The Memphis Girls' health Enrichment Multi-site Studies (GEMS): an evaluation of the efficacy of a 2-year obesity prevention program in African American girls.
OBJECTIVE
To determine the efficacy of a 2-year obesity prevention program in African American girls.


METHODS
Memphis GEMS (Girls' health Enrichment Multi-site Studies) was a controlled trial in which girls were randomly assigned to an obesity prevention program or alternative intervention.


METHODS
Local community centers and YWCAs (Young Women's Christian Associations) in Memphis, Tennessee.


METHODS
Girls aged 8 to 10 years (N = 303) who were identified by a parent or guardian as African American and who had a body mass index (BMI) at or higher than the 25th percentile for age or 1 parent with a BMI of 25 or higher.


METHODS
Group behavioral counseling to promote healthy eating and increased physical activity (obesity prevention program) or self-esteem and social efficacy (alternative intervention).


METHODS
The BMI at 2 years.


RESULTS
The BMI increased in all girls with no treatment effect (obesity prevention minus alternative intervention) at 2 years (mean, 0.09; 95% confidence interval [CI], -0.40 to 0.58). Two-year treatment effects in the expected direction were observed for servings per day of sweetened beverages (mean, -0.19; 95% CI, -0.39 to 0.09), water (mean, 0.21; 95% CI, 0.03 to 0.40), and vegetables (mean, 0.15; 95% CI,-0.02 to 0.30), but there were no effects on physical activity. Post hoc analyses suggested a treatment effect in younger girls (P for interaction = .08). The mean BMI difference at 2 years was -2.41 (95% CI, -4.83 to 0.02) in girls initially aged 8 years and -1.02 (95% CI, -2.31 to 0.27) in those initially aged 10 years.


CONCLUSIONS
The lack of significant BMI change at 2 years indicates that this intervention alone is insufficient for obesity prevention. Effectiveness may require more explicit behavior change goals and a stronger physical activity component as well as supportive changes in environmental contexts.
Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline Street, Memphis, TN 38105, USA. Bob.Klesges@STJUDE.ORG
Robert C
RC
Klesges
Eva
E
Obarzanek
Shiriki
S
Kumanyika
David M
DM
Murray
Lisa M
LM
Klesges
George E
GE
Relyea
Michelle B
MB
Stockton
Jennifer Q
JQ
Lanctot
Bettina M
BM
Beech
Barbara S
BS
McClanahan
Deborah
D
Sherrill-Mittleman
Deborah L
DL
Slawson
D001741:Black or African American / Q000193:education* / Q000523:psychology; D000704:Analysis of Variance; D000886:Anthropometry; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002648:Child; D004034:Diet Surveys; D017097:Electric Impedance; D005260:Female; D006266:Health Education; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008991:Monitoring, Physiologic; D009043:Motor Activity; D009765:Obesity / Q000517:prevention & control*; D015397:Program Evaluation; D012649:Self Concept; D020377:Self Efficacy; D013714:Tennessee; D016896:Treatment Outcome