Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Obesity prevention in low socioeconomic status urban African-American adolescents: study design and preliminary findings of the HEALTH-KIDS Study

European Journal of Clinical Nutrition volume 60, pages 92–103 (2006)Cite this article

Abstract

Objectives:

Obesity prevention among children and adolescents is a public health priority; however, limited school-based intervention trials targeting obesity have been conducted. This article provides an overview of the study design and baseline preliminary findings of our ongoing school-based intervention study.

Design:

Randomized intervention trial to test a school-based, environmental obesity prevention program in urban low socioeconomic status (SES) African-American adolescents. The intervention program was developed based on several behavioral theories and was guided by preliminary findings based on focus group discussion and baseline data.

Setting:

Four Chicago public schools in the US.

Subjects:

Over 450 5–7th graders and their families and schools were involved.

Results:

Our baseline data indicate a high prevalence of overweight (43% in boys and 41% in girls) and a number of problems in these children's physical activity and eating patterns. Only 26% reported spending ⩾20 min engaged in vigorous-moderate exercise in ⩾5 days over the past 7 days; 29% reported spending ⩾5 h each day watching TV, playing video games, or using computer. They also consumed too many fried foods and soft drinks. On average, 55% consumed fried foods ⩾2 times/day over the past 7 days; regarding soft drinks, 70% reported consuming ⩾2 times/day.

Conclusion:

School-based obesity prevention programs are urgently needed in the target US urban, low SES, minority communities. These data can be used to inform intervention activities.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  • Adams LB (1997). An overview of adolescent eating behavior barriers to implementing dietary guidelines. Ann NY Acad Sci 817, 36–48.

    Article  CAS  Google Scholar 

  • Allensworth DD, Kolbe LJ (1987). The comprehensive school health program: exploring an expanded concept. J School Health 57, 409–412.

    Article  CAS  Google Scholar 

  • Bandura A (1986). Social Foundation of Thought and Action: a Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  • Baranowski T, Cullen KW, Nicklas T, Thompson D, Baranowski J (2002a). School-based obesity prevention: a blueprint for taming the epidemic. Am J Health Behav 26, 486–493.

    Article  Google Scholar 

  • Baum A, Garofalo JP, Yali AM (1999). Socioeconomic status and chronic stress. Does stress account for SES effects on health? Ann NY Acad Sci 896, 131–144.

    Article  CAS  Google Scholar 

  • Bautista-Castano I, Doreste J, Serra-Majem L (2004). Effectiveness of interventions in the prevention of childhood obesity. Eur J Epidemiol 19, 617–622.

    Article  Google Scholar 

  • Birch LL, Davison KK (2001). Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight. Pediatr Clin N Am 48, 893–907.

    Article  CAS  Google Scholar 

  • Bradley RH, Corwyn RF (2002). Socioeconomic status and child development. Annu Rev Psychol 53, 371–399.

    Article  Google Scholar 

  • Brown M (1999). Supermarket blackout: there are few supermarkets in cities, meaning that blacks pay more for food, lose out on jobs, and go elsewhere for quality goods. Black Enterprise 29, 81–92.

    Google Scholar 

  • Caballero B (2004). Obesity prevention in children: opportunities and challenges. Int J Obes Relat Metab Disord 28 (Suppl 3), S90–S95.

    Article  Google Scholar 

  • Centers for Disease Control and Prevention (1996). Guidelines for school health programs to promote lifelong healthy eating. MMWR Recomm Rep 45, 1–41.

  • Centers for Disease Control and Prevention (1997). Guidelines for School and Community Programs to Promote Lifelong Physical Activity Among Young People. MMWR 46, 1–36.

  • Centers for Disease Control and Prevention. Secretary of Health and Human Services, Secretary of Education (2000) Promoting better health for young people through physical activity and sports: a report to the President Atlanta: CDC.

  • Cheadle A, Psaty B, Curry S, Wagner E, Diehr P, Koepsell T et al. (1991). Community-level comparison between the grocery store environment and individual dietary practices. Prev Med 20, 250–262.

    Article  CAS  Google Scholar 

  • Chicago Tribune (2001). Tribune investigation: school food safety. December 9–11, A special report on lax safety in the school food supply chain.

  • Cullen KW, Baranowski T, Rittenberry L, Olvera N (2000). Social–environmental influences on children's diets: results from focus groups with African-, Euro- and Mexican-American children and their parents. Health Educ Res 15, 581–590.

    Article  CAS  Google Scholar 

  • Dietz WH (1994). Critical periods in childhood for the development of obesity. Am J Clin Nutr 59, 955–959.

    Article  CAS  Google Scholar 

  • Edmonds J, Baranowski T, Baranowski J, Cullen KW, Myres D (2001). Ecological and socioeconomic correlates of fruit, juice, and vegetable consumption among African-American boys. Prev Med 32, 476–481.

    Article  CAS  Google Scholar 

  • Flay BR, Graumlich S, Segawa E, Burns JL, Holliday MY (2004). Effects of 2 prevention programs on high-risk behaviors among African American youth: a randomized trial. Arch Pediatr Adolesc Med 158, 377–384.

    Article  Google Scholar 

  • Flay BR, Petraitis J (1994). The theory of triadic influence: a new theory of health behavior with implications for preventive interventions. In Advances in Medical Sociology, Vol IV: A Reconsideration of Models of Health Behavior Change ed. GS Albrecht JAI Press: Greenwich, CT. pp 19–44.

    Google Scholar 

  • Flegal KM, Carroll MD, Ogden CL, Johnson CL (2002). Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288, 1723–1727.

    Article  Google Scholar 

  • Fox MK, Crepinsek P, Connor P, Battagia M (2001). School/Nutrition Dietary Assessment Study-II – Summary of Findings. Alexandria VA: US Department of Agriculture, Food and Nutrition Service, Office of Analysis, Nutrition and Evaluation.

  • Freedman AM (1990). Habit forming: fast-food chains' central role in diet of the inner-city poor. Wall Street J Dec 19, p. A6.

  • French SA, Story M, Jeffery RW (2001). Environmental influences on eating and physical activity. Annu Rev Public Health 22, 309–335.

    Article  CAS  Google Scholar 

  • Glanz K, Rimer BK, Lewis FM (2002). Health Behavior and Health Education: Theory, Research, and Practice. San Francisco, CA: Jossey-Bass.

    Google Scholar 

  • Gortmaker SL, Peterson K, Wiecha J, Sobol AM, Dixit S, Fox MK et al. (1999). Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Arch Pediatr Adolesc Med 153, 409–418.

    Article  CAS  Google Scholar 

  • Hill JO, Peters JC (1998). Environmental contributions to the obesity epidemic. Science 280, 1371–1374.

    Article  CAS  Google Scholar 

  • Johnson D (1998). Trend Toward No-recess Policy is Accelerating at Nation's Schools The New York Times, April 7.

  • Kaiser Family Foundation (1999). Kids and media at the new millennium [monograph]. Menlo Park, CA: Kaiser Family Foundation.

  • Kremers SP, Visscher TL, Brug J, Paw MJ, Schouten EG, Schuit AJ et al. (2005). Netherlands research programme weight gain prevention (NHF-NRG): rationale, objectives and strategies. Eur J Clin Nutr 59, 498–507.

    Article  CAS  Google Scholar 

  • Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R et al. (2000). CDC growth charts: United States. Advance Data. No. 314.

  • Kumanyika SK, Odoms A (2001). Nutrition in African-Americans. In Health Issues in the Black Community, The Jossey-Bass Health Series, eds RL Braithwaite and SE Taylor. 2nd Edition San Francisco: Jossey-Bass.

    Google Scholar 

  • Littell RC, Milliken GA, Stroup WW, Wolfinger RD (1996). SAS System for Mixed Models. Cary, NC: SAS Institute Inc.

    Google Scholar 

  • Meininger JC (2000). School-based interventions for primary prevention of cardiovascular disease: evidence of effects for minority populations. Annu Rev Nurs Res 18, 219–244.

    Article  CAS  Google Scholar 

  • MMWR (1999). Neighborhood safety and the prevalence of physical inactivity – selected states, 1996. Morb Mortal Wkly Rep 48, 143–146.

  • Morgan DL, Krueger RA (1998). The Focus Group Kit Thousand Oaks. Beverley Hills, CA: Sage Publications.

    Google Scholar 

  • Morland K, Wing S, Diez Roux A, Poole C (2002). Neighborhood characteristics associated with the location of food stores and food service places. Am J Prev Med 22, 23–29.

    Article  Google Scholar 

  • Muller MJ, Asbeck I, Mast M, Langnase K, Grund A (2001). Prevention of obesity – more than an intention. Concept and first results of the Kiel Obesity Prevention Study (KOPS). Int J Obes Relat Metab Disord 25 (Suppl 1), S66–S74.

    Article  Google Scholar 

  • Must A, Strauss RS (1999). Risks and consequences of childhood and adolescent obesity. Int J Obes Relat Metab Disord 23 (Suppl 2), S2–S11.

    Article  Google Scholar 

  • Nicholson SO (2000). The effect of cardiovascular health promotion on health behaviors in elementary school children: an integrative review. J Pediatr Nurs 15, 343–355.

    Article  CAS  Google Scholar 

  • Ogden CL, Flegal KM, Carroll MD, Johnson CL (2002). Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA 288, 1728–1732.

    Article  Google Scholar 

  • Patton MQ (1990). Qualitative Evaluation and Research Methods. Newbury Park: Sage Publications.

    Google Scholar 

  • Perry CL, Sellers DE, Johnson C, Pedersen S, Bachman KJ, Parcel GS et al. (1997). The Child and Adolescent Trial for Cardiovascular Health (CATCH): intervention, implementation, and feasibility for elementary schools in the United States. Health Educ Behav 24, 716–735.

    Article  CAS  Google Scholar 

  • Power C, Lake JK, Cole TJ (1997). Measurement and long-term health risks of child and adolescent fatness. Int J Obes Relat Metab Disord 21, 507–526.

    Article  CAS  Google Scholar 

  • Resnicow K, Baranowski T, Ahluwalia JS, Braithwaite RL (1999). Cultural sensitivity in public health: defined and demystified. Ethnic Dis 9, 10–21.

    CAS  Google Scholar 

  • Resnicow K, Robinson T (1997). School-based cardiovarscular disease prevention studies: review and synthesis. Ann Epidemiol S7, S14–S31.

    Article  Google Scholar 

  • Robinson TN (1999). Reducing children's television viewing to prevent obesity: a randomized controlled trial. JAMA 282, 1561–1567.

    Article  CAS  Google Scholar 

  • Rochon J, Klesges RC, Story M, Robinson TN, Baranowski T, Obarzanek E et al. (2003). Common design elements of the Girls health Enrichment Multi-site Studies (GEMS). Ethnic Dis 13 (Suppl 1), S6–S14.

    Google Scholar 

  • Rockett HR, Breitenbach M, Frazier AL, Witschi J, Wolf AM, Field AE et al. (1997). Validation of a youth/adolescent food frequency questionnaire. Prev Med 26, 808–816.

    Article  CAS  Google Scholar 

  • Rockett HR, Wolf AM, Colditz GA (1995). Development and reproducibility of a food frequency questionnaire to assess diets of older children and adolescents. J Am Diet Assoc 95, 336–340.

    Article  CAS  Google Scholar 

  • Sahota P, Rudolf MC, Dixey R, Hill AJ, Barth JH, Cade J (2001). Randomised controlled trial of primary school based intervention to reduce risk factors for obesity. BMJ 323, 1029–1032.

    Article  CAS  Google Scholar 

  • Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T (1993). Do obese children become obese adults? A review of the literature. Prev Med 22, 167–177.

    Article  CAS  Google Scholar 

  • Stone EJ, Norman JE, Davis SM, Stewart D, Clay TE, Caballero B et al. (2003). Design, implementation, and quality control in the pathways American-Indian multicenter trial. Prev Med 37, S13–S23.

    Article  Google Scholar 

  • Story M (1999). School-based approaches for preventing and treating obesity. Int J Obes Relat Metab Disord 23 (Suppl 2), S43–S51.

    Article  Google Scholar 

  • Trahms CM, Pipes PL (1997). Nutrition in Infancy and Childhood 6th Edition New York: WCB/McGraw-Hill.

    Google Scholar 

  • Treuth MS, Sherwood NE, Butte NF, McClanahan B, Obarzanek E, Zhou A et al. (2003). Validity and reliability of activity measures in African-American girls for GEMS. Med Sci Sports Exerc 35, 532–539.

    Article  Google Scholar 

  • US Department of Health and Human Services (2001). Public Health Service. The Surgeon General's Call To Action To Prevent and Decrease Overweight and Obesity. Rockville, MD: Office of the Surgeon General.

  • US Department of Transportation (1997). Federal Highway Administration. Research and Technical Support Center. Nationwide personal transportation survey. Lantham, MD: Federal Highway Administration.

  • Wechsler H, Devereaux RS, Davis M, Collins J (2000). Using the school environment to promote physical activity and healthy eating. Prev Med 31, S121–S137.

    Article  Google Scholar 

  • World Health Organization (2000). Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Geneva, Switzerland: World Health Organization. WHO Technical Report Series 894.

Download references

Acknowledgements

This study was supported by the National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK), National Health Institutes (#1R01 DK63383). We are indebted to the participants in the study for their cooperation and support.

Author information

Authors and Affiliations

  1. Department of International Health, Bloomberg School of Public Health, Center for Human Nutrition, Johns Hopkins University, USA

    Y Wang

  2. Department of Human Nutrition, University of Illinois at Chicago (UIC), USA

    Y Wang, L Tussing & C Braunschweig

  3. UIC School of Public Health, USA

    A Odoms-Young

  4. School of Allied Health, Northern Illinois University, USA

    B Flay & D Hedeker

  5. UIC Department of Movement Sciences, USA

    D Hellison

Authors
  1. Y Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L Tussing
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A Odoms-Young
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C Braunschweig
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B Flay
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D Hedeker
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. D Hellison
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Y Wang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wang, Y., Tussing, L., Odoms-Young, A. et al. Obesity prevention in low socioeconomic status urban African-American adolescents: study design and preliminary findings of the HEALTH-KIDS Study. Eur J Clin Nutr 60, 92–103 (2006). https://doi.org/10.1038/sj.ejcn.1602272

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ejcn.1602272

Keywords

This article is cited by

Search

Advanced search

Quick links