We propose to test the efficacy of a dance program and a family-based intervention to reduce television, videotape and video game use to reduce weight gain among African-American pre-adolescent girls from lower socioeconomic status families. In a twelve-week controlled, school-based pilot study of using dance during physical education classes, we demonstrated that (1) dance is a feasible and acceptable form of physical activity for low-income African-American girls and (2) a dance intervention can result in significant reductions in body mass index (BMI) and improved physical fitness among girls. In two pilot studies of reducing television viewing in 8-10 year olds, we demonstrated that (1) it is possible to significantly reduce children's television, videotape and video game use and (2) that an intervention reducing children's television, videotape and video game use can result in clinically significant decreases in BMI, triceps skinfold thickness and waist-to-hip ratio. Interventions and measures will be developed during a 20-month formative evaluation period, using interviews and focus groups. Sixty 8-10 year old, low SES African-American girls and their families will participate in a twelve-week pilot test of intervention methods and measurement protocols. These results will lead to a 2-year randomized, controlled trial involving 240 African-American 8-10 year old girls and their families. Half will be randomized to the dance and television reduction intervention and half will be randomized to a non-specific """"""""active placebo"""""""" control group. In-home surveys of activity, inactivity and dietary behaviors and measures of height, weight, skinfold thicknesses, waist and hip circumferences, Tanner stage of sexual maturation and blood pressure will occur at baseline and every six months. Four days of activity and heart rate monitoring and three 24-hour dietary recalls will occur annually. An exercise treadmill testing of physical fitness, fasting blood lipids, and measures of insulin resistance will occur annually during Medical Center assessments. A CT scan of the abdomen to measure visceral and subcutaneous abdominal fat and lumbar spine vertebral bone density will be performed at baseline and at the end of the two-year trial. DNA will be collected at baseline to examine the role of genetic polymorphisms on response to the intervention. We will use random regression models to test the following hypothesis: Compared to controls, girls in the treatment group will significantly reduce their weight gain over the two-year study period.
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