Adolescents demonstrate improvement in obesity risk behaviors after completion of choice, control & change, a curriculum addressing personal agency and autonomous motivation.
BACKGROUND
The rapid increase of obesity and diabetes risk beginning in youth, particularly those from disadvantaged communities, calls for prevention efforts.


OBJECTIVE
To examine the impact of a curriculum intervention, Choice, Control & Change, on the adoption of the energy balance-related behaviors of decreasing sweetened drinks, packaged snacks, fast food, and leisure screen time, and increasing water, fruits and vegetables, and physical activity, and on potential psychosocial mediators of the behaviors.


METHODS
Ten middle schools were randomly assigned within matched pairs to either intervention or comparison/delayed control conditions during the 2006-2007 school year.


METHODS
Students were from low-income New York City neighborhoods; 562 were in the intervention condition, and 574 in the comparison condition.


METHODS
Students received the 24 Choice, Control & Change lessons that used science inquiry investigations to enhance motivation for action, and social cognitive and self-determination theories to increase personal agency and autonomous motivation to take action.


METHODS
Self-report instruments to measure energy balance-related behaviors targeted by the curriculum and potential psychosocial mediators of the behaviors.


METHODS
Analysis of covariance with group (intervention/control) as a fixed factor and pretest as covariate.


RESULTS
Students in intervention schools compared to the delayed intervention controls reported consumption of considerably fewer sweetened drinks and packaged snacks, smaller sizes of fast food, increased intentional walking for exercise, and decreased leisure screen time, but showed no increases in their intakes of water, fruits, and vegetables. They showed substantial increases in positive outcome expectations about the behaviors, self-efficacy, goal intentions, competence, and autonomy.


CONCLUSIONS
The Choice, Control & Change curriculum was effective in improving many of the specifically targeted behaviors related to reducing obesity risk, indicating that combining inquiry-based science education and behavioral theory is a promising approach.
Program in Nutrition, Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY 10027, USA. irc6@columbia.edu
Isobel R
IR
Contento
Pamela A
PA
Koch
Heewon
H
Lee
Angela
A
Calabrese-Barton
D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D053198:Child Nutrition Sciences / Q000193:education*; D002755:Choice Behavior; D003479:Curriculum; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009042:Motivation; D009765:Obesity / Q000517:prevention & control*; D000297:Psychology, Adolescent; D040242:Risk Reduction Behavior; D013334:Students / Q000523:psychology*