title: The YMCA Healthy, Fit, and Strong Program: a community-based, family-centered, low-cost obesity prevention/treatment pilot study.
abstract: BACKGROUND
  Many resources are available for adults, but there are few community-based programs for overweight and obese children. Community engagement may be instrumental in overcoming barriers physicians experience in managing childhood obesity. Our objective was to design and test the feasibility of a community-based (YMCA), family-centered, low-cost intervention for overweight and obese children.
  
  
  METHODS
  Children 6-11 years over the 85th BMI percentile for age and sex were recruited to YMCA sites in four North Carolina communities. The children had physical activity sessions three times weekly for 3 months (one activity session weekly was family night). The parents received a once-weekly nutrition education class conducted by a registered dietitian using the NC Eat Smart Move More curriculum (10 sessions). Changes in BMI were measured at 3, 6, and 12 months and diet and activity behaviors at 3 and 12 months after baseline.
  
  
  RESULTS
  Significant reductions were observed in BMI percentile for age and BMI z-scores at 3, 6, and 12 months. Improvements occurred in dietary and physical activity behaviors, including drinking fewer sugar-sweetened beverages, spending more time in physically active behaviors, and spending less time in sedentary behaviors. The program was low-cost, and qualitative comments suggest the parents and children benefited from the experience.
  
  
  CONCLUSIONS
  This low-cost YMCA-based intervention was associated with BMI reductions and positive nutritional and activity behavior changes, providing an additional strategy for addressing childhood obesity in community settings.
authors.affiliation: Department of Pediatrics Wake Forest School of Medicine, Winston-Salem, NC 27157, USA. rschwrtz@wakehealth.edu
authors.forename: Robert P
authors.initials: RP
authors.lastname: Schwartz
authors.forename: Mara Z
authors.initials: MZ
authors.lastname: Vitolins
authors.forename: L Douglas
authors.initials: LD
authors.lastname: Case
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Armstrong
authors.forename: Eliana M
authors.initials: EM
authors.lastname: Perrin
authors.forename: Josephine
authors.initials: J
authors.lastname: Cialone
authors.forename: Ronny A
authors.initials: RA
authors.lastname: Bell
mesh_terms: D015992:Body Mass Index; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D003258:Consumer Behavior; D003365:Costs and Cost Analysis; D004032:Diet; D005006:Ethnicity; D015444:Exercise; D005190:Family; D005260:Female; D015438:Health Behavior; D006266:Health Education; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D009657:North Carolina; D009765:Obesity / Q000517:prevention & control / Q000628:therapy*; D050177:Overweight / Q000628:therapy; D010290:Parents; D010809:Physical Fitness; D010865:Pilot Projects; D012946:Social Welfare / Q000191:economics