Food & Health Alliance

Resnicow, K.; Yaroch, A. L.; Davis, A.; Wang, D. T.; Carter, S.; Coleman, D. & Baranoswski, T.  Department of Behavioral Science and Health Education, Rollins School of Public Health, Emory University and Department of Pediatrics, Children’s Research Center, Baylor College of Medicine.  (2000).

Study that examines the effect of a nutrition and activity intervention for overweight, African-American adolescent females.  This study summarises the development, delivery and results of the GO GIRLS! intervention.

Method:  Discussions took place with researchers, practitioners and focus groups of African-American adolescent females to investigate general health attitudes and nutrition knowledge.  An advisory panel, consisting of nutrition and physical activity researchers, provided further advice.  All of this qualitative information was used to inform the development of the intervention.

In order to take part in the study females had to be aged 11 to 17 years old, live in a public housing development and be classified as overweight.  The intervention was delivered in four 6-month cycles over a period of 2 years. 

The intervention focused on increasing fruit and vegetable intake, decreasing fat intake, decreasing TV viewing and increasing physical activity levels. Opportunities to eat healthy food and take part in cookery classes were also provided.  Each session consisted of interactive educational/behavioral activity, 30-60 minutes of physical activity and the preparation and tasting of healthy food.  Girls were also trained to recognise their own satiation along with tasting new healthy foods. 

Participants completed physiologic, dietary, behavioural and cognitive assessments at baseline and after the intervention.  Measures of nutrient intake, dietary practices, physiological attributes (e.g. BMI, blood pressure and aerobic capacity), psychosocial ratings (e.g. self-esteem, self-efficacy and perceived weight) and physical activity levels were recorded. 

Findings:  Few problems were noted in recruiting participants, however a high drop-out rate was observed, with only 43% of the participants attending all of the sessions.  Participants enjoyed physically active field trips (such as hiking and ice skating), but enjoyed ‘getting away’ from their local environment as much as the activity itself.  Comparisons were made between low and high attendees, with high attendees having better post-intervention values than low attendees.  However, the only significant improvements were noted for nutrition knowledge, low-fat practices and perceived social support. 

Some clinically significant differences were noted for total calories consumed and sodium intake.  The intervention had a positive impact on knowledge and dietary behaviors, and perhaps contributed to reduced weight gain.  Participants reported not being fully committed to weight loss throughout the programme, which may explain why no significant impact was made in terms of weight loss.  Lack of parental support with shopping and cooking was noted as a key barrier to full participation.   

Suggestions:  Additional strategies are needed to maximize participation and retention.  Future interventions should engage with parents in order to provide encouragement in healthy behaviours for their daughters.  Delivery staff should have been more representative of the community from which the participants came in order to increase efficacy of the programme.  Working with food providers may have also increased the impact of the interventions, e.g. by increasing access to healthy food within the school canteen. 

The provision of a daily food plan may have also assisted the participants in improving their diet.  Providing an opportunity to eat at each session was regarded as being very effective.  Screening for readiness to change may improve outcomes of the intervention, especially in terms of using project resources effectively. 

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