title: Challenge! Health promotion/obesity prevention mentorship model among urban, black adolescents.
abstract: OBJECTIVE
  The objective of this study was to evaluate a 12-session home/community-based health promotion/obesity prevention program (Challenge!) on changes in BMI status, body composition, physical activity, and diet.
  
  
  METHODS
  A total of 235 black adolescents (aged 11-16 years; 38% overweight/obese) were recruited from low-income urban communities. Baseline measures included weight, height, body composition, physical activity (PA), and diet. PA was measured by 7-day play-equivalent physical activity (> or =1800 activity counts per minute). Participants were randomly assigned to health promotion/obesity prevention that is anchored in social cognitive theory and motivational interviewing and was delivered by college-aged black mentors or to control. Postintervention (11 months) and delayed follow-up (24 months) evaluations were conducted. Longitudinal analyses used multilevel models with random intercepts and generalized estimating equations, controlling for baseline age/gender. Stratified analyses examined baseline BMI category.
  
  
  RESULTS
  Retention was 76% over 2 years; overweight/obese status declined 5% among intervention adolescents and increased 11% among control adolescents. Among overweight/obese youth, the intervention reduced total percentage of body fat and fat mass and increased fat-free mass at delayed follow-up and increased play-equivalent physical activity at postintervention but not at delayed follow-up. Intervention adolescents declined significantly more in snack/dessert consumption than control adolescents at both follow-up evaluations.
  
  
  CONCLUSIONS
  At postintervention, there were intervention effects on diet and PA but not BMI category or body composition. At delayed follow-up, dietary changes were sustained and the intervention prevented an increase in BMI category. Body composition was improved for overweight/obese youth. Changes in body composition follow changes in diet and PA and may not be detected immediately after intervention.
authors.affiliation: Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA. mblack@peds.umaryland.edu
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Black
authors.forename: Erin R
authors.initials: ER
authors.lastname: Hager
authors.forename: Katherine
authors.initials: K
authors.lastname: Le
authors.forename: Jean
authors.initials: J
authors.lastname: Anliker
authors.forename: S Sonia
authors.initials: SS
authors.lastname: Arteaga
authors.forename: Carlo
authors.initials: C
authors.lastname: Diclemente
authors.forename: Joel
authors.initials: J
authors.lastname: Gittelsohn
authors.forename: Laurence
authors.initials: L
authors.lastname: Magder
authors.forename: Mia
authors.initials: M
authors.lastname: Papas
authors.forename: Soren
authors.initials: S
authors.lastname: Snitker
authors.forename: Margarita S
authors.initials: MS
authors.lastname: Treuth
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002391:Catchment Area, Health; D002648:Child; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008611:Mentors; D009042:Motivation; D009043:Motor Activity; D009765:Obesity / Q000208:ethnology* / Q000517:prevention & control*; D015995:Prevalence; D012153:Retention, Psychology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*