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Innovative Obesity Prevention for African-American Girls

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We propose a 2-arm parallel group, randomized controlled trial to test the efficacy of an after school dance program and a family-based intervention to reduce television, videotape and video game use to reduce weight gain among lower socioeconomic status African-American preadolescent girls. An active placebo control group will receive an information-based community health education intervention. A total of 260 girls will be randomized to the two conditions and the interventions will last for the full 2-year period of the study. Our interventions and study design are supported by prior studies demonstrating the feasibility and potential efficacy of dance classes and reducing television viewing for reducing weight gain, formative studies, and the success of a 12-week randomized controlled pilot study of the proposed trial. Measures will be collected in girls' homes at baseline and 6, 12, 18 and 24 months. Body Mass Index (BMI) is the primary outcome measure, The primary hypothesis will be tested by comparing individual trajectories of change in the treatment and control groups over the entire two-year course of the trial, using random regression models, Specific Aims include: 1. To participate with NHLBI and the Memphis GEMS investigators to conduct a full-scale, collaborative, 2-year randomized controlled trial, including both site-specific and collaborative measures and site-specific and collaborative analyses. 2. To test the effect of the Stanford GEMS intervention on BMI over 2 years (the primary outcome). We hypothesize that, compared to controls, girls in the treatment-group will significantly reduce their weight gain (BMI) over the two-year study period. 3. To test the effects of the Stanford GEMS intervention on secondary outcomes over two years. We hypothesize that, compared to controls, girls in the treatment group will significantly reduce their waist circumference, triceps skinfold thickness, resting blood pressures, resting heart rate, fasting insulin, total cholesterol, LDL-cholesterol, triglycerides, television, videotape and video game use, meals eaten in front of television, total dietary calorie intake, percent of calories from fat, weight concerns, and body disatisfaction, and significantly increase their HDL-cholesterol, after school and daily physical activity, self-esteem, and school performance. 4. To conduct analyses to evaluate potential moderators and mediators of intervention effects on primary and secondary outcomes.
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