@article{1b7d93445f3f448592abe2c023dee4f1,
title = "Student public commitment in a school-based diabetes prevention project: Impact on physical health and health behavior",
abstract = "Background: As concern about youth obesity continues to mount, there is increasing consideration of widespread policy changes to support improved nutritional and enhanced physical activity offerings in schools. A critical element in the success of such programs may be to involve students as spokespeople for the program. Making such a public commitment to healthy lifestyle program targets (improved nutrition and enhanced physical activity) may potentiate healthy behavior changes among such students and provide a model for their peers. This paper examines whether student's {"}public commitment{"} - voluntary participation as a peer communicator or in student-generated media opportunities - in a school-based intervention to prevent diabetes and reduce obesity predicted improved study outcomes including reduced obesity and improved health behaviors. Methods. Secondary analysis of data from a 3-year randomized controlled trial conducted in 42 middle schools examining the impact of a multi-component school-based program on body mass index (BMI) and student health behaviors. A total of 4603 students were assessed at the beginning of sixth grade and the end of eighth grade. Process evaluation data were collected throughout the course of the intervention. All analyses were adjusted for students' baseline values. For this paper, the students in the schools randomized to receive the intervention were further divided into two groups: those who participated in public commitment activities and those who did not. Students from comparable schools randomized to the assessment condition constituted the control group. Results: We found a lower percentage of obesity (greater than or equal to the 95th percentile for BMI) at the end of the study among the group participating in public commitment activities compared to the control group (21.5% vs. 26.6%, p = 0.02). The difference in obesity rates at the end of the study was even greater among the subgroup of students who were overweight or obese at baseline; 44.6% for the {"}public commitment{"} group, versus 53.2% for the control group (p = 0.01). There was no difference in obesity rates between the group not participating in public commitment activities and the control group (26.4% vs. 26.6%). Conclusions: Participating in public commitment activities during the HEALTHY study may have potentiated the changes promoted by the behavioral, nutrition, and physical activity intervention components. Trial Registration. ClinicalTrials.gov number, NCT00458029.",
author = "Debar, {Lynn L.} and Margaret Schneider and Drews, {Kimberly L.} and Ford, {Eileen G.} and Stadler, {Diane D.} and Moe, {Esther L.} and Mamie White and Hernandez, {Arthur E.} and Sara Solomon and Ann Jessup and Venditti, {Elizabeth M.}",
note = "Funding Information: We wish to thank the administration, faculty, staff, students, and their families at the middle schools and school districts that participated in the HEALTHY study. This work was completed with funding from NIDDK/NIH grant numbers U01-DK61230, U01-DK61249, U01-DK61231, and U01-DK61223 to the STOPP-T2D collaborative group. The following individuals and institutions constitute the HEALTHY Study Group (* indicates principal investigator or director): Study Chair Childrens Hospital Los Angeles: F.R. Kaufman Field Centers Baylor College of Medicine: T. Baranowski*, L. Adams, J. Baranowski, A. Canada, K.T. Carter, K.W. Cullen, M.H. Dobbins, R. Jago, A. Oceguera, A.X. Rodriguez, C. Speich, L.T. Tatum, D. Thompson, M.A. White, C.G. Williams Oregon Health & Science University: L. Goldberg*, D. Cusimano, L. DeBar, D. Elliot, H.M. Grund, S. McCormick, E. Moe, J.B. Roullet, D. Stadler Temple University: G. Foster* (Steering Committee Chair), J. Brown, B. Creighton, M. Faith, E.G. Ford, H. Glick, S. Kumanyika, J. Nachmani, L. Rosen, S. Sherman, S. Solomon, A. Virus, S. Volpe, S. Willi University of California at Irvine: D. Cooper*, S. Bassin, S. Bruecker, D. Ford, P. Galassetti, S. Greenfield, J. Hartstein, M. Krause, N. Opgrand, Y. Rodriguez, M. Schneider University of North Carolina at Chapel Hill: J. Harrell*, A. Anderson, T. Blackshear, J. Buse, J. Caveness, A. Gerstel, C. Giles, W. Hall, A. Jessup, P. Kennel, R. McMurray, A-M. Siega-Riz, M. Smith, A. Steckler, A. Zeveloff University of Pittsburgh: M.D. Marcus*, M. Carter, S. Clayton, B. Gillis, K. Hindes, J. Jakicic, R. Meehan, R. Noll, J. Vanucci, E. Venditti University of Texas Health Science Center at San Antonio: R. Trevi{\~n}o*, A. Garcia, D. Hale, A. Hernandez, I. Hernandez, C. Mobley, T. Murray, J. Stavinoha, K. Surapiboonchai, Z. Yin Coordinating Center George Washington University: K. Hirst*, K. Drews, S. Edelstein, L. El ghormli, S. Firrell, M. Huang, P. Kolinjivadi, S. Mazzuto, T. Pham, A. Wheeler Project Office National Institute of Diabetes and Digestive and Kidney Diseases: B. Linder*, C. Hunter, M. Staten Central Biochemistry Laboratory University of Washington Northwest Lipid Metabolism and Diabetes Research Laboratories: S.M. Marcovina* HEALTHY intervention materials are available for download at http://www. healthystudy.org/. Past and present HEALTHY study group members on the social-marketing based communications committee on whose work this report was based were: Lynn DeBar (Chair), Tara Blackshear, Jamie Bowen, Sarah Clayton, Tamara Costello, Kimberly Drews, Eileen Ford, Angela Garcia, Katie Giles, Bonnie Gillis, Healthy Murphy Grund, Art Hernandez, Ann Jessup, Megan Krause, Barbara Linder, Jeff McNamee, Esther Moe, Chris Nichols, Margaret Schneider, Brenda Showell, Sara Solomon, Diane Stadler, Mamie White, and Alissa Wheeler. The committee was supported by the creative teams at the Academy for Educational Development and Planit Agency. We attest that everyone who contributed substantially to the study has been included in these acknowledgements.",
year = "2011",
doi = "10.1186/1471-2458-11-711",
language = "English (US)",
volume = "11",
journal = "BMC public health",
issn = "1471-2458",
publisher = "BioMed Central",
}