School-Based Approaches to Affect Adolescents’ Diets: Results From the TEENS Study

This article reports on the outcomes of the Teens Eating for Energy and Nutrition at School (TEENS) study, a 2-year intervention study conducted in 16 middle schools with a goal of increasing students’ intakes of fruits, vegetables, and lower fat foods. Despite positive interim results for students randomized to intervention schools, the positive effects of the intervention were not seen for the primary outcomes at the end of the 2nd year. Positive effects were seen only for a food choice score (suggesting that the students usually choose lower versus higher fat foods) and not for measures of food intake. Future studies may need to take a step back toward more controlled efficacy studies in working with this age-group. In addition, future work may consider the use of peer leaders, more intensive teacher training, ongoing formative assessment, and the testing of more powerful environmental change intervention strategies.

[1]  Michael M. Engelgau,et al.  Type 2 diabetes among North adolescents: An epidemiologic health perspective , 2000 .

[2]  T. Patterson,et al.  A Family Approach to Cardiovascular Risk Reduction: Results from The San Diego Family Health Project , 1989, Health education quarterly.

[3]  R. Ballard-Barbash,et al.  Food intakes of US children and adolescents compared with recommendations. , 1997, Pediatrics.

[4]  C. Perry,et al.  Parent involvement with children's health promotion: the Minnesota Home Team. , 1988, American journal of public health.

[5]  C. Perry,et al.  Peer-led, school-based nutrition education for young adolescents: feasibility and process evaluation of the TEENS study. , 2002, The Journal of school health.

[6]  C. Perry,et al.  Applying Research and Theory in Program Planning: An Example from a Nutrition Education Intervention , 2001 .

[7]  B. Popkin,et al.  US adolescent food intake trends from 1965 to 1996 , 2000, Archives of disease in childhood.

[8]  C. Perry,et al.  Are Differences in Exposure to a Multicomponent School-Based Intervention Associated with Varying Dietary Outcomes in Adolescents? , 2002, Health education & behavior : the official publication of the Society for Public Health Education.

[9]  C. Perry,et al.  Food-related beliefs, eating behavior, and classroom food practices of middle school teachers. , 2002, The Journal of school health.

[10]  H A Feldman,et al.  The effects of the Child and Adolescent Trial for Cardiovascular Health upon psychosocial determinants of diet and physical activity behavior. , 1996, Preventive medicine.

[11]  C. Perry,et al.  Creating Health Behavior Change: How to Develop Community-Wide Programs for Youth , 1999 .

[12]  K. Reynolds,et al.  Increasing the fruit and vegetable consumption of fourth-graders: results from the high 5 project. , 2000, Preventive medicine.

[13]  Lillian S. Lin,et al.  Gimme 5 Fruit, Juice, and Vegetables for Fun and Health: Outcome Evaluation , 2000, Health education & behavior : the official publication of the Society for Public Health Education.

[14]  M. Barker,et al.  Milk intake and bone mineral acquisition in adolescent girls: randomised, controlled intervention trial , 1997, BMJ.

[15]  K. Glanz,et al.  Health Behavior and Health Education , 1990 .

[16]  David M Murray,et al.  Survey development for assessing correlates of young adolescents' eating. , 2002, American journal of health behavior.

[17]  C. Perry,et al.  Project Northland: outcomes of a communitywide alcohol use prevention program during early adolescence. , 1996, American journal of public health.

[18]  Alan D. Lopez,et al.  The global burden of disease: a comprehensive assessment of mortality and disability from diseases injuries and risk factors in 1990 and projected to 2020. , 1996 .

[19]  L. Lytle,et al.  A practical, theory-based approach to establishing school nutrition advisory councils. , 2001, Journal of the American Dietetic Association.

[20]  H. Wechsler,et al.  Guidelines for school health programs to promote lifelong healthy eating. , 1996, The Journal of school health.

[21]  C. Perry,et al.  Changing fruit and vegetable consumption among children: the 5-a-Day Power Plus program in St. Paul, Minnesota. , 1998, American journal of public health.

[22]  David M. Murray,et al.  Design and Analysis of Group- Randomized Trials , 1998 .

[23]  C. Ebbeling,et al.  Childhood obesity: public-health crisis, common sense cure , 2002, The Lancet.

[24]  Katherine M Flegal,et al.  Prevalence and trends in overweight among US children and adolescents, 1999-2000. , 2002, JAMA.

[25]  K. Flegal,et al.  Prevalence and trends in obesity among US adults, 1999-2000. , 2002, JAMA.

[26]  L S Geiss,et al.  Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. , 2000, The Journal of pediatrics.

[27]  D. A. Cook,et al.  Fruit and vegetable intakes of children and adolescents in the United States. , 1996, Archives of pediatrics & adolescent medicine.

[28]  L. Lytle,et al.  Maintenance of a Health Promotion Program in Elementary Schools: Results from the Catch-on Study Key Informant Interviews , 2003, Health education & behavior : the official publication of the Society for Public Health Education.

[29]  L. Lytle.  Nutritional issues for adolescents. , 2002, Journal of the American Dietetic Association.

[30]  L. Lytle,et al.  Wellness and risk communication from parent to teen: the “Parental Energy Index” , 1999 .

[31]  A. Manley.  Physical Activity And Health: A Report Of The Surgeon General , 2004 .

[32]  John D. Potter,et al.  The University of Minnesota Cancer Prevention Research Unit vegetable and fruit classification scheme (United States) , 1995, Cancer Causes & Control.

[33]  C. Perry,et al.  The association of the school food environment with dietary behaviors of young adolescents. , 2003, American journal of public health.

[34]  S. Syme,et al.  Preadolescent and Adolescent Influences on Health , 2000 .

[35]  S. Kelder,et al.  Outcomes of a field trial to improve children's dietary patterns and physical activity. The Child and Adolescent Trial for Cardiovascular Health. CATCH collaborative group. , 1996, JAMA.

[36]  S. Gortmaker,et al.  Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. , 1999, Archives of pediatrics & adolescent medicine.

[37]  L. Lytle,et al.  Conducting nutrition education research in junior high schools: approaches and challenges. , 2001, Journal of nutrition education.

[38]  R. Doll,et al.  The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. , 1981, Journal of the National Cancer Institute.

[39]  S. Syme,et al.  Promoting Health: Intervention Strategies from Social and Behavioral Research , 2001 .

[40]  T. Baranowski,et al.  Dietary change for cardiovascular disease prevention among Black-American families , 1990 .

[41]  J. Powles,et al.  Fruit and vegetables, and cardiovascular disease: a review. , 1997, International journal of epidemiology.

[42]  Usdhhs.  Physical Activity and Health: A Report of the Surgeon General , 1996 .

[43]  G A Colditz,et al.  Comparison of 4 questionnaires for assessment of fruit and vegetable intake. , 1998, American journal of public health.

[44]  Frank Hu,et al.  The Effect of Fruit and Vegetable Intake on Risk for Coronary Heart Disease , 2001, Annals of Internal Medicine.