Design and Methods for an Intervention Utilizing Peer Facilitators to Reduce Adolescent Obesity: Team Up for Healthy Living

The proportion of obese adolescents in Southern Appalachia is among the highest in the nation. Currently there are few effective programs that address this issue, especially among high school students. Through funding from the National Institute on Minority Health and Health Disparities in the National Institutes of Health, the Team Up for Healthy Living Project targets obesity prevention in adolescents through a crosspeer intervention. The specific aims of the project are: 1) To develop a peer-based health education program focusing on establishing positive peer norms and supportive peer relationships toward healthy eating and physical activity among high school students, 2) To test the efficacy of the program, and 3) To explore the mechanisms underlying the program. The intervention is based on the Theory of Planned Behavior, which presupposes that human behavior is primarily driven by attitude, subjective norms, perceived behavior control, and social support. Through influencing these components, the intervention is expected to improve eating behavior, increase physical activity, and lead to healthier body weight among adolescents in Southern Appalachia. Ten area high schools were selected to be a part of the project, and schools were matched based on similar demographics (school size and number of students enrolled) and were randomized to intervention or control. Wave one of baseline data collection was completed in January 2012; with 265 students assigned to intervention and 276 to control. A second wave of subject recruitment will occur in fall 2012. To deliver the intervention, undergraduate students from the disciplines of Public Health, Nutrition, and Kinesiology were trained as peer facilitators. These peer facilitators are teaching the eight-week Team Up curriculum during Lifetime Wellness classes at intervention schools. The curriculum focuses on nutrition awareness, physical activity, leadership, and communication skills. Page 84 2012 Appalachian Student Research Forum Control group participants receive their regularly scheduled Lifetime Wellness curriculum. Body mass index percentile, dietary behavior, and physical activity among study subjects will be assessed at baseline, and at three and twelve months post-baseline. In addition, peer group norms, body image, supportive peer relationships, role modeling, behavioral control/self-efficacy, attitudes, and intentions toward healthy eating and physical activity will also be assessed. Group differences will be assessed at each data collection period. The long-term goal of the study is to establish an effective academia-community partnership program to address adolescent obesity disparity in Southern Appalachia