Healthy School Recognized Campus is a Texas A\&M AgriLife Extension initiative that supports the delivery of school-based physical activity and nutrition programs for diverse youth across Texas. The purpose of this study is to improve the delivery of these programs and optimize the effect they have on youth's cardiovascular risk factors.
The investigators will conduct a group randomized factorial trial using the Multiphase Optimization STrategy (MOST) framework to evaluate the impact (i.e., implementation and effectiveness) of three implementation strategies on program implementation and youth's cardiovascular disease risk. HSRC is a Texas A\&M AgriLife Extension initiative that supports the delivery of school-based physical activity and nutrition programs. Elementary schools in North and East Texas (n=16) of similar socio-economic status will be randomized at baseline to receive either 3, 2, 1, or no strategies to support HSRC program implementation. All schools will participate in HSRC during the full school year. The investigators hypothesize that one strategy will result in significantly greater HSRC implementation and effectiveness than the other strategies tested.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
159
Schools in this group will participate in meetings and discussion boards and receive newsletters to help with program implementation.
Schools in this group will receive extra resources such as program incentives to aid in program implementation.
Schools in this group will participate in program contests to aid program implementation.
Texas A&M AgriLife Dallas Center
Dallas, Texas, United States
Presence or absence of metabolic syndrome (MetS)
MetS is present after identifying abdominal obesity plus at least two of the four other MetS Risk factors: high blood pressure, high blood sugar, low HDL cholesterol, and high triglyceride levels. MetS = (abdominal obesity) + (2 of 4 other MetS Risk factors) Measures to determine MetS risk factors: 1. Abdominal obesity: waist circumference \>90th percentile for child's sex and age 2. High blood pressure: systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥90 mmHg) 3. High blood glucose: blood glucose ≥5.6 mmol/L or known diabetes 4. Low HDL cholesterol: HDL cholesterol \<1.03 mmol/L 5. High triglyceride level: Triglyceride level ≥ 1.7mmol/L
Time frame: Baseline, 9 months (immediate post intervention)
Change in the number of MetS risk factors
Change in the number of MetS risk factors = (new # of MetS risk factors) - (original # of MetS risk factors) Measures to determine MetS risk factors: 1. Abdominal obesity: waist circumference \>90th percentile for child's sex and age 2. High blood pressure: systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥90 mmHg) 3. High blood glucose: blood glucose ≥5.6 mmol/L or known diabetes 4. Low HDL cholesterol: HDL cholesterol \<1.03 mmol/L 5. High triglyceride level: Triglyceride level ≥ 1.7mmol/L
Time frame: Baseline, 9 months (immediate post intervention)
Number of programs schools delivered (in addition to Walk Across Texas)
Time frame: Baseline, 9 months (immediate post intervention)
Number of sessions delivered for each program
Time frame: Baseline, 9 months (immediate post intervention)
Length of the sessions delivered
Time frame: Baseline, 9 months (immediate post intervention)
Individual-level attendance data for programs delivered
Time frame: Baseline, 9 months (immediate post intervention)
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Body mass index (BMI)
Weight will be measured with a scale (in pounds), and height will be measured using a stadiometer (in inches). Weight and height will be combined to report BMI as follows, BMI = (weight (lb)/height (inches)2) x 703.
Time frame: Baseline, 9 months (immediate post intervention)
Concentration of subdermal carotenoids
The concentration of subdermal carotenoids will assess the changes in fruit and vegetable consumption using the Veggie Meter: A non-invasive, portable machine that measures subdermal carotenoid levels using resonance Raman spectroscopy.
Time frame: Baseline, 9 months (immediate post intervention)
Physical fitness capacity estimation
Physical fitness will be measured using the FitnessGram PACER multistage aerobic capacity test: Children will run back and forth 20 meters, with an initial running speed of 8.5 km/hour and a progressive 0.5-km/hour increase in running speed every minute. As the test continues it becomes progressively harder. The number of laps completed is used to estimate children's physical fitness physical fitness.
Time frame: Baseline, 9 months (immediate post intervention)
Blood pressure level
Blood pressure (systolic and diastolic) will be measured with two numbers using an automated Omron sphygmomanometer.
Time frame: Baseline, 9 months (immediate post intervention)
Concentration of blood glucose
Glucose will be measured using a portable CardioChek Plus analyzer to assess a single capillary blood sample following an overnight fast.
Time frame: Baseline, 9 months (immediate post intervention)
Waist circumference
Waist circumference will be measured at the midpoint between the floating rib and iliac crest using a tape measure.
Time frame: Baseline, 9 months (immediate post intervention)
Concentration of HDL cholesterol
HDL-C will be measured using a portable CardioChek Plus analyzer to assess a single capillary blood sample following an overnight fast.
Time frame: Baseline, 9 months (immediate post intervention)
Concentration of serum triglycerides
Triglycerides will be measured using a portable CardioChek Plus analyzer to assess a single capillary blood sample following an overnight fast.
Time frame: Baseline, 9 months (immediate post intervention)
Height
Height will be measured using a stadiometer in inches.
Time frame: Baseline, 9 months (immediate post intervention)
Weight
Weight will be measured with a scale in pounds.
Time frame: Baseline, 9 months (immediate post intervention)