Abstract
BackgroundAdolescent obesity is a major public health concern. Open to all high school students regardless of weight status, HealthCorps is a nationwide program offering a comprehensive high school-based participatory educational program to indirectly address obesity. We tested a hypothesis that the HealthCorps program would decrease BMI z-scores among overweight or obese students, and reduce obesity rates, and evaluated its effects on health knowledge and behaviors.MethodsHealthCorps aimed to improve student knowledge and behaviors regarding nutrition quality, physical activity, sleep, breakfast intake, and mental resilience. Participating students received through HealthCorps coordinators weekly or bi-weekly classroom lessons either for a semester or a year in addition to various during- and after-school health-promoting activities and mentorship. Self-reported height and weight were collected along with questionnaires assessing knowledge and behaviors during 2013-2014 academic year among 14 HealthCorps-participating New York City high schools. This quasi experimental two-arm pre-post trial included 611 HealthCorps and 221 comparison arm students for the analytic sample. Sex-specific analyses stratified by weight status were adjusted for age and Hispanic ethnicity with clustering effects of schools and students taken into account.ResultsHealthCorps female overweight/obese and obese student had a significant decrease in BMI z-scores (post-pre delta BMI z-score = −0.16 (95%CI = (−0.26, −0.05), p = 0.004 for the former; and = −0.23 (−0.44, −0.03), p = 0.028, for the latter) whereas comparison female counterparts did not. The HealthCorps students, but not the comparison students, had a significant increase for all knowledge domains except for the breakfast realm, and reported a greater number of significant behavior changes including fruit and vegetable intake and physical activities.ConclusionsThe HealthCorps program was associated with reduced BMI z-score in overweight/obese and obese female adolescents, with enhanced health knowledge and behavior for both sexes. With its wide reach, this may be a promising program to help combat adolescent obesity in schools.Trial registrationThis study is registered as a clinical trial at the ClinicalTrials.gov registry with trial number NCT02277496 on September 10, 2014 (Retrospectively registered).
Highlights
Adolescent obesity is a major public health concern
It is estimated that more than 1.8 million adolescents to date have been exposed to the program since its foundation in 2003 when the HealthCorps program was the first of its kind that was implemented in New York City (NYC) public high schools with intense and challenging urban inner city environments
Effect of HealthCorps program on body mass index (BMI) z-scores (Table 2) There was a significant decrease in the BMI z-scores for overweight/obese (BMI ≥ 85th%-tile) and obese (BMI ≥ 95th%-tile) HealthCorps female students: post-pre delta = −0.16±0.05 (p = 0.004) and −0.23±0.10 (p = 0.028), respectively
Summary
Open to all high school students regardless of weight status, HealthCorps is a nationwide program offering a comprehensive high school-based participatory educational program to indirectly address obesity. We tested a hypothesis that the HealthCorps program would decrease BMI z-scores among overweight or obese students, and reduce obesity rates, and evaluated its effects on health knowledge and behaviors. [18,19,20] to our knowledge, no school-based trial to date has utilized an extramural program to address adolescent weight improvement in a high school setting while minimizing potential weight stigmatization. (www.healthcorps.org), an United States nationwide extramural non-profit non-governmental organization, offers a unique comprehensive high schoolbased voluntary participatory educational program that is open to all students regardless of their weight status. The program focuses on improving the health knowledge and behaviors on: nutrition, physical activities, breakfast intake, adequate sleep, and mental resilience
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