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Clinician Promotion of Healthy Diet and Activity to Reduce Obesity Among Adolescents: HEALTHY SMILES

Not Applicable
Completed
Conditions
Obesity
Interventions
Behavioral: Obesity Prevention
Behavioral: Tobacco Prevention
Registration Number
NCT01510483
Lead Sponsor
San Diego State University
Brief Summary

This study will test an 18-month intervention designed to increase physical activity, reduce sedentary practices and promote healthy diets or reduce tobacco use and exposure among preteens who obtain orthodontic care. Relevance: If successful, this study may inform policies that would promote all specialists (orthodontists, physicians, general dentists) to deliver brief counseling for diet, physical activity, and tobacco prevention.

Detailed Description

This study will test a 18-month multi-component intervention designed to increase physical activity, reduce sedentary practices and promote healthy diets among preteens who obtain orthodontic care. The intervention is based on the Behavioral Ecological Model (BEM), where interacting physiological, environmental, and cultural contingencies select behavior. This study will require five years to recruit 40 orthodontist offices, and 1700 youth, and implement an office-wide intervention for promoting healthy diet and physical activity among 8-14 yr old youth. Our primary aims are to detect a differential change in diet, physical activity and BMI in our experimental group compared to the tobacco prevention control group; to observe differential effects of the intervention between low vs. high SES; and similarly for males vs. females; to validate our primary outcome variables by contrasting them with a "gold standard"; and determine the degree to which family and peer encouragement for sedentary and high caloric diet at baseline increases the relative effect of the orthodontist intervention. Offices will be assigned at random to condition producing a 2 (experimental group) by 2 strata (low vs. high SES) by 2 strata (male vs. female) by 4 (repeated measures) experimental design. Those in the experimental condition will be exposed to the office-wide intervention for diet and activity; those in the control condition will be exposed to an office-wide intervention for tobacco prevention. The intervention will consist of training of orthodontists and office staff to provide appropriate social prompts, reinforcement and counseling, and modification of the offices to provide supportive physical and social resources for their patients and parents. Measures of diet, physical activity, body composition, tobacco use, fitness and family and peer encouragement will occur at baseline, 12, 18, and 24 months. Differential change over time will be analyzed using Random Effects Multivariate modeling. Analyses will include control for office cluster effects and multivariate models will include analyses of hypothetical main effects, experimental group by time interactions, and moderating effects by inclusion of interaction terms for susceptibility by experimental condition and other possible moderators. Relevance: If successful, this study may inform policies that would promote all specialists (physicians, general dentists) to deliver brief counseling for diet and physical activity. Doing so might yield the cumulative exposure necessary to effect and sustain change in a large proportion of the preteen population.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
693
Inclusion Criteria
  • 8-14 years old
  • receiving orthodontic care at a participating orthodontic office
  • at least 1 year left in braces
Exclusion Criteria
  • participating in 9 or more months of structured
  • organized sports for 3 or more days a week, youth who have serious conditions that preclude physical activity or make the child incapable of managing his/her own care will not qualify for this study
  • individuals who report anorexia, bulimia or severe, diagnosed depression will not be eligible

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Obesity preventionObesity PreventionOrthodontist promotion of physical activity and healthy diet
Tobacco preventionTobacco PreventionOrthodontist promotion of tobacco and second hand smoke avoidance
Primary Outcome Measures
NameTimeMethod
Change in Body Mass IndexBaseline, 2, 4, 6, 8, 10, 12, 14, 16, 18, 24 months

Body Mass Index assessed at Baseline, 12 month, 18 months and 24 months; and every 6-8 weeks during intervention period.

Secondary Outcome Measures
NameTimeMethod
Change in tobacco use and exposureBaseline, 12, 18 and 24 months
Change in physical and sedentary activityBaseline, 12, 18 and 24 months
Change in dietary intakeBaseline, 12, 18 and 24 months

Trial Locations

Locations (1)

SDSU-Center for Behavioral Epidemiology & Community Health

🇺🇸

San Diego, California, United States

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