B'N Fit POWER Initiative for Obese Low Income, Ethnic Minority Adolescents
Grant Status: Completed
Training Category: Healthy Tomorrows Partnership for Children Program (HTPCP)
Project Director(s):
Jessica Rieder, MD
Montefiore Medical Center
Brooklyn, NY
Phone: (718) 920-2897
Email: jrieder@montefiore.org
Problem:
Obesity prevalence rates are among the highest in Hispanic and African-American youth and in low income families. Multidisciplinary weight management programs that effectively produce long-term meaningful weight loss outcomes require intense engagement and retention efforts with minority inner-city adolescents. These adolescents face many financial, familial, social and logistical barriers which typically manifest as low engagement and high attrition rates. In our prior 2008-2014 HRSA HTPCP cycle we successfully achieved initial show rates of almost 80%, improved retention from 22% in 2009 to 40% in 2013, and of those completing the 9 month program almost 82% maintained or lost 5% of their BMI.
Goals and Objectives:
Our goal is to improve the health of obese adolescents in the Bronx. Our objectives are to optimize youth engagement and attendance at a comprehensive adolescent focused weight management program. We will achieve a 25% improvement in program session attendance rates and 9 month program completion. We will reduce the proportion of participants in all three obesity risk classes by 10%.
Methodology:
Our proposal is grounded in evidence based practices to promote the acquisition of healthy lifestyle behaviors, adolescent motivation and developmental assets. We will augment the program's youth development component through four activities: improved youth-focused programming, a youth-focused incentive program, development of an internship program, and care coordination with primary care providers, families, and community services. Specifically, we will: 1) incorporate a youth development curriculum that supports attainment of personal educational, career, and social goals into the existing healthy lifestyle curriculum to assist with the attainment of target healthy behaviors.; 2) institute the B'N Fit Bucks Incentive system to motivate and incentivize youth to attain target goals based on their readiness to change specific target healthy lifestyle behaviors; 3) develop a service learning internship that supports the continued attainment of the target behaviors and further development of youth assets through community based projects; 4) further develop the shared treatment plan approach through partnership with referring primary care providers and community partners to consistently support program participants in achieving quarterly treatment map and attendance objectives.
Evaluation:
We will evaluate the project using the RE-AIM approach, Reach, Efficacy, Adoption, Implementation, and Maintenance. Program referrals, initial appointments, and attendance at all activities will be documented. Anthropometric measures including height, weight, and BMI will be obtained as will attainment of the 6 B'N Fit Target Behaviors - increased sugar-free beverage consumption, improved regularity of appropriate meal consumption, increasing fruit and vegetable consumption, increased frequency of obtaining adequate sleep, increased frequency of obtaining adequate daily physical activity, and decreased frequency of excessive screen time. We will track specific youth-focused outcome attainment -school absences, academic performance, involvement in extra-curricular activities, socialization activities, and youth employment. Changes in these measures from program initiation to program completion will be compared.