DESCRIPTION: Hispanic Americans will be the largest ethnic racial minority
group by the year 2000. The comparatively higher prevalence of obesity
among Hispanic Americans coupled with diets that are relatively higher in
fat and lower in fiber may place Hispanic Americans at increased risk of
cancer. Therefore, the investigators propose to develop and evaluate a
cancer risk factor prevention program targeting pre-adolescents in schools
serving predominantly low income Hispanic families that will include both a
behavioral and an environmental component. Students in the study will
receive interventions during both their fourth and fifth grade years. The
prevention program will include a classroom-based intervention focusing on
preventing obesity by a) increasing the perceived incentive value of
adopting helpful eating and physical activity behaviors and b) providing
instruction in weight regulation skills. Environmental intervention
components will include a parent intervention coupled with the school
intervention and a school food service intervention.
The investigators will evaluate the efficiency of their comprehensive
intervention in a cohort of 1100 underestimate from 14 elementary schools in
the Alum Rock Union Elementary School District, in East San Jose,
California. Students will be approximately 50 percent female, 70 percent
Hispanic, 10 percent Asian, 7 percent white, 6 percent Filipino, 5 percent
Black, 1 percent American Indian/Alaskan Native and 1 percent Pacific
Islander. Seven schools will be randomly assigned to the comprehensive
intervention, and the remaining seven schools will receive an attention
placebo control intervention to minimize the potential for compensatory
rivalry or resentful demoralization. Assessments of children's height,
weight, tricep skinfold thickness, waste and hip circumferences, food
preferences, cardiorespiratory fitness and self-reported behavior, attitudes
and knowledge and Tanner Stage of development will occur at baseline (4th
grade), post test (5th grade), and at 10-month follow-up (6th grade).
Parent interviews will occur annually. A careful assessment of effects on
parents and school personnel will be completed. However, the crucial
question is whether the overall intervention has an impact on pre-adolescent
The primary objective is to reduce the prevalence of obesity at the end of
the two year intervention. Secondary objectives include reducing intake of
dietary fat; increasing consumption of low fat foods, fruits, vegetables and
dietary fiber; and increasing levels of moderate to vigorous physical
activity. Finally, the investigators want to conduct risk assessment and
targeting studies including response to treatment analyses.
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