The Memphis Girls' Health Enrichment Multi-Site Studies (GEMS): An Evaluation of the Efficacy of a 2-Year Obesity Prevention Program in African American Girls
Document Type
Article
Publication Date
11-1-2010
Description
Objective: To determine the efficacy of a 2-year obesity prevention program in African American girls. Design: Memphis GEMS (Girls' health Enrichment Multi-site Studies) was a controlled trial in which girls were randomly assigned to an obesity prevention program or alternative intervention. Setting: Local community centers and YWCAs (Young Women's Christian Associations) in Memphis, Tennessee. Participants: Girls aged 8 to 10 years (N=303) who were identified by a parent or guardian as African American and who had a body mass index (BMI) at or higher than the 25th percentile for age or 1 parent with a BMI of 25 or higher. Interventions: Group behavioral counseling to promote healthy eating and increased physical activity (obesity prevention program) or self-esteem and social efficacy (alternative intervention). Main Outcome Measure: The BMI at 2 years. Results: The BMI increased in all girls with no treatment effect (obesity prevention minus alternative intervention) at 2 years (mean, 0.09; 95% confidence interval [CI], -0.40 to 0.58). Two-year treatment effects in the expected direction were observed for servings per day of sweetened beverages (mean, -0.19; 95% CI, -0.39 to 0.09), water (mean, 0.21; 95% CI, 0.03 to 0.40), and vegetables (mean, 0.15; 95% CI,-0.02 to 0.30), but there were no effects on physical activity. Post hoc analyses suggested a treatment effect in younger girls (P for interaction=.08). The mean BMI difference at 2 years was -2.41 (95% CI, -4.83 to 0.02) in girls initially aged 8 years and -1.02 (95% CI, -2.31 to 0.27) in those initially aged 10 years. Conclusions: The lack of significant BMI change at 2 years indicates that this intervention alone is insufficient for obesity prevention. Effectiveness may require more explicit behavior change goals and a stronger physical activity component as well as supportive changes in environmental contexts. Trial Registration: Clinicaltrials.gov Identifier: NCT00000615
Citation Information
Klesges, Robert C.; Obarzanek, Eva; Kumanyika, Shiriki; Murray, David M.; Klesges, Lisa M.; Relyea, George E.; Stockton, Michelle B.; Lanctot, Jennifer Q.; Beech, Bettina M.; McClanahan, Barbara S.; Sherrill-Mittleman, Deborah; and Slawson, Deborah L.. 2010. The Memphis Girls' Health Enrichment Multi-Site Studies (GEMS): An Evaluation of the Efficacy of a 2-Year Obesity Prevention Program in African American Girls. Archives of Pediatrics and Adolescent Medicine. Vol.164(11). 1007-1014. https://doi.org/10.1001/archpediatrics.2010.196 PMID: 21041593 ISSN: 1072-4710