Trial Of Activity For Adolescent Girls Research Articles

Re-recruiting young adult women into a second follow-up study.

BackgroundRecruitment among young adults presents a unique set of challenges as they are difficult to reach through conventional methods.PurposeTo describe our experience using both traditional and nontraditional methods in the re-recruitment of young adult women into the second follow-up study of the Trial of Activity for Adolescent Girls (TAAG).Methods589 adolescent girls were re-recruited as 11th graders into TAAG 2. Re-recruitment efforts were conducted when they were between 22 and 23 years of age (TAAG 3). Facebook, email, postal mail, and telephone (call and text) were used. Descriptive statistics were used to summarize cohort characteristics. Discrete categorical variables were compared using Pearson chi-square or Fisher's exact test, while Wilcoxon rank sum or t-tests were calculated for continuous variables. Pearson's chi square test, analysis of variance, and the Kruskal-Wallis test were also used. Logistic regression was used to calculate adjusted models.ResultsAll 589 cohort members were located and 479 (81.3%) were re-recruited. Participants who reported living in a two parent household or with their mothers only, and who did not perceive a lot of crime in their neighborhood were more likely to consent to participate in TAAG 3 (p = 0.047 and p = 0.008, respectively). Perceived neighborhood crime remained significant in the adjusted model (OR 0.48, 95% CI 0.25–0.90, p = 0.02). Early and late consenters differed by race/ethnicity (p = 0.015), household type (p = 0.001), and socioeconomic status (p = 0.005). In the adjusted model, Black participants were more likely to consent later than White participants (OR 1.83, 95% CI 1.07–3.13, p = 0.03).ConclusionsA number of recruitment strategies and outreach attempts were needed to recruit young adult women into a follow-up study. Persistent efforts may be needed to recruit participants with race/ethnic diversity and lower socioeconomic status.

Energy balance in adolescent girls: The trial of activity for adolescent girls cohort

ObjectivesTo study correlates of change in BMI percentile and body fat among adolescent girlsDesign and MethodsA longitudinal prospective study following 265 girls from the Trial of Activity for Adolescent Girls (TAAG) cohort measured in 8th grade and during 10 and 11th grade or 11th and 12th grade. Twice during 2009-2011 girls wore an accelerometer and completed a food frequency questionnaire and 7-day diary documenting trips and food eaten away from home and school. Physical activity, BMI, and percent body fat were objectively measured at each time point.ResultsModerate to vigorous physical activity (MVPA) declined, but was not independently associated with changes in BMI percentile. Increased vigorous physical activity was associated with reductions in body fat. Diet was associated with both changes in BMI percentile and body fat. Girls who increased the percentage of caloric intake from snacks and desserts reduced their BMI percentile and body fat.ConclusionsSome relationships between energy balance behaviors and BMI and body composition were counter-intuitive. While it is plausible that vigorous activity would result in reductions of body fat, until more accurate methods are devised to measure diet, the precise contribution of dietary composition to health will be difficult to assess.

Physical Activity Behavior and Related Characteristics of Highly Active Eighth-Grade Girls

Although girls are generally less physically active than boys, some girls regularly engage in high levels of physical activity (PA); however, very little is known about these girls and how they differ from those who are less physically active. This study examined the PA behavior and related characteristics of highly active adolescent girls and compared them with those who are less active. Data from 1,866 eighth-grade girls from six field centers across the United States participating in the Trial of Activity for Adolescent Girls (TAAG) were included in the present analysis. Mixed-model analysis of variance examined differences in sociodemographic, anthropometric, psychosocial, and physical activity (accelerometry and self-report) variables between high- and low-active girls; effect sizes were calculated for the differences. High-active girls were taller, had lower body mass indices and body fat, and were less sedentary. High-active girls scored higher on self-efficacy, enjoyment of PA, self-management strategies, outcome-expectancy value, and support from family and friends than low-active girls. Low-active girls participated in more leisure time and educational sedentary activities than high-active girls. High-active girls participated in more PA classes/lessons outside of school, team sports, and individual sports. They were also more likely to participate in sports in an organized setting in the community or at school than low-active girls. Health promotion efforts should focus on decreasing the amount of time girls spend in sedentary activities and replacing that time with organized PA opportunities; such efforts should seek to minimize perceived barriers and increase self-efficacy and support for PA.

Recruiting adolescent girls into a follow-up study: Benefits of using a social networking website

BackgroundRecruitment and retention of adolescent research participants presents unique challenges and considerations when conducting epidemiological studies. PurposeTo describe the use of the social networking website in the re-recruitment and tracking of adolescent girls into a follow-up study of the Trial of Activity for Adolescent Girls (TAAG) at the University of Maryland field site. Methods730 girls were recruited as 8th graders into TAAG. Re-recruitment efforts were conducted when they were 11th graders (TAAG 2). Traditional methods, including mailings and school visits, were conducted. A TAAG 2 Facebook site was created to search for girls not found through traditional recruitment methods. Chi-square and t-tests were conducted to identify differences in characteristics between those found and “friended” through Facebook and through traditional recruitment methods. ResultsThere were 175 girls we were unable to locate using traditional recruitment methods. Of these, 78 were found on Facebook, 68 responded to our friend request, and 43 girls (6% of the girls previously recruited) participated in the study. Demographic data were similar for those who friended us on Facebook and traditional methods. 8th grade body mass index and percent body fat were lower for those recruited from Facebook (p=0.03 and 0.04, respectively). Number of daily minutes of moderate-to-vigorous physical activity tended to be lower among the TAAG 2 Facebook friends (19±11 vs 21±11, p=0.06). ConclusionsLoss to follow-up was minimized by contacting potential participants through Facebook. Social networking websites are a promising method to recruit adolescents.

Obesity and depressed mood associations differ by race/ethnicity in adolescent girls

Abstract Objectives. To evaluate bidirectional associations between obesity and depressed mood in adolescent girls, and determine if associations differed by racial/ethnic group. Methods. We analyzed data collected from 918 adolescent girls studied in 6(th) and 8(th) grades in the Trial of Activity for Adolescent Girls (TAAG). Racial/ethnic group was defined as non-Hispanic white, non-Hispanic black, and Hispanic. Height and weight were measured and obesity was defined as a body mass index-for-age ≥95(th) percentile. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms and depressed mood, defined as CES-D ≥24. Generalized estimating equations were used to examine associations between 6(th) grade obesity and 8(th) grade depressed mood, as well as 6(th) grade depressed mood and 8(th) grade obesity. Results. Racial/ethnic group was a statistically significant effect modifier in both directions of association (p<0.02). Among white girls, 6(th) grade obesity was associated with greater likelihood of depressed mood in 8(th) grade (odds ratio [OR]=2.47, 95% confidence interval [CI]: 1.85, 3.30), whereas for black and Hispanic girls this association was not observed (OR= 1.16 and 0.82, respectively). Also for white girls, 6(th) grade depressed mood was associated with greater likelihood of obesity in 8(th) grade (OR = 4.47, CI: 1.96, 10.24), whereas for black and Hispanic girls, OR=0.83 and 1.89, respectively. Conclusions. Associations between obesity and depressed mood may be most problematic among adolescent girls in the white racial/ethnic group. Our results are consistent both with depressed mood contributing to obesity and obesity contributing to depressed mood.

Compensation or displacement of physical activity in middle-school girls: the Trial of Activity for Adolescent Girls

The “activitystat” hypothesis suggests that increases in moderate-to-vigorous physical activity (MVPA) are accompanied by a compensatory reduction in light physical activity (LPA) and/or an increase in inactivity in order to maintain a consistent total physical activity level (TPA).ObjectiveThe purpose of this study was to identify evidence of compensation in middle school girls.SubjectsParticipants were 6,916, 8th grade girls from the Trial of Activity for Adolescent Girls (TAAG).DesignInactivity and physical activity were measured over 6- consecutive days using accelerometry (MTI Actigraph). A within-girl, repeated measures design was used to assess associations between physical activity and inactivity using general linear mixed models.ResultsWithin a given day, for every one MET-minute more of inactivity, there was 3.18 MET-minutes (95% confidence interval: −3.19, −3.17) less of TPA (activity > 2 METS) on the same day. Daily inactivity was also negatively associated with TPA on the following day. Each additional minute of MVPA was associated with 1.85 minutes less of inactivity on the same day (95% confidence interval: −1.89, −1.82). Daily MVPA was also negatively associated with inactivity the following day.ConclusionOur results, based on 6-days of observational data, were not consistent with the “activitystat” hypothesis, and instead indicated that physical activity displaced inactivity, at least in the short term. Longer intervention trials are needed, nevertheless our findings support the use of interventions to increase physical activity over discrete periods of time in middle school girls.

Neighborhood Socioeconomic Status and Non School Physical Activity and Body Mass Index in Adolescent Girls

Socioeconomic status (SES) has well known associations with a variety of health conditions and behaviors in adults but is unknown in adolescents. Multilevel analysis was conducted to examine the associations between individual and neighborhood-level measures of SES and physical activity and body mass index in a sample of 1554 6th grade girls selected at random from 36 middle schools across 6 geographic regions in the United States that participated in the Trial of Activity for Adolescent Girls (TAAG). Data on parental education and employment, and receipt of subsidized school lunch were collected by questionnaire. Neighborhood-level SES was measured by the Townsend Index. Nonschool physical activity levels were measured by accelerometer and type, location and context was measured using a 3 day physical activity recall (3DPAR). After controlling for race, lower parental education and higher levels of social deprivation were associated with higher BMI. In a model with both variables, effects were attenuated and only race remained statistically significant. None of the indices of SES were related to accelerometer measured physical activity. Bivariate associations with self-reported Moderate-Vigorous Physical Activity (MVPA) location and type (3DPAR) varied by SES. Among adolescent girls in the TAAG Study, the prevalence of overweight is high and inversely related to individual and neighborhood SES.

A Longitudinal Study of Sedentary Behavior and Overweight in Adolescent Girls

The aim of this study is to examine sedentary and light activity in relation to overweight in adolescent girls. Adolescent girls were randomly recruited from 36 schools participating in the Trial of Activity for Adolescent Girls (TAAG). Assessments included age, ethnicity, socioeconomic status, and body composition estimated from weight, height, and triceps skinfold. Sedentary and light activity was measured for 6 days using accelerometry in 6th and in 8th grade among two randomly sampled cross-sections of girls. Sedentary activity increased from the 6th to 8th grade by 51.5 min/day. In the 8th grade, a significantly higher number of hours in sedentary activity for each of the 6-days of measurement were evident with higher tertiles of percent body fat (30-35%, >35% fat) (P < 0.05), but not across all increasing tertiles of BMI (5th to 85th, 85th to 95th, and >95th percentiles). The increase in sedentary activity was observed on weekdays, but not on weekends for percent body fat tertiles. In the cohort of girls measured in both 6th and 8th grades, the mean cross-sectional coefficient estimates were significant for percent body fat, but not BMI for sedentary and light activities. Adolescent girls from the 6th to 8th grade are shifting their time from light to more sedentary activity as measured by accelerometers. In addition, the increase in sedentary activity is not associated with an adverse effect on BMI or percent body fat. The eventual impact of this shift to a more sedentary lifestyle on body composition and other outcomes needs to be evaluated further.

Physical and Social Contexts of Physical Activities Among Adolescent Girls

With limited opportunities for physical activity during school hours, it is important to understand the contexts of physical activities done outside of school time. Given the importance of physical and social aspects of environments, the purpose of this study was to describe where and with whom girls participate in physical activities outside of school. Participants were 1925 sixth-grade girls in the Trial of Activity for Adolescent Girls (TAAG). At baseline, they completed a 3-day physical activity recall (3DPAR), reporting the main activity performed during 30-minute intervals and the physical and social contexts of physical activities. The most frequently reported physical activities done outside of school time were house chores, walking (for transportation or exercise), dance, basketball, playing with younger children, and running or jogging. The most common location for these activities was at home or in the neighborhood. With the exception of household chores, these activities were typically done with at least one other person. Interventions that promote physical activities that can be done at or around home or developing supportive social networks for physical activity would be consistent with the current physical activity contexts of adolescent girls.

Tracking of Physical Activity and Inactivity in Middle School Girls

The purpose of this study was to describe and compare the levels of tracking of physical activity and inactivity as assessed by self-report and accelerometry in middle school girls during a 2-yr period. Participants (n = 951) were from the Trial of Activity for Adolescent Girls (TAAG). The TAAG intervention had minimal effect on physical activity; therefore, both intervention and control participants were included. Inactivity and physical activity were measured by accelerometry (MTI ActiGraph) and self-report (3-d physical activity recall). Weighted kappa statistics ranged from 0.14 to 0.17 across inactivity, moderate-to-vigorous physical activity (MVPA), and vigorous physical activity (VPA) for self-report, from 0.13 to 0.20 for 3-d accelerometry, and from 0.22 to 0.29 for a 6-d accelerometry. Intraclass correlations ranged from 0.17 to 0.22 for self-report, 0.06 to 0.23 for 3-d accelerometry, and 0.16 to 0.33 for a 6-d accelerometry. In general, the estimates from the 6-d accelerometry tended to be higher than those from self-report, whereas few differences were observed between 3-d accelerometry and self-report. Odds ratios (OR) for being in the highest quintile at eighth grade for those in the highest quintile at sixth grade compared with those in any other quintile at sixth grade were 3.26 (95% confidence interval = 2.28-4.67), 3.64 (2.55-5.20), and 3.45 (2.42-4.93) for the 6-d accelerometry-measured inactivity, MVPA, and VPA. Corresponding OR from self-report were 2.44 (1.66-3.58) for inactivity, 2.63 (1.83-3.79) for MVPA, and 2.23 (1.54-3.23) for VPA. Tracking of inactivity and physical activity in middle school girls was fair to moderate. Our results suggest that physical activity and inactivity habits are dynamic for most girls during early adolescence. Population-based efforts should be made in this age group to promote physical activity and offer alternatives to inactivity for all girls.

Age-Related Change in Physical Activity in Adolescent Girls

Purpose To determine the annual rate at which physical activity changes in girls during middle school using both objective and self-report measures of physical activity. Methods Participants were sixth- and eighth-grade girls from the control schools in the Trial of Activity for Adolescent Girls (TAAG). Random cross-sectional samples initially were drawn from sixth-grade girls (n = 786) and 2 years later from eighth-grade girls (n = 1545). A cohort of 501 girls was in both the sixth- and the eighth-grade samples. The girls wore an accelerometer for 6 days and completed the 3-Day Physical Activity Recall. Data were summarized using 3.0-, 4.6-, and 6.5-metabolic equivalent cutpoints for accelerometry and self-reported physical activity. Analyses were performed using repeated-measures analysis of variance in PROC MIXED. Results More than 40% of the girls were white, approximately 20% were African American, and 20% were Hispanic. The annual percent decrease in physical activity in the cross-sectional sample was approximately 4% (−1.76 min moderate-to-vigorous physical activity/day), using accelerometer data. The percent decrease in physical activity based on self-report data was higher, 6% to 13%, depending on the physical activity variable. Declines tended to be larger in African American girls, but the ethnic differences were not statistically significant. Conclusions Based on comparisons of cross-sectional samples of sixth- and eighth-grade girls, objectively measured physical activity declined at a rate of 4% per year.

Recruiting a Diverse Group of Middle School Girls Into the Trial of Activity for Adolescent Girls

School-based study recruitment efforts are both time consuming and challenging. This paper highlights the recruitment strategies employed by the national, multisite Trial of Activity for Adolescent Girls (TAAG), a study designed to measure the effectiveness of an intervention to reduce the decline of physical activity levels among middle school-aged girls. TAAG provided a unique opportunity to recruit large cohorts of randomly sampled girls within 36 diverse middle schools across the United States. Key elements of the formative planning, coordination, and design of TAAG's recruitment efforts included flexibility, tailoring, and the use of incentives. Various barriers, including a natural disaster, political tension, and district regulations, were encountered throughout the recruitment process, but coordinated strategies and frequent communication between the 6 TAAG sites were helpful in tailoring the recruitment process at the 36 intervention and control schools. Progressively refined recruitment strategies and specific attention to the target audience of middle school girls resulted in overall study recruitment rates of 80%, 85%, and 89%, for the baseline, posttest, and follow-up period, respectively. The steady increase in recruitment rates over time is attributed to an emphasis on successful strategies and a willingness to modify less successful methods. Open and consistent communication, an increasingly coordinated recruitment strategy, interactive recruitment presentations, and participant incentives resulted in an effective recruitment campaign.

School Design and Physical Activity Among Middle School Girls

Building design and grounds might contribute to physical activity, and youth spend much of their daylight hours at school. We examined the associations among school building footprints, the size of school grounds, and in-school physical activity of 1566 sixth-grade girls from medium to large middle schools enrolled in the Trial of Activity for Adolescent Girls (TAAG). The school building footprint and the number of active outdoor amenities were associated with physical activity among adolescent girls. On average, the school footprint size accounted for 4% of all light physical activity and 16% of all MET-weight moderate-to-vigorous physical activity (MW-MVPA) during school hours. Active outdoor amenities accounted for 29% of all MW-MVPA during school. School design appears to be associated with physical activity, but it is likely that programming (eg, physical education, intramurals, club sports), social factors, and school siting are more important determinants of total physical activity.

Contribution of Light Physical Activity to Total Daily Physical Activity in Adolescent Girls

Investigations examining physical activity (PA) in children/youth focus on increasing moderate-to-vigorous physical activity (MVPA) and/or achievement of activity recommendations. However, there is increasing evidence that light intensity physical activity (LPA) may play a role in obesity prevention. Little is known about the contribution of LPA to total activity (TPA). PURPOSE: The purposes of this investigation were to determine the contribution of LPA to TPA and to describe the characteristics of LPA in adolescent girls. METHODS: The Trial of Activity for Adolescent Girls (TAAG) was a multi-center grouprandomized trial designed to test an intervention to reduce the usual decline in MVPA in middle-school girls. Data represent a cross-sectional examination of 3443 8th grade girls (46% White, 22% African American, 21% Hispanic, 11% Other) at the follow-up measurement in spring 2005. PA was measured by accelerometry (ActiGraph 7164), with readings between 51-1499 counts·30 sec-1 considered LPA and those 1500-2600 as MVPA. Percent of time spent in LPA was calculated two ways: proportion of LPA per TPA (LPA+ MVPA) and proportion of LPA per time spent in non-sleep activity (sedentary + LPA+ MVPA). Participants also completed the 3-Day PA Recall (3DPAR) to provide context regarding PA. Data analysis consisted of 3-way ANOVAs (race x weight status x free/ reduced lunch), controlling for age, with site and school as random effects. RESULTS: Girls spent 93% of activity time in LPA and 36% of non-sleep activity time in LPA. African American girls spent more time in TPA (328 min/day) and LPA (307 min/day) than other racial groups (p<0.05). White girls spent the least amount of TPA in LPA (93%; p<0.001), and almost all race groups were different from each other in time spent in LPA per time spent in non-sleep activity. Overweight girls spent the highest percentage of activity time in LPA. There were no differences by free/reduced lunch. The most common light activities reported were travel by walking, chores, PE class, walking for exercise, dancing, and working. CONCLUSION: Adolescent girls spend a large proportion of time in LPA. These light activities could be potential intervention targets. Supported by NIH grants U01HL66858, U01HL66857, U01HL66845, U01HL66856, U01HL66855, U01HL66853, U01HL66852

Depressive Symptoms and Physical Activity in Adolescent Girls

To evaluate the relationship between depressive symptoms and physical activity in a geographically and ethnically diverse sample of sixth-grade adolescent girls. The Trial of Activity for Adolescent Girls (TAAG) baseline measurement included a random sample (N = 1721) of sixth-grade girls in 36 schools at six field sites. Measurements were accelerometry and the 3-d Physical Activity Recall (3DPAR) for physical activity, and the Center for Epidemiological Studies-Depression scale (CES-D) for depressive symptoms. Girls with complete data (N = 1397), mean age 12 yr, had an average CES-D score of 14.7 (SD = 9.25) and engaged in an average of about 460 min of sedentary activity, < 24 min of moderate to vigorous physical activity (MVPA), and < 6 min of vigorous physical activity (VPA) in an 18-h day. Thirty-minute segments of MVPA ranged in number from 3.9 to 1.2, and METS for these segments ranged from > 3.0 to > 6.5. Mixed-model regression indicated no relationship between depressive symptoms and physical activity; however, a significant but modest inverse relationship between sedentary activity and depressive symptoms was observed. A sufficient sample size, standardized procedures, and validated instruments characterized this study; however, a relationship between depressive symptoms and physical activity was not observed for sixth-grade girls from diverse geographic locations. The average CES-D score was lower than is considered clinically meaningful for either adolescents or adults, and MET-minutes of sedentary activity were high. This combination of data may be different from other studies and could have contributed to the unexpected finding. This unexpected finding is informative, however, because it shows the need for additional research that includes a wider range of possible combinations of data, especially with young adolescent girls.

Process evaluation results from a school- and community-linked intervention: the Trial of Activity for Adolescent Girls (TAAG)

Process evaluation is a component of intervention research that evaluates whether interventions are delivered and received as intended. Here, we describe the process evaluation results for the Trial of Activity for Adolescent Girls (TAAG) intervention. The intervention consisted of four synergistic components designed to provide supportive school- and community-linked environments to prevent the decline in physical activity in adolescent girls. Process evaluation results indicate that the intervention components were delivered from intervention staff to teachers with high fidelity (84–97%) to the protocol and with lower fidelity (range: 18–93%) from teachers to students. Physical activity programs for girls, a unique feature of the TAAG intervention, increased from a mean of 10 programs per school to a mean of 16 and 15 in years 1 and 2, respectively, in intervention schools, with no change in control schools. These findings suggest that a multicomponent school- and community-based physical activity intervention can be delivered with fidelity and result in a middle school environment that supports physical activity for girls.

Commercial venues as supports for physical activity in adolescent girls

Objective The purposes of this study were to describe the types and availability of commercial facilities for physical activity (PA) in six diverse geographic areas (Washington DC and Maryland; South Carolina; Minnesota; Louisiana; Arizona; and California) and to assess the relationship between those facilities and the non-school PA of adolescent girls. Methods A total of 1556 6th grade girls participating in the Trial of Activity for Adolescent Girls (TAAG) wore accelerometers for 7 days providing 6 days of complete data, completed questionnaires in 2003 and had their residential addresses geocoded. Nearby commercial facilities available to provide PA (i.e. dance studios, youth organizations) within a 1-mile radius of participants' residences were identified and geocoded. The association between the presence of any commercial PA facility and girls' PA was determined using a multi-level design and controlling for demographic characteristics and other potential confounders. Analyses were conducted in 2005–2006. Results Sixty-eight percent of the girls had at least one commercial PA facility near their homes. Availability and types of commercial PA facilities differed by where participants lived. Girls who lived near one or more commercial PA facilities had higher non-school MET-weighted moderate-to-vigorous PA than girls who had none near their homes. Conclusions The findings suggest that commercial PA facilities are important contributors to the accumulation of PA among adolescent girls.

Comparing Perceived and Objectively Measured Access to Recreational Facilities as Predictors of Physical Activity in Adolescent Girls

A number of studies in recent years have identified both self-report and objectively measured accessibility of recreational facilities as important predictors of physical activity in youth. Yet, few studies have: (1) examined the relationship between the number and proximity of objectively measured neighborhood physical activity facilities and respondents' perceptions and (2) compared objective and self-report measures as predictors of physical activity. This study uses data on 1,367 6th-grade girls who participated in the Trial of Activity for Adolescent Girls (TAAG) to explore these issues. Girls reported whether nine different types of recreational facilities were easily accessible. These facilities included basketball courts, golf courses, martial arts studios, playing fields, tracks, skating rinks, swimming pools, tennis courts, and dance/gymnastic clubs. Next, geographic information systems (GIS) were used to identify all the parks, schools, and commercial sites for physical activity located within a mile of each girl's home. These sites were then visited to inventory the types of facilities available. Girls wore accelerometers to measure their weekly minutes of non-school metabolic equivalent weighted moderate-to-vigorous physical activity (MW-MVPA). The number of facilities within a half-mile of girls' homes strongly predicted the perception of easy access to seven out of nine facility types. Both individual facility perceptions and the total number of facilities perceived were associated with increased physical activity. For each additional facility perceived, girls clocked 3% more metabolic equivalent weighted moderate-to-vigorous physical activity (p < 0.001). Although girls tended to record 3% more of this kind of physical activity (p < 0.05) per basketball court within a mile of their homes, objective facility measures were otherwise unrelated to physical activity. The results from this study suggest that raising the profile of existing facilities may help increase physical activity among adolescent girls.

Travel by Walking Before and After School and Physical Activity Among Adolescent Girls

To examine how "travel by walking" before and after school contributes to total physical activity of adolescent girls. Cross-sectional sample. Thirty-six middle schools from Arizona, Maryland, Minnesota, Louisiana, California, and South Carolina participating in the Trial of Activity for Adolescent Girls (TAAG). Seventeen hundred twenty-one sixth-grade girls consented to participate; adequate information was available for 1596 participants (93%). Travel by walking before school, after school, and before and after school combined assessed from the 3-Day Physical Activity Recall. Mean minutes of physical activity measured by accelerometry were estimated for total physical activity (light, moderate, vigorous), moderate to vigorous activity (MVPA), and MVPA of 3 metabolic equivalents. Travel by walking was reported by 14% of participants before school and 18% after school. Girls who reported travel by walking before and after school (combined) had 13.7 more minutes (95% confidence interval, 1.2-26.3) of total physical activity and 4.7 more minutes (95% confidence interval, 2.2-7.2) of MVPA than girls who did not report this activity. Before-school and after-school walkers (but not both) accumulated 2.5 more minutes (95% confidence interval, 0.10-4.9) and 2.2 more minutes (95% confidence interval, 0.24-4.2) of MVPA on an average weekday, respectively, than nonwalkers. Our results provide evidence that walking to and from school increases weekday minutes of total physical activity and MVPA for middle-school girls.

Process evaluation results from a school- and community-linked intervention: the Trial of Activity for Adolescent Girls (TAAG)

Process evaluation results from a school- and community-linked intervention: the Trial of Activity for Adolescent Girls (TAAG)