"Girls on the Move" intervention protocol for increasing physical activity among low-active underserved urban girls: a group randomized trial

Lorraine B Robbins, Karin A Pfeiffer, Amber Vermeesch, Kenneth Resnicow, Zhiying You, Lawrence An, Stacey M Wesolek, Lorraine B Robbins, Karin A Pfeiffer, Amber Vermeesch, Kenneth Resnicow, Zhiying You, Lawrence An, Stacey M Wesolek

Abstract

Background: Increasing moderate to vigorous physical activity among urban girls of low socioeconomic status is both a challenge and a public health priority. Physical activity interventions targeting exclusively girls remain limited, and maintenance of moderate to vigorous physical activity during the post-intervention period has been difficult to maintain. The main aim of the 5-year "Girls on the Move" group randomized trial is to evaluate the efficacy of a comprehensive school-based intervention in increasing girls' minutes of moderate to vigorous physical activity and improving cardiovascular fitness, body mass index, and percent body fat immediately post-intervention (after 17 weeks) and at 9-month post-intervention follow-up (9 months after end of intervention).

Methods/design: A total of 24 urban middle schools in the Midwestern U.S. will be randomized to either receive the intervention or serve as a control (N = 1200 girls). The intervention, based on the Health Promotion Model and Self-Determination Theory, will include: (1) two face-to-face motivational, individually tailored counseling sessions with a registered nurse, one at the beginning and the other at the end of the intervention period; (2) an interactive Internet-based session during which each girl receives individually tailored motivational and feedback messages via iPad at 11 weeks (shortly after midpoint of intervention); and (3) a 90-minute after-school physical activity club. Racially diverse, low-active, 10- to 14-year-old 5th to 8th-grade girls will complete questionnaires and physical measures at baseline and post-intervention (n = 50 per school). Minutes of moderate to vigorous physical activity will be assessed with accelerometers. Cardiovascular fitness will be assessed by estimating VO2 max with PACER (Progressive Aerobic Cardiovascular Endurance Run) scores. Height and weight will be assessed to calculate body mass index. Percent body fat will be estimated with a foot-to-foot bioelectric impedance scale. Linear mixed effects regression analyses will be performed to assess intervention effects.

Discussion: This multi-component approach is expected to improve girls' moderate to vigorous physical activity and related physical outcomes.

Trial registration: ClinicalTrials.gov Identifier NCT01503333.

References

    1. Centers for Disease Control and Prevention. Youth risk behavior surveillance - United States. MMWR Morb Mortal Wkly Rep. 2011;61:1–162.
    1. May AL, Kuklina EV, Yoon PW. Prevalence of cardiovascular disease risk factors among US adolescents, 1999–2008. Pediatrics. 2012;129:1035–1041.
    1. Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40:181–188.
    1. Kimm SYS, Glynn NW, Kriska AM, Barton BA, Kronsberg SS, Daniels SR, Crawford PB, Sabry ZI, Liu K. Decline in physical activity in black girls and white girls during adolescence. N Engl J Med. 2002;347:709–715.
    1. Kimm SYS, Glynn NW, Kriska AM, Fitzgerald SL, Aaron DJ, Similo SL, McMahon RP, Barton BA. Longitudinal changes in physical activity in a biracial cohort during adolescence. Med Sci Sports Exerc. 2000;32:1445–1454.
    1. Kimm SYS, Glynn NW, Obarzanek E, Kriska AM, Daniels SR, Barton BA, Liu K. Relation between the changes in physical activity and body-mass index during adolescence: a multicentre longitudinal study. Lancet. 2005;366:301–307.
    1. Kronsberg SS, Obarzanek E, Affenito SG, Crawford PB, Sabry ZI, Schmidt M, Striegel-Moore R, Kimm SY, Barton BA. Macronutrient intake of black and white adolescent girls over 10 years: the NHLBI Growth and Health Study. J Am Diet Assoc. 2003;103:853–860.
    1. Obarzanek E. In: Obesity: Impact on Cardiovascular Disease. Fletcher GF, Grundy SM, Armonk HL, editor. NY: Futura; 1999. Obesity in children, adolescents, and families; pp. 31–53.
    1. Daniels SR. The consequences of childhood overweight and obesity. Future Child. 2006;16:47–67.
    1. van Dam RM, Willett WC, Manson JE, Hu FB. The relationship between overweight in adolescence and premature death in women. Ann Intern Med. 2006;145(2):91–97.
    1. Wilson DK. New perspectives on health disparities and obesity interventions in youth. J Pediatr Psychol. 2009;34:231–244.
    1. Wang Y, Liang H, Tussing L, Braunschweig C, Caballero B, Flay B. Obesity and related risk factors among low socio-economic status minority students in Chicago. Public Health Nutr. 2007;10:927–938.
    1. Veugelers PJ, Fitzgerald AL. Prevalence of and risk factors for childhood overweight and obesity. Can Med Assoc J. 2005;173:607–613.
    1. Spruijt-Metz D, Nguyen-Michel ST, Goran MI, Chou CP, Huang TT. Reducing sedentary behavior in minority girls via a theory-based, tailored classroom media intervention. Int J Pediatr Obes. 2008;3:240–248.
    1. Slootmaker SM, Chinapaw MJ, Seidell JC, van Mechelen W, Schuit AJ. Accelerometers and Internet for physical activity promotion in youth? Feasibility and effectiveness of a minimal intervention. Prev Med. 2010;51:31–36.
    1. De Bourdeaudhuij I, Maes L, De Henauw S, De Vriendt T, Moreno LA, Kersting M, Sarri K, Manios Y, Widhalm K, Sjöstrom M, Ruiz JR, Haerens L. HELENA Study Group. Evaluation of a computer-tailored physical activity intervention in adolescents in six European countries: the Activ-O-Meter in the HELENA intervention study. J Adolesc Health. 2010;46:458–466.
    1. Haerens L, Maes L, Vereecken C, De Henauw S, Moreno L, De Bourdeaudhuij I. Effectiveness of a computer tailored physical activity intervention in adolescents compared to a generic advice. Patient Educ Couns. 2009;77:38–41.
    1. Resnicow K, Lazarus Yaroch A, Davis A, Wang DT, Carter S, Slaughter L, Coleman D, Baranowski T. GO GIRLS! Results from a nutrition and physical activity program for low-income, overweight African American adolescent females. Health Educ Behav. 2000;27:616–631.
    1. Flattum C, Friend S, Neumark-Sztainer D, Story M. Motivational interviewing as a component of a school-based obesity prevention program for adolescent girls. J Am Diet Assoc. 2009;109:91–94.
    1. Hamel LM, Robbins LB, Wilbur J. Computer- and web-based interventions to increase preadolescent and adolescent physical activity: a systematic review. J Adv Nurs. 2011;67:251–268.
    1. Kreuter M, Farrell D, Olevitch L, Brennan L. Tailoring health messages: customizing communication with computer technology. Mawah, NJ: Lawrence Erlbaum Associates; 2000.
    1. Hamilton G, Cross D, Resnicow K, Hall M. A school-based harm minimization smoking intervention trial: outcome results. Addict. 2005;100:689–700.
    1. Hamilton G, Cross D, Resnicow K, Shaw T. Does harm minimisation lead to greater experimentation? Results from a school smoking intervention trial. Drug Alcohol Rev. 2007;26:605–613.
    1. Schulz KF, Altman DG, Moher D. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332.
    1. Robbins LB, Pfeiffer KA, Maier KS, Lo YJ, Ladrig SM. Pilot intervention to increase physical activity among sedentary urban middle school girls: a two-group pretest-posttest quasi-experimental design. J Sch Nurs. 2012;28:302–315.
    1. Pender NJ, Murdaugh CL, Parsons MA. Health promotion in nursing practice. Upper Saddle River, NJ: Pearson/Prentice Hall; 2010.
    1. Ryan RM, Deci EL. Self-Determination Theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55:68–78.
    1. Garcia AW, Norton Broda MA, Frenn M, Coviak C, Pender NJ, Ronis DL. Gender and developmental differences in exercise beliefs among youth and prediction of their exercise behavior. J Sch Health. 1995;65:213–219.
    1. Neumark-Sztainer D, Story M, Hannan PJ, Tharp T, Rex J. Factors associated with changes in physical activity. Arch Pediatr Adolesc Med. 2003;157:803–810.
    1. Bungum T, Pate RR, Dowda M, Vincent M. Correlates of physical activity among African-American and Caucasian female adolescents. Am J Health Behav. 1999;23:25–31.
    1. Lytle LA, Murray DM, Evenson KR, Moody J, Pratt CA, Metcalfe L, Parra-Medina D. Mediators affecting girls' levels of physical activity outside of school: findings from the trial of activity in adolescent girls. Ann Behav Med. 2009;38:124–136.
    1. Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc. 2000;32:963–975.
    1. Dishman RK, Motl RW, Saunders R, Felton G, Ward DS, Dowda M, Pate R. Enjoyment mediates effects of a school-based physical-activity intervention. Med Sci Sports Exerc. 2005;37:478–487.
    1. Miller WR, Rollnick S. Motivational interviewing: preparing people for change. New York: Guilford Publications; 2002.
    1. Rollnick S, Miller WR, Butler C. Motivational interviewing in health care: helping patients change behavior. New York: The Guilford Press; 2008.
    1. Stevens J, Murray DM, Catellier DJ, Hannan PJ, Lytle LA, Elder JP, Young DR, Simons-Morton DG, Webber LS. Design of the Trial of Activity in Adolescent Girls (TAAG) Contemp Clin Trials. 2005;26:223–233.
    1. Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc. 2005;37:S531–S543.
    1. Hänggi JM, Phillips LRS, Rowlands AV. Validation of the GT3X ActiGraph in children and comparison with the GT1M ActiGraph. J Sci Med Sport. 2013;16:40–44.
    1. Trost SG, Ward DS, Moorehead SM, Watson PD, Riner W, Burke JR. Validity of the computer science and applications (CSA) activity monitor in children. Med Sci Sports Exerc. 1998;30:629–633.
    1. Evenson KR, Catellier DJ, Gill K, Ondrak KS, McMurray RG. Calibration of two objective measures of physical activity for children. J Sports Sci. 2008;26:1557–1565.
    1. Trost SG, Loprinzi PD, Moore R, Pfeiffer KA. Comparison of accelerometer cut points for predicting activity intensity in youth. Med Sci Sports Exerc. 2011;43:1360–1368.
    1. Treuth MS, Sherwood NE, Butte NF, McClanahan B, Obarzanek E, Zhou A, Ayers C, Adolph A, Jordan J, Jacobs DR, Rochon J. Validity and reliability of activity measures in African-American girls for GEMS. Med Sci Sports Exerc. 2003;35:532–539.
    1. McMurray RG, Ring KB, Treuth MS, Welk GJ, Pate RR, Schmitz KH, Pickrel JL, Gonzalez V, Almedia MJCA, Rohm Young D, Sallis JF. Comparison of two approaches to structured physical activity surveys for adolescents. Med Sci Sports Exerc. 2004;36:2135–2143.
    1. Meredith MD, Welk GJ, editor. The Cooper Institute. Fitnessgram & Activitygram Test Administration Manual. Champaign, IL: Human Kinetics; 2010.
    1. Resnicow K, Taylor R, Baskin M, McCarty F. Results of Go Girls: a weight control program for overweight African-American adolescent females. Obes Res. 2005;13:1739–1748.
    1. Robbins LB, Wu TY, Sikorski A, Morley B. Psychometric assessment of the adolescent physical activty perceived benefits and barriers scales. J Nurs Meas. 2008;16:98–112.
    1. Kendzierski D, DeCarlo KJ. Physical activity enjoyment scale: two validation studies. J Sport Exerc Psychol. 1991;13:50–64.
    1. Dishman RK, Hales DP, Sallis JF, Saunders R, Dunn AL, Bedimo-Rung AL, Ring KB. Validity of social-cognitive measures for physical activity in middle-school girls. J Pediatr Psychol. 2010;35:72–88.
    1. Lawman HG, Wilson DK, Van Horn ML, Resnicow K, Kitzman-Ulrich H. The relationship between psychosocial correlates and physical activity in underserved adolescent boys and girls in the ACT Trial. J Phys Act Health. 2011;8:253–261.
    1. Robbins LB, Stommel M, Hamel LM. Social support for physical activity of middle school students. Public Health Nurs. 2008;25:451–460.
    1. Prochaska JJ, Rodgers MW, Sallis JF. Association of parent and peer support with adolescent physical activity. Res Q Exerc Sport. 2002;73:206–210.
    1. Sallis JF, Taylor WC, Dowda M, Freedson PS, Pate RR. Correlates of vigorous physical activity for children in grades 1 through 12: Comparing parent-reported and objectively measured physical activity. Pediatr Exerc Sci. 2002;14:30–44.
    1. Saunders RP, Pate RR, Felton G, Dowda M, Weinrich MC, Ward DS, Parsons MA, Baranowski T. Development of questionnaires to measure psychosocial influences on children's physical activity. Prev Med. 1997;26:241–247.
    1. Dishman RK, Motl RW, Sallis JF, Dunn AL, Birnbaum AS, Welk GJ, Bedimo-Rung AL, Voorhees CC, Jobe JB. Self-management strategies mediate the association of self-efficacy with physical activity among sixth and eighth grade adolescent girls. Am J Prev Med. 2005;29:10–18.
    1. Sallis JF, Pinski RB, Grossman RM, Patterson TL, Nader PR. The development of self-efficacy scales for healthrelated diet and exercise behaviors. Health Educ Res. 1988;3:283–292.
    1. Wilson DK, Van Horn ML, Kitzman-Ulrich H, Saunders R, Pate R, Lawman HG, Hutto B, Griffin S, Zarrett N, Addy CL, Mansard L, Mixon G, Brown PV. Results of the "Active by Choice Today" (ACT) randomized trial for increasing physical activity in low-income and minority adolescents. Health Psychol. 2011;30:463–471.
    1. Wilson DK, Evans AE, Williams J, Mixon G, Sirard JR, Pate R. A preliminary test of a student-centered intervention on increasing physical activity in underserved adolescents. Ann Behav Med. 2005;30:119–124.
    1. Wilson DK, Friend R, Teasley N, Green S, Reaves IL, Sica DA. Motivational versus social cognitive interventions for promoting fruit and vegetable intake and physical activity in African American adolescents. Ann Behav Med. 2002;24:310–319.
    1. Gillison FB, Standage M, Skevington SM. Relationships among adolescents' weight perceptions, exercise goals, exercise motivation, quality of life and leisure-time exercise behaviour: a self-determination theory approach. Health Educ Res. 2006;21:836–847.
    1. Verloigne M, De Bourdeaudhuij I, Tanghe A, D'Hondt E, Theuwis L, Vansteenkiste M, Deforche B. Self-determined motivation towards physical activity in adolescents treated for obesity: an observational study. Int J Behav Nutr Phys Act. 2011;8:97.
    1. Peterson AC, Crockett L, Richards M, Boxer A. A self-report measure of pubertal status: reliability, validity, and initial norms. J Youth Adolesc. 1988;17:117–133.
    1. Pender NJ, Bar-Or O, Wilk B, Mitchell S. Self-efficacy and perceived exertion of girls during exercise. Nurs Res. 2002;51:86–91.
    1. Moyers TB, Martin T, Manuel JK, Miller WR, Ernst D. Revised Global Scales: Motivational Interviewing Treatment Integrity 3.1.1 (MITI 3.1.1) .
    1. Moyers TBMT, Manuel JK, Hendrickson SML, Miller W. Assessing competence in the use of motivational interviewing. J Subst Abuse Treat. 2005;28:19–26.
    1. Bloom HS, Bos JM, Lee SW. Using cluster random assignment to measure program impacts. Statistical implications for the evaluations of education programs. Eval Rev. 1999;23:445–469.
    1. Murray DM. Design and analysis of group-randomized trials. New York: Oxford University Press; 1998.
    1. Murray D, Stevens J, Hannan P, Catellier D, Schmitz K, Dowda M, Conway T, Rice J, Yang S. School-level intraclass correlation for physical activity in sixth grade girls. Med Sci Sports Exerc. 2006;38:926–936.
    1. Murray DM, Catellier DJ, Hannan PJ, Treuth MS, Stevens J, Schmitz KH, Rice JC, Conway TL. School-level intraclass correlation for physical activity in adolescent girls. Med Sci Sports Exerc. 2004;36:876–882.
    1. Yin Z, Moore JB, Johnson MH, Barbeau P, Cavnar M, Thornburg J, Gutin B. The Medical College of Georgia FitKid Project: the relations between program attendance and changes in outcomes in year 1. Int J Obes. 2005;29:540–545.
    1. Gortmaker SL, Cheung LWY, Peterson KE, Chomitz G, Cradle JH, Dart H, Fox MK, Bullock RB, Sobol AM, Colditz G, Field AE, Laird N. Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children. Arch Pediatr Adolesc Med. 1999;153:975–983.
    1. Luepker RV, Perry CL, McKinlay SM, Nader PR, Parcel GS, Stone EJ, Webber LS, Elder JP, Feldman HA, Johnson CC, Kelder SH, Wu M. for the CATCH Collaborative Group. Outcomes of a field trial to improve children's dietary patterns and physical activity. J Am Med Assoc. 1996;275:768–776.
    1. Littell RC, Milliken GA, Stroup WW, Wolfinger RD, Schabenberger O. SAS® for Mixed Models. 2. Cary, NC: SAS Institute Inc.; 2006.
    1. Raudenbush SW. Statistical analysis and optimal design in cluster randomized trials. Psychol Methods. 1999;2:173–185.
    1. Diggle P, Liang KY, Zeger SL. The analysis of longitudinal data. New York: Oxford University Press; 1994.
    1. Porter AC, Raudenbush SW. Analysis of covariance: its model and use in psychological research. J Couns Psychol. 1987;34:383–392.
    1. McCullagh P, Nelder JA. Generalized linear models. London: Chapman and Hall; 1989.
    1. Little RJA, Rubin DB. Statistical analysis with missing data. New York: Wiley & Son; 1987.
    1. Armitage P. In: Clinical Trials. Shapiro SH, Louis TA, editor. New York: Marcel Dekker; 1983. Exclusions, losses to follow-up and withdrawals in clinical trials.
    1. Sackett D, Gent M. Controversy in counting and attributing events in clinical trials. N Engl J Med. 1979;301:1410–1412.
    1. Sandler RS, Halabi S, Baron JA, Budinger S, Paskett E, Keresztes R, Petrelli N, Pipas JM, Karp DD, Loprinzi CL, Steinbach G, Schilsky R. A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer. N Engl J Med. 2003;348:883–890.
    1. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51:1173–1182.
    1. MacKinnon DP. In: Scientific Methods for Prevention Intervention Research (National Institute on Drug Abuse Research Monograph 139) Cázares A, Beatty LA, editor. Washington, DC: U.S. Department of Health and Human Services; 1994. Analysis of mediating variables in prevention and intervention research; pp. 127–153. .
    1. MacKinnon DP, Krull JL, Lockwood CM. Equivalence of the mediation, confounding, and suppression effect. Prev Sci. 2000;1:173–181.
    1. MacKinnon DP, Warsi G, Dwyer JH. A simulation study of mediated effect measure. Multivariate Behav Res. 1995;30:41–62.
    1. Sobel ME. Effect analysis and causation in linear structural equation models. Psychometrica. 1990;55:495–515.
    1. Sobel ME. In: Sociological methodology. Leinhart S, editor. San Francisco: Jossey-Bass; 1982. Asymptotic confidence intervals for indirect effects in structural equation models; pp. 290–312.
    1. MacKinnon DP. Introduction to Statistical Mediation Analysis. New York: Lawrence Erlbaum Associates, Taylor & Francis Group; 2008.
    1. Freedman LS, Schatzkin A. Sample size for studying intermediate endpoints within intervention trials or observational studies. Am J Epidemiol. 1992;136:1148–1159.
    1. Dudley WN, Benuzillo JG, Carrico MS. SPSS and SAS programming for the testing of mediation models. Nurs Res. 2004;53:59–62.
    1. Wang Y, Tussing L, Odoms-Young A, Braunschweig C, Flay B, Hedeker D, Hellison D. Obesity prevention in low socioeconomic status urban African-American adolescents: Study design and preliminary findings of the HEALTH-KIDS Study. Eur J Clin Nutr. 2006;60:92–103.

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