI is above or below the average BMI value for their age group and gender.	12 weeks
Waist circumference	Waist circumference at the umbilicus is assessed to the nearest 0.5cm using a constant tension tape.	12 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Activity self-efficacy	An individual-level covariate. Activity self-efficacy refers to adolescents' belief in their capability to participate in physical activity despite barriers. Adolescent participants will complete an 8-item activity self-efficacy measure, to assess activity self-efficacy during free time on most days overall, despite barriers (screen time, weather, location, schedule, social support).	12 weeks
Self-monitoring	An individual-level covariate. Adolescent participants set up daily goals for physical activity, screen time, dietary behaviors, and sleep; track their behavior efforts, and evaluate goal attainment on the ProudMe Tech system.	3-5 times per week over 12 weeks
Social support	An interpersonal-level covariate. To assess the sources and types of social support.	12 weeks
School Wellness Policy	The Wellness School Assessment Tool 3.0 (WellSAT 3.0) to assess environmental/policy changes in schools (pre to post tests).	12 weeks
Cafeteria Nutrition	School Cafeteria Nutrition Assessment (SCNA) to evaluate the lunch menus and observe foods offered in the cafeteria (monthly).	12 weeks

Collaborators and Investigators

• Sponsor: Louisiana State University and A&M College
• Collaborators: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); University of Nevada, Las Vegas; Pennington Biomedical Research Center; Texas A&M University

Study record dates

Study Major Dates

• Study Start (Actual): February 19, 2024
• Primary Completion (Estimated): December 1, 2025
• Study Completion (Estimated): April 1, 2026

Study Registration Dates

• First Submitted: February 26, 2024
• First Submitted That Met QC Criteria: March 21, 2024
• First Posted (Actual): March 28, 2024

Study Record Updates

• Last Update Posted (Actual): March 28, 2024
• Last Update Submitted That Met QC Criteria: March 21, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Overnutrition; Nutrition Disorders; Overweight; Body Weight; Obesity; Pediatric Obesity
• Other Study ID Numbers: IRBAM-21-0702; 1R15HD108765-01A1 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No