Childhood patterns of poor dietary intake and sedentary lifestyle are prerequisites for cardiovascular disease later in life with evidence that risk behaviors track from childhood to adulthood. These risk patterns and health disparities are also more prevalent among underserved children who perform less well in school. To date, school-based programs have achieved modest success in addressing risk behaviors in children. There is a need to test innovative intervention models that are adequate enough in dose to achieve changes, but practical in demands placed on school settings; address the challenge of involving parents through creative means; and promote protective factors that will assist high risk, underserved children in breaking the cycle leading to poor health outcomes. This study will test a cardiovascular risk prevention program for underserved children that promotes adherence to the National Cholesterol Education Program and Healthy People 2000 Guidelines and is implemented through the Older Adult Services and Information Systems (OASIS) Intergenerational Tutoring Program, a community-based organization for older adults. The """"""""Foods and Activities That Children Experience Module (FACE) will prevent poor diet and activity patterns through a combination of one-to-one mentoring by older adult tutors and parents, using computer-based tailoring of storybooks for children. The primary outcome is reduction in serum total cholesterol while intermediate outcomes include lowering percent calories from total dietary fat and saturated fat, increasing moderate levels of physical activity, changes in body-mass index and dietary knowledge. In addition, the investigators will measure intervention impact on parent-focused outcomes of parental modeling, dietary fat intake, and physical activity. The project will use a group randomized nested cohort design randomizing schools (n=136) and students (n=830) to intervention or control sites, and to evaluate program impact on children. Extensive process evaluation methods will assure the intervention is delivered as designed. This innovative proposal is the first of its kind (1) to address the unique needs of underserved children, (2) to test a diet and activity intervention that combines one-to-one personal mentoring and child focused computer based tailoring, (3) to address barriers to adequate dose, cited in prior school-based studies as a reason for limited success, by delivering this intervention through an intergenerational program, (4) to test the impact of a child-focused computer-based tailored intervention on both the child and parent, and (5) to secure a foundation for disseminating an empirically tested intervention, with the potential for nationwide impact on 7000 underserved students, their tutors and parents, participating in 245 OASIS Intergenerational Programs in 14 states across the country.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR005079-04
Application #
6639287
Study Section
Nursing Research Study Section (NURS)
Program Officer
Huss, Karen
Project Start
2000-08-01
Project End
2005-04-30
Budget Start
2003-05-01
Budget End
2005-04-30
Support Year
4
Fiscal Year
2003
Total Cost
$396,174
Indirect Cost
Name
Saint Louis University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
050220722
City
Saint Louis
State
MO
Country
United States
Zip Code
63103
Haire-Joshu, Debra; Nanney, Marilyn S; Elliott, Michael et al. (2010) The use of mentoring programs to improve energy balance behaviors in high-risk children. Obesity (Silver Spring) 18 Suppl 1:S75-83
Mushi-Brunt, Christina; Haire-Joshu, Debra; Elliott, Michael (2007) Food spending behaviors and perceptions are associated with fruit and vegetable intake among parents and their preadolescent children. J Nutr Educ Behav 39:26-30
Nanney, Marilyn S; Haire-Joshu, Debra; Elliott, Michael et al. (2005) Evaluating changeability to improve fruit and vegetable intake among school aged children. Nutr J 4:34