Summer Youth Employment Programs for Health Promotion

Leveraging Summer Youth Employment Programs to Prevent Obesity in Adolescents

The purpose of this proof-of-concept study is to assess the initial signal of effectiveness of summer youth employment programs (SYEP) on understudied obesity-related outcomes in adolescents. This small-scale study is essential to identify early success and refine the intervention before scaling to a larger, more resource-intensive randomized trial. Specifically, this one-group pre-posttest study will:

Aim 1 (Primary): Evaluate if a 6-week SYEP provides an initial signal for effectiveness (maintenance or decrease in zBMI) over the summer.

Hypothesis 1: Adolescents who participated in a SYEP will maintain or decrease their BMI over the summer.

Aim 2 (Secondary): Evaluate changes in obesogenic behaviors (physical activity, sleep, sedentary, and diet) over the summer.

Hypothesis 2: Adolescents who participated in a SYEP will increase physical activity, reduce sedentary behavior, and improve sleep and diet quality over the summer.

Aim 3 (Secondary): Evaluate the feasibility of SYEP for obesity prevention intervention to inform intervention scalability.

Hypothesis 3: The SYEP program will be a feasible and acceptable intervention strategy for the prevention of obesity in adolescents over the summer.

Study Overview

• Status: Completed
• Conditions: Obesity, Childhood; Healthy Lifestyle; Behavior, Health
• Intervention / Treatment: Behavioral: Summer Youth Employment Program

Detailed Description

Preliminary evidence suggests that summer employment can be an age-appropriate, structured intervention to prevent unhealthy changes in obesogenic behaviors among adolescents. While these findings are promising, none of the existing studies have measured changes in BMI over the summer or conducted comprehensive assessments of obesogenic behaviors, including diet, sedentary behavior, sleep, and physical activity. To address these gaps, this study proposes a small proof-of-concept study to assess the initial signal of effectiveness on understudied obesity-related outcomes in adolescents.

SYEPs are well-established, continuously operating initiatives over 60 years with proven benefits in academics, workforce development, and crime prevention, and may also act as obesity prevention strategies. Rather than creating new interventions, investing in and expanding access to SYEPs-programs with high demand yet limited capacity (with only ~28% of applicants matched with jobs each summer, leaving the majority on waitlists)-can offer a practical solution for youth obesity prevention.

• Study Type: Interventional
• Enrollment (Actual): 15
• Phase: Early Phase 1

Contacts and Locations

Study Locations

• United States
  • Texas
    • Houston, Texas, United States, 77204
      • University of Houston

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Age 14-17 years at the time of enrollment, in accordance with Texas Child Labor Law
• Willing to work at the summer camp for six consecutive weeks
• Able to pass the employment admission procedure (job interview)
• Able to obtain parental consent and provide assent for study participation

Exclusion Criteria:

• Currently pregnant or planning to become pregnant, due to physical activity restrictions and potential weight changes that could confound study results
• Diagnosis of an intellectual and/or physical disability requiring specialized employment regulations or intervention strategies
• Participation in a health promotion intervention within the past six months

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Summer Youth Employment Program; Participants will work as junior summer camp counselors at a University of Houston camp, up to 24 hours/week, Monday-Thursday, 8:30 AM-3:30 PM (with a 12-1 PM lunch break), for six weeks from mid-June to the end of July. Participants will assist senior counselors with indoor/outdoor activities such as games, enrichment, and academics. On Fridays, from 10 AM to 12 PM, participants will attend professional development workshops on topics such as communication, teamwork, resume building, and job search skills. From 12-2:30 PM, undergraduate staff will lead social activities and mentoring.

Behavioral: Summer Youth Employment Program; The intervention aims to employ adolescents in paid positions for six weeks during the summer, providing them with a structured, routine-based, and adult-supervised environment similar to that of the school year.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Age- and Sex-Specific Body Mass Index (BMI)-For-Age Z-Score (zBMI) From Baseline to Week 6	Height and weight will be directly measured by trained staff. Each measurement will be taken twice, and the average will be used for analysis. Body mass index (BMI) will be calculated and expressed as Centers for Disease Control and Prevention (CDC) age- and sex-specific BMI-for-age z-scores (zBMI). The outcome will represent the change in zBMI from baseline to Week 6. A positive change score will indicate an increase (gain) in zBMI from baseline to Week 6, which will be considered a less favorable outcome. A negative change score will indicate a decrease in zBMI, which will be considered a favorable outcome. A change score of 0 will indicate no change in zBMI (maintenance), which will also be considered a favorable outcome for this intervention because preventing excess BMI gain during summer is a primary goal.	Baseline and Week 6 (post)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Sedentary Behavior From Baseline to Week 6	Sedentary behavior will be measured in minutes per day using a wrist-worn ActiGraph GT3X accelerometer on the non-dominant wrist over 8 consecutive days, including at least 2 valid weekdays and 1 valid weekend day. Activity intensities will be classified using cut points published by Hildebrand et al. The reported outcome will be the change in average daily sedentary behavior (minutes/day) from baseline to Week 6. A positive change score will indicate an increase in sedentary behavior, which will be considered an unfavorable outcome. A negative change score will indicate a decrease in sedentary behavior, which will be considered a favorable outcome. A change score of 0 will indicate no change in sedentary behavior (maintenance).	Baseline and Week 6 (post)
Change in Moderate-to-Vigorous Physical Activity (MVPA) From Baseline to Week 6	Moderate-to-vigorous physical activity (MVPA) will be measured in minutes per day using a wrist-worn ActiGraph GT3X accelerometer on the non-dominant wrist over 8 consecutive days, including at least 2 valid weekdays and 1 valid weekend day. Activity intensities will be classified using cut points published by Hildebrand et al. The reported outcome will be the change in average daily MVPA (minutes/day) from baseline to Week 6. A positive change score will indicate an increase in MVPA, which will be considered a favorable outcome. A negative change score will indicate a decrease in MVPA, which will be considered an unfavorable outcome. A change score of 0 will indicate no change in MVPA (maintenance), which will also be considered a favorable outcome.	Baseline and Week 6 (post)
Change in Sleep Duration From Baseline to Week 6	Sleep duration will be measured in minutes per day using a wrist-worn ActiGraph GT3X accelerometer on the non-dominant wrist over 8 consecutive days, including at least 2 valid weekdays and 1 valid weekend day. Sleep duration will be estimated using the heuristic algorithm looking at the distribution of change in Z-Angle (HDCZA). The reported outcome will be the change in average daily sleep duration (minutes/day) from baseline to Week 6. A positive change score will indicate an increase in sleep duration, which will be considered a favorable outcome. A negative change score will indicate a decrease in sleep duration, which will be considered an unfavorable outcome. A change score of 0 will indicate no change in sleep duration (maintenance), which will also be considered a favorable outcome.	Baseline and Week 6 (post)
Change in Screen Time From Baseline to Week 6	Screen time in hours and minutes (e.g., television, computer, video games, smart phones, tablets) will assessed via self-report during each 8-day behavioral assessment period. Screen time will be calculated as the average daily duration (minutes/day) by summing total reported screen time across completed daily logbooks and dividing by the number of valid diary days within each assessment period. The reported outcome will be the change in average daily screen time (minutes/day) from baseline to Week 6. A positive change score will indicate an increase in screen time, which will be considered an unfavorable outcome. A negative change score will indicate a decrease in screen time, which will be considered a favorable outcome. A change score of 0 will indicate no change in screen time (maintenance), which will also be considered a favorable outcome.	Baseline and Week 6 (post)
Change in Unhealthy Food Intake From Baseline to Week 6	Dietary intake will be assessed using the NHANES 23-item Dietary Screener Questionnaire. Adolescents will self-report consumption of food and beverage items over the past day. For this outcome, unhealthy food items will include desserts, sugar-sweetened beverages, salty snacks, and fast food items. Responses will be used to estimate daily intake frequency (times/day) of unhealthy food consumption. The reported outcome will be the change in average daily frequency of unhealthy food intake (times/day) from baseline to Week 6. A positive change score will indicate an increase in unhealthy food intake, which will be considered an unfavorable outcome. A negative change score will indicate a decrease in unhealthy food intake, which will be considered a favorable outcome. A change score of 0 will indicate no change in unhealthy food intake (maintenance), which will also be considered a favorable outcome.	Baseline and Week 6 (post)
Recruitment Capacity (Percentage Meeting Recruitment Goal)	Recruitment capacity is the percentage meeting the recruitment goal.	Baseline
Retention	Retention will be calculated as the percentage of enrolled participants who complete both baseline and post-intervention assessments for the primary outcome measures.	Baseline and Week 6 (post)
Fidelity	Fidelity will be assessed through weekly unannounced direct observations using a structured checklist developed by the research team specifically for the intervention. The checklist will assess key components of intervention implementation, including adherence, dose delivered, quality of delivery, and participant engagement. Each item will be rated using either binary scoring (0 = not implemented, 1 = implemented) or a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree), depending on the construct. All domain scores will be standardized and converted to a percentage scale. Each intervention session will be independently rated by two trained researcher, and ratings will be averaged. Session-level fidelity scores will then be averaged across all observation weeks to produce a single fidelity score. The fidelity score will be expressed as a percentage, with higher scores indicating greater fidelity to the intervention protocol and lower scores indicating reduced fidelity.	Weekly during intervention (Weeks 1-6)
Attendance	Attendance will be calculated as the average number of days attended across total offered workdays, using employer time sheets.	Weekly during intervention (Weeks 1-6)
Acceptability	Acceptability will be assessed using a quantitative satisfaction measure administered to adolescents following intervention participation. Participants will be asked to rate their likelihood of returning as a paid counselor the following summer on a scale ranging from 1 (not at all likely) to 10 (extremely likely). Individual responses will be averaged to generate a single acceptability score. The total score will range from 1 to 10, with higher scores indicating greater acceptability and willingness to participate again, and lower scores indicating lower acceptability. Scores closer to 10 will represent high acceptability, while scores closer to 1 will represent low acceptability of the intervention experience.	Week 7 (Follow-up)
Change in Healthy Food Intake From Baseline to Week 6	Dietary intake will be assessed using the NHANES 23-item Dietary Screener Questionnaire. Adolescents will self-report consumption of food and beverage items over the past day. For this outcome, healthy food items will include fruits, vegetables, 100% fruit juice, and milk items. Responses will be used to estimate daily intake frequency (times/day) of healthy food consumption. The reported outcome will be the change in average daily frequency of healthy food intake (times/day) from baseline to Week 6. A positive change score will indicate an increase in healthy food intake, which will be considered a favorable outcome. A negative change score will indicate a decrease in healthy food intake, which will be considered an unfavorable outcome. A change score of 0 will indicate no change in healthy food intake (maintenance), which will also be considered a favorable outcome.	Baseline and Week 6 (post)

Collaborators and Investigators

• Sponsor: University of Houston
• Collaborators: National Institute on Minority Health and Health Disparities (NIMHD)

Publications and helpful links

General Publications

• Czajkowski SM, Powell LH, Adler N, Naar-King S, Reynolds KD, Hunter CM, Laraia B, Olster DH, Perna FM, Peterson JC, Epel E, Boyington JE, Charlson ME. From ideas to efficacy: The ORBIT model for developing behavioral treatments for chronic diseases. Health Psychol. 2015 Oct;34(10):971-82. doi: 10.1037/hea0000161. Epub 2015 Feb 2.
• Pierce B, Bowden B, McCullagh M, Diehl A, Chissell Z, Rodriguez R, Berman BM, D Adamo CR. A Summer Health Program for African-American High School Students in Baltimore, Maryland: Community Partnership for Integrative Health. Explore (NY). 2017 May-Jun;13(3):186-197. doi: 10.1016/j.explore.2017.02.002. Epub 2017 Feb 24.
• Yazel-Smith L, El-Mikati HK, Adjei M, Haberlin-Pittz KM, Agnew M, Hannon TS. Integrating Diabetes Prevention Education Among Teenagers Involved in Summer Employment: Encouraging Environments for Health in Adolescence (ENHANCE). J Community Health. 2020 Aug;45(4):856-861. doi: 10.1007/s10900-020-00802-2.
• Modestino AS, Paulsen RJ. Reducing inequality summer by summer: Lessons from an evaluation of the Boston Summer Youth Employment Program. Eval Program Plann. 2019 Feb;72:40-53. doi: 10.1016/j.evalprogplan.2018.09.006. Epub 2018 Sep 24.

Study record dates

Study Major Dates

• Study Start (Actual): March 31, 2025
• Primary Completion (Actual): July 7, 2025
• Study Completion (Actual): July 29, 2025

Study Registration Dates

• First Submitted: August 4, 2025
• First Submitted That Met QC Criteria: November 10, 2025
• First Posted (Actual): November 12, 2025

Study Record Updates

• Last Update Posted (Actual): July 27, 2026
• Last Update Submitted That Met QC Criteria: June 29, 2026
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Nutrition Disorders; Overnutrition; Body Weight; Overweight; Obesity; Pathological Conditions, Signs and Symptoms; Behavior; Nutritional and Metabolic Diseases; Signs and Symptoms; Pediatric Obesity; Health Behavior
• Other Study ID Numbers: STUDY00005180; U54MD015946 (U.S. NIH Grant/Contract)

Drug and device information, study documents

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