Development and evaluation of a nutrition curriculum to prevent obesity in inner-city teens
Date
1998
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Abstract
Obesity is a major health concern in the United States. Obese adolescents have been found, later in life, to be at increased risk for noninsulin dependent diabetes mellitus, cardiovascular disease, hypertension and certain cancers. NHANES III and HHANES data reveal that regardless of ethnicity, an estimated 21% of adolescents (12-17 years of age) in the United States are considered overweight or obese. Obese adolescent girls are at especially high risk for remaining obese in adulthood. Adolescence represents a crucial time for reversing and preventing obesity. The purpose of this study was two-fold: 1) to develop a nutrition education curriculum targeting sedentary, inner-city adolescents living in Denver, Colorado; and 2) to evaluate the effectiveness of this curriculum by assessing changes in knowledge, attitudes, self-efficacy, stage of change for exercise and fat intake behaviors, dietary behaviors, physical fitness indices, and certain physiological parameters. The goal of this course was to promote metabolic fitness by modifying food intake and increasing exercise frequency. In Denver Colorado, twenty-three treatment subjects were compared to fifty-three control subjects. The treatment subjects received two years of nutrition education, while the control subjects received none. Formative evaluations were used to establish course content, and the curriculum was developed utilizing Prochaska's Stages of Change along with Bandura's Self- Efficacy and Social Learning Theory. Promotion of behavior change and progression to the next stage of change was accomplished through instruction and activities focused on consciousness-raising, promotion of social support, environmental reevaluation, management of emotional arousal, self-monitoring and self-evaluation, goal-setting, and improving self-efficacy for selecting and eating healthier foods. After two years of intervention, only 36% of the developed curriculum had been delivered to treatment subjects due to instructor related problems. However, despite implementation difficulties, some positive results were seen. Treatment subjects reported significant improvements in: knowledge, their intentions to change fat intake and exercise behaviors (stages of change), their fat intake as measured by two food frequency questionnaires, and their waist-to-hip ratios. The lack of more positive results are most likely due to poor curriculum implementation.
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Subject
Obesity in adolescence
Teenagers -- Nutrition
Nutrition -- Study and teaching