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Title: Rationale, design and methods of the HEALTHY study behavior intervention component

Author
item VENDITTI, ELIZABETH - University Of Pittsburgh Medical Center
item ELLIOT, DIANE - Oregon Health & Science University
item FAITH, MYLES - University Of Pennsylvania
item FIRRELL, LINDA - George Washington University
item GILES, CATHERINE - University Of North Carolina
item GOLDBERG, LINN - Oregon Health & Science University
item MARCUS, MARSHA - University Of Pittsburgh Medical Center
item SCHNEIDER, MARGARET - University Of California
item SOLOMON, SARA - Temple University
item Thompson, Deborah - Debbe
item YIN, ZENONG - University Of Texas

Submitted to: International Journal of Obesity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/1/2009
Publication Date: 8/1/2009
Citation: Venditti, E.M., Elliot, D.L., Faith, M.S., Firrell, L.S., Giles, C.M., Goldberg, L., Marcus, M.D., Schneider, M., Solomon, S., Thompson, D.J., Yin, Z. 2009. Rationale, design and methods of the HEALTHY study behavior intervention component. International Journal of Obesity. 33(Supp 4):S44-S51.

Interpretive Summary: HEALTHY was a study to reduce risk factors for type 2 diabetes among adolescents. The school-based study included nutrition, physical education, behavior change, and communications components. The purpose of this article is to describe the design and development of the behavior change component. One part of the behavior intervention component was a series of peer-led, teacher-facilitated learning activities known as FLASH (Fun Learning Activities for Student Health). Five FLASH modules were implemented over five semesters of the HEALTHY study. Each module contained sessions that were designed to be delivered on a weekly basis to foster self-awareness, knowledge, decision-making skills, and peer involvement for health behavior change. Family outreach activities were also included to extend learning beyond the classroom. Family outreach strategies included newsletters and materials to promote healthy behavior in the home environment during school summer and winter holiday breaks. In conclusion, the HEALTHY behavior intervention component, when integrated with total school food and physical education environmental changes enhanced by communications and promotional campaigns, is a feasible and acceptable way to promote age-appropriate healthy eating and physical activity behaviors among an ethnically diverse group of US middle school students.

Technical Abstract: HEALTHY was a multi-center primary prevention trial designed to reduce risk factors for type 2 diabetes in adolescents. Seven centers each recruited six middle schools that were randomized to either intervention or control. The HEALTHY intervention integrated multiple components in nutrition, physical education, behavior change, and communications and promotion. The conceptual rationale as well as the design and development of the behavior intervention component are described. Pilot study data informed the development of the behavior intervention component. Principles of social learning and health-related behavior change were incorporated. One element of the behavior intervention component was a sequence of peer-led, teacher-facilitated learning activities known as FLASH (Fun Learning Activities for Student Health). Five FLASH modules were implemented over five semesters of the HEALTHY study, with the first module delivered in the second semester of the sixth grade and the last module in the second semester of the eighth grade. Each module contained sessions that were designed to be delivered on a weekly basis to foster self-awareness, knowledge, decision-making skills, and peer involvement for health behavior change. FLASH behavioral practice incorporated individual and group self-monitoring challenges for eating and activity. Another element of the behavior intervention component was the family outreach strategy for extending changes in physical activity and healthy eating beyond the school day and for supporting the student's lifestyle change choices. Family outreach strategies included the delivery of newsletters and supplemental packages with materials to promote healthy behavior in the home environment during school summer and winter holiday breaks. In conclusion, the HEALTHY behavior intervention component, when integrated with total school food and physical education environmental changes enhanced by communications and promotional campaigns, is a feasible and acceptable mechanism for delivering age-appropriate social learning for healthy eating and physical activity among an ethnically diverse group of middle school students across the United States.