We propose a 2-arm parallel group, randomized controlled trial to test the efficacy of an after school dance program and a family-based intervention to reduce television, videotape and video game use to reduce weight gain among lower socioeconomic status African-American preadolescent girls. An active placebo control group will receive an information-based community health education intervention. A total of 260 girls will be randomized to the two conditions and the interventions will last for the full 2-year period of the study. Our interventions and study design are supported by prior studies demonstrating the feasibility and potential efficacy of dance classes and reducing television viewing for reducing weight gain, formative studies, and the success of a 12-week randomized controlled pilot study of the proposed trial. Measures will be collected in girls' homes at baseline and 6, 12, 18 and 24 months. Body Mass Index (BMI) is the primary outcome measure, The primary hypothesis will be tested by comparing individual trajectories of change in the treatment and control groups over the entire two-year course of the trial, using random regression models, Specific Aims include: 1. To participate with NHLBI and the Memphis GEMS investigators to conduct a full-scale, collaborative, 2-year randomized controlled trial, including both site-specific and collaborative measures and site-specific and collaborative analyses. 2. To test the effect of the Stanford GEMS intervention on BMI over 2 years (the primary outcome). We hypothesize that, compared to controls, girls in the treatment-group will significantly reduce their weight gain (BMI) over the two-year study period. 3. To test the effects of the Stanford GEMS intervention on secondary outcomes over two years. We hypothesize that, compared to controls, girls in the treatment group will significantly reduce their waist circumference, triceps skinfold thickness, resting blood pressures, resting heart rate, fasting insulin, total cholesterol, LDL-cholesterol, triglycerides, television, videotape and video game use, meals eaten in front of television, total dietary calorie intake, percent of calories from fat, weight concerns, and body disatisfaction, and significantly increase their HDL-cholesterol, after school and daily physical activity, self-esteem, and school performance. 4. To conduct analyses to evaluate potential moderators and mediators of intervention effects on primary and secondary outcomes.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project--Cooperative Agreements (U01)
Project #
2U01HL062663-05
Application #
6555956
Study Section
Special Emphasis Panel (ZHL1-CSR-B (M2))
Program Officer
Obarzanek, Eva
Project Start
1999-08-01
Project End
2006-11-30
Budget Start
2003-03-15
Budget End
2003-11-30
Support Year
5
Fiscal Year
2003
Total Cost
$1,247,608
Indirect Cost
Name
Stanford University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
Hare, Marion E; Sherrill-Mittleman, Deborah; Klesges, Robert C et al. (2012) Energy underreporting in African-American girls: a longitudinal analysis. Child Obes 8:551-60
Stockton, Michelle B; McClanahan, Barbara S; Lanctot, Jennifer Q et al. (2012) Identification of facilitators and barriers to participation in weight gain prevention research by African American girls. Contemp Clin Trials 33:38-45
Dalton, William T; Klesges, Lisa M; Sherrill-Mittleman, Deborah et al. (2011) Family context as it relates to weight-related behaviors in preadolescent African American girls. Am J Health Behav 35:269-79
Klesges, Robert C; Obarzanek, Eva; Kumanyika, Shiriki et al. (2010) The Memphis Girls' health Enrichment Multi-site Studies (GEMS): an evaluation of the efficacy of a 2-year obesity prevention program in African American girls. Arch Pediatr Adolesc Med 164:1007-14
Alhassan, Sofiya; Robinson, Thomas N (2010) Defining accelerometer thresholds for physical activity in girls using ROC analysis. J Phys Act Health 7:45-53
Robinson, Thomas N; Matheson, Donna M; Kraemer, Helena C et al. (2010) A randomized controlled trial of culturally tailored dance and reducing screen time to prevent weight gain in low-income African American girls: Stanford GEMS. Arch Pediatr Adolesc Med 164:995-1004
Sherrill-Mittleman, D A; Klesges, L M; Lanctot, J Q et al. (2009) Measurement characteristics of dietary psychosocial scales in a Weight Gain Prevention Study with 8- to 10-year-old African-American girls. Health Educ Res 24:586-95
McClanahan, Barbara S; Stockton, Michelle B; Lanctot, Jennifer Q et al. (2009) Measurement of body composition in 8-10-year-old African-American girls: a comparison of dual-energy X-ray absorptiometry and foot-to-foot bioimpedance methods. Int J Pediatr Obes 4:389-96
Klesges, Robert C; Obarzanek, Eva; Klesges, Lisa M et al. (2008) Memphis Girls health Enrichment Multi-site Studies (GEMS): Phase 2: design and baseline. Contemp Clin Trials 29:42-55
Alhassan, Sofiya; Sirard, John R; Spencer, Tirzah R et al. (2008) Estimating physical activity from incomplete accelerometer data in field studies. J Phys Act Health 5 Suppl 1:S112-25

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