Randomized Controlled Trial of a Primary Care and Home-Based Intervention for Physical Activity and Nutrition Behaviors: PACE+ for Adolescents
Abstract
OBJECTIVE: Many adolescents do not meet national guidelines for participation in regular moderate or vigorous physical activity (PA); limitations on sedentary behaviors; or dietary intake of fruits and vegetables, fiber, or total dietary fat. This study evaluated a health care-based intervention to improve these behaviors. DESIGN: Randomized controlled trial. SETTING: Primary care with follow-up at home. PARTICIPANTS: Eight hundred seventy-eight adolescent girls and boys aged 11 to 15 years. INTERVENTIONS: Two experimental conditions: (1) Primary care, office-based, computer-assisted diet and PA assessment and stage-based goal setting followed by brief health care provider counseling and 12 months of monthly mail and telephone counseling and (2) a comparison condition addressing sun exposure protection. MAIN OUTCOME MEASURES: Minutes per week of moderate plus vigorous PA measured by self-report and accelerometer; self-report of days per week of PA and sedentary behaviors; and percentage of energy from fat and servings per day of fruits and vegetables measured by three 24-hour diet recalls. Body mass index (calculated as weight in kilograms divided by the square of height in meters) was a secondary outcome. RESULTS: Compared with adolescents in the sun protection condition, girls and boys in the diet and PA intervention significantly reduced sedentary behaviors (intervention vs control change, 4.3 to 3.4 h/d vs 4.2 to 4.4 h/d for girls, respectively [P = .001]; 4.2 to 3.2 h/d vs 4.2 to 4.3 h/d for boys, respectively [P = .001]). Boys reported more active days per week (intervention vs control change: 4.1 to 4.4 d/wk vs 3.8 to 3.8 d/w, respectively [P = .01]), and the number of servings of fruits and vegetables for girls approached significance (intervention vs control change, 3.5 to 4.2 servings/d vs 3.5 to 3.9 servings/d, respectively [P = .07]). No intervention effects were seen with percentage of calories from fat or minutes of PA per week. Percentage of adolescents meeting recommended health guidelines was significantly improved for girls for consumption of saturated fat (intervention vs control change, 23.4% to 41.0% vs 18.5% to 31%, respectively [relative risk, 1.33; 95% confidence interval, 1.01-1.68]) and for boys' participation in d/wk of PA (intervention vs control change, 45.3% to 55.4% vs 41.9% to 38.0%, respectively [relative risk, 1.47; 95% confidence interval, 1.19-1.75]). No between-group differences were seen in body mass index. CONCLUSIONS: Improvements in some diet, PA, and sedentary behaviors in adolescents can be enabled through the use of a 1-year, integrated intervention using the computer, health provider counseling, mail, and telephone. The amount of intervention received may contribute to its efficacy.
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Currently available evidence suggests that counseling may have beneficial effects on physical activity and sedentary behaviors in the pediatric primary care setting, although there is no evidence of its use in the emergency department.
“Currently available evidence suggests that counseling may have beneficial effects on physical activity and sedentary behaviors in the pediatric primary care setting although there is no evidence of its use in the emergency department. 37,38”
From Association of Physical Activity, Sports, and Screen Time With Adolescent Behaviors in Youth Who Visit the Pediatric Emergency Department (2022) · cites this paper as [37]
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BackgroundMoyer, V. A., & on behalf of the U.S. Preventive Services Task Force* (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-157-1-201207030-00442 · Cited by 111 · see citing works
“It also looked for evidence that children receiving counseling to avoid the outdoors would be less physically active as a result; 2 studies (16, 17), one of which was conducted in a primary care setting, found neither a decrease in outdoor activity time nor an increase in body mass in young persons who received an int…”
BackgroundOutcomes of a 12-Month Web-Based Intervention for Overweight and Obese Men
Patrick, K., Calfas, K. J., Norman, G. J., Rosenberg, D. E., Zabinski, M. F., Sallis, J. F., Rock, C. L., & Dillon, L. W. (2011) · Annals of Behavioral Medicine · doi:10.1007/s12160-011-9296-7 · Cited by 108 · see citing works
Self-citationPardo, B. M., Bengoechea, E. G., Lanaspa, E. G., Bush, P. L., Casterad, J. Z., Clemente, J. A. J., & García‐González, L. (2013) · Health Education Research · doi:10.1093/her/cyt040 · Cited by 105 · see citing works
“3% among the intervention group boys, whereas no changes were found in the control group [98].”
BackgroundCouch, S. C., Saelens, B. E., Khoury, P. R., Dart, K. B., Hinn, K., Mitsnefes, M. M., Daniels, S. R., & Urbina, E. M. (2020) · Hypertension · doi:10.1161/hypertensionaha.120.16156 · Cited by 111 · see citing works
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Population-Level Intervention Strategies and Examples for Obesity Prevention in Children
Foltz, J. L., May, A. L., Belay, B., Nihiser, A. J., Dooyema, C., & Blanck, H. M. (2012) · Annual Review of Nutrition · doi:10.1146/annurev-nutr-071811-150646 · Cited by 104 · see citing works
“Use of counseling messages along with motivational interviewing improves some diet, physical activity, and sedentary behaviors (89, 112).”
InfluentialBrannon, E. E., & Cushing, C. C. (2014) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsu108 · Cited by 103 · see citing works
Creating a Robust Public Health Infrastructure for Physical Activity Promotion
Yancey, A. K., Fielding, J. E., Flores, G. R., Sallis, J. F., McCarthy, W. J., & Breslow, L. (2007) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2006.08.029 · Cited by 102 · see citing works
Self-citationMcGoey, T., Root, Z., Bruner, M. W., & Law, B. (2016) · Preventive Medicine · doi:10.1016/j.ypmed.2015.11.004 · Cited by 93 · see citing works
“The four studies that reported on the representativeness of the recruited participants compared to the nonparticipants found no differences (Haerens et al., 2007; Patrick et al., 2006), or that non-participantsweremore likely to live in a low socioeco-”
BackgroundReducing Recreational Sedentary Screen Time
Buchanan, L. R., Rooks-Peck, C. R., Finnie, R. K. C., Wethington, H. R., Jacob, V., Fulton, J. E., Johnson, D. B., Kahwati, L. C., PRATT, C. A., Ramı́rez, G., et al. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2015.09.030 · Cited by 95 · see citing works
A Review of Primary Care-Based Childhood Obesity Prevention and Treatment Interventions
Seburg, E. M., Olson‐Bullis, B. A., Bredeson, D. M., Hayes, M. G., & Sherwood, N. E. (2015) · Current Obesity Reports · doi:10.1007/s13679-015-0160-0 · Cited by 94 · see citing works
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“An objective measure (accelerometry) to verify self-reported changes in sedentary behaviour and physical activity was used in one study (24).”
BackgroundMethodInfluentialPediatricians' and Family Physicians' Weight-Related Care of Children in the U.S.
Huang, T. T. ‐., Borowski, L. A., Liu, B., Galuska, D. A., Ballard-Barbash, R. R., Yanovski, S. Z., Olster, D. H., Atienza, A. A., & Smith, A. W. (2011) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2011.03.016 · Cited by 91 · see citing works
Keyserling, T. C., Samuel‐Hodge, C. D., Jilcott, S. B., Johnston, L. F., Garcia, B. A., Gizlice, Z., Gross, M. D., Saviñon, C. E., Bangdiwala, S. I., Will, J. C., et al. (2008) · Preventive Medicine · doi:10.1016/j.ypmed.2008.02.011 · Cited by 90 · see citing works
Novel Strategies to Promote Children’s Physical Activities and Reduce Sedentary Behavior
Salmon, J. (2010) · Journal of Physical Activity and Health · doi:10.1123/jpah.7.s3.s299 · Cited by 81 · see citing works
Hodder, R. K., O’Brien, K. M., Lorien, S. J., Wolfenden, L., Moore, T. H., Hall, A. E., Yoong, S. L., & Summerbell, C. D. (2022) · EClinicalMedicine · doi:10.1016/j.eclinm.2022.101635 · Cited by 81 · see citing works
Cochrane review: Interventions for treating obesity in children
Luttikhuis, H. O., Baur, L. A., Jansen, H., Shrewsbury, V. A., O’Malley, C. L., Stolk, R. P., & Summerbell, C. D. (2009) · Evidence-Based Child Health A Cochrane Review Journal · doi:10.1002/ebch.462 · Cited by 81 · see citing works
Behavioral Counseling for Skin Cancer Prevention
Henrikson, N. B., Morrison, C. C., Blasi, P. R., Nguyen, M., Shibuya, K. C., & Patnode, C. D. (2018) · JAMA · doi:10.1001/jama.2017.21630 · Cited by 86 · see citing works
Effectiveness of weight management programs in children and adolescents.
Whitlock, E. P., O'Connor, E. P., Williams, S. B., Beil, T. L., & Lutz, K. W. (2008) · PubMed Central · Cited by 76 · see citing works
Pediatrician-led Motivational Interviewing to Treat Overweight Children: An RCT
Davoli, A. M., Broccoli, S., Bonvicini, L., Fabbri, A., Ferrari, E., D’Angelo, S., Buono, A. D., Montagna, G., Panza, C., Pinotti, M., et al. (2013) · PEDIATRICS · doi:10.1542/peds.2013-1738 · Cited by 76 · see citing works
Compliance With Wearing Physical Activity Accelerometers in High School Students
Sirard, J. R., & Slater, M. E. (2009) · Journal of Physical Activity and Health · doi:10.1123/jpah.6.s1.s148 · Cited by 73 · see citing works
Blackburn, N. E., Wilson, J. J., McMullan, I., Caserotti, P., Giné‐Garriga, M., Wirth, K., Coll‐Planas, L., Alias, S. B., Figuls, M. R. I., Deidda, M., et al. (2020) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-020-00957-0 · Cited by 71 · see citing works
Exercise—Promoting healthy lifestyles in children and adolescents
Trost, S. G., & Loprinzi, P. D. (2008) · Journal of clinical lipidology · doi:10.1016/j.jacl.2008.03.001 · Cited by 72 · see citing works
Howie, E. K., & Straker, L. M. (2016) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2015.12.520 · Cited by 71 · see citing works
The Healthcare Sector’s Role in the U.S. National Physical Activity Plan
Patrick, K., Pratt, M., & Sallis, R. E. (2009) · Journal of Physical Activity and Health · doi:10.1123/jpah.6.s2.s211 · Cited by 70 · see citing works
Self-citationMcGoey, T., Root, Z., Bruner, M. W., & Law, B. (2015) · Preventive Medicine · doi:10.1016/j.ypmed.2015.04.006 · Cited by 61 · see citing works
“…that reported on the representativeness of the recruited participants compared to the nonparticipants found no differences (Haerens et al., 2007; Patrick et al., 2006), or that non-participantsweremore likely to live in a low socioeconomic environment (Dzewaltowski et al., 2009), older, less…”
BackgroundInfluentialCullen, K. W., Thompson, D. I., Boushey, C. J., Konzelmann, K. L., & Chen, T. (2013) · Health Education Research · doi:10.1093/her/cyt059 · Cited by 68 · see citing works
“[8–20] and promoting weight loss [21].”
A Randomized Trial of a Multicomponent Intervention for Adolescent Sun Protection Behaviors
Norman, G. J., Adams, M. A., Calfas, K. J., Covin, J. R., Sallis, J. F., Rossi, J. S., Redding, C. A., Cella, J. A., & Patrick, K. (2007) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.161.2.146 · Cited by 62 · see citing works
“The physical activity and diet intervention was designed to promote adoption and maintenance of improved physical activity and eating behaviors.(18) The intervention consisted of a computerized expert system kiosk in the primary care provider’s office, coupled with monthly stage-matched telephone calls, a printed manu…”
MethodSelf-citationPolicies for promotion of physical activity and prevention of obesity in adolescence
Pate, R. R., Flynn, J. I., & Dowda, M. C. (2016) · Journal of Exercise Science & Fitness · doi:10.1016/j.jesf.2016.07.003 · Cited by 60 · see citing works
“One of those studies, a randomized controlled trial of adolescent boys and girls (11e15 years), assessed two experimental conditions.(76) The first was a primary care officebased, computer-assisted diet and physical activity intervention that used goal setting and brief counseling.”
BackgroundCommunity-based interventions to promote increased physical activity
Bopp, M., & Fallon, E. A. (2008) · Applied Health Economics and Health Policy · doi:10.1007/bf03256132 · Cited by 60 · see citing works
Webb, M. J., Kauer, S. D., Ozer, E. M., Haller, D. M., & Sanci, L. A. (2016) · BMC Family Practice · doi:10.1186/s12875-016-0504-1 · Cited by 59 · see citing works
Haerens, L. L., Deforche, B. I., Vandelanotte, C., Maes, L., & Bourdeaudhuij, I. D. (2007) · Patient Education and Counseling · doi:10.1016/j.pec.2007.01.003 · Cited by 58 · see citing works
Bjelland, M., Bergh, I. H., Grydeland, M., Klepp, K., Andersen, L. F., Anderssen, S. A., Ommundsen, Y., & Lien, N. (2011) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-8-63 · Cited by 58 · see citing works
“Five of the studies [42-44,47,48] reported effects both for boys and girls, while one reported effect for boys only [41].”
BackgroundInterventions to prevent obesity in children aged 12 to 18 years old
Spiga, F., Tomlinson, E., Davies, A. L., Moore, T. H., Dawson, S., Breheny, K., Savović, J., Hodder, R. K., Wolfenden, L., Higgins, J. P. T., et al. (2024) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd015330.pub2 · Cited by 58 · see citing works
Norman, G. J., Adams, M. A., Kerr, J., Ryan, S., Frank, L. D., & Roesch, S. C. (2010) · Journal of Public Health Management and Practice · doi:10.1097/phh.0b013e3181c60e92 · Cited by 55 · see citing works
Self-citationTercyak, K. P., Abraham, A. A., Graham, A. L., Wilson, L. D., & Walker, L. R. (2009) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsn085 · Cited by 50 · see citing works
Wright, J. A., Phillips, B. D., Watson, B. L., Newby, P. K., Norman, G. J., & Adams, W. G. (2013) · Obesity · doi:10.1002/oby.20388 · Cited by 54 · see citing works
“Children who used the system more frequently had greater improvements in weight status and self-management behaviors consistent with previous computer-based diet and exercise interventions for child and adult PC populations (15,32,33).”
BackgroundResultSelf-citationErmetici, F., Zelaschi, R., Briganti, S., Dozio, E., Gaeta, M., Ambrogi, F., Pelissero, G., Tettamanti, G., Romanelli, M. M. C., Carruba, M. O., et al. (2016) · Obesity · doi:10.1002/oby.21365 · Cited by 53 · see citing works
Velicer, W. F., Redding, C. A., Paiva, A. L., Mauriello, L. M., Blissmer, B. J., Oatley, K., Meier, K. S., Babbin, S. F., McGee, H. A., Prochaska, J. O., et al. (2013) · Translational Behavioral Medicine · doi:10.1007/s13142-013-0197-0 · Cited by 49 · see citing works
Effects of total fat intake on bodyweight in children
Naude, C. E., Visser, M. E., Nguyen, K. A., Durão, S., & Schoonees, A. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012960.pub2 · Cited by 48 · see citing works
Exercise Aids, Neighborhood Safety, and Physical Activity in Adolescents and Parents
Kerr, J., Norman, G. J., Sallis, J. F., & Patrick, K. (2008) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31816b8797 · Cited by 47 · see citing works
“In the adolescent sample, the analyses were stratified by gender as differences in boys and girls’ physical activity patterns are to be expected (17).”
MethodSelf-citationSchlechter, C. R., Rosenkranz, R. R., Guagliano, J. M., & Dzewaltowski, D. A. (2016) · Preventive Medicine · doi:10.1016/j.ypmed.2016.08.030 · Cited by 47 · see citing works
Latina Mothers’ Perceptions of Healthcare Professional Weight Assessments of Preschool-Aged Children
Guerrero, A. D., Slusser, W. M., Barreto, P. M., Rosales, N. F., & Kuo, A. A. (2010) · Maternal and Child Health Journal · doi:10.1007/s10995-010-0683-7 · Cited by 45 · see citing works
“Considering the lack of effective primary care-based interventions targeting the prevention and management of obesity among preschool age children [12] and the fact that primary-care-based interventions for overweight adult patients and adolescents can effectively contribute to weight loss efforts [13] and improve die…”
BackgroundCorrelates of physical activity in adolescence: a study from a developing country
Shokrvash, B., Majlessi, F., Montazeri, A., Nedjat, S., Rahimi, A., Djazayeri, A., & Shojaeezadeh, D. (2013) · Global Health Action · doi:10.3402/gha.v6i0.20327 · Cited by 45 · see citing works
“(4) Family support specific to physical activity: this was a 17-item questionnaire containing questions about perceived informational family support specific to physical activity (PIFSPA, three items), perceived emotional family support specific to physical activity (PEFSPA, three items), and perceived practical famil…”
BackgroundAssessment of the Impact of a Workplace Intervention to Reduce Prolonged Occupational Sitting Time
Cooley, D., Pedersen, S., & Mainsbridge, C. P. (2013) · Qualitative Health Research · doi:10.1177/1049732313513503 · Cited by 44 · see citing works
“For example, Patrick et al. (2006) identified that a lack of change in obesity levels is often identified as a failure of health interventions.”
BackgroundSanders, L., Perrin, E. M., Yin, H. S., Delamater, A. M., Flower, K. B., Bian, A., Schildcrout, J. S., Rothman, R. L., & Greenlight Study Team (2021) · PEDIATRICS · doi:10.1542/peds.2020-049866 · Cited by 44 · see citing works
Psychometric Assessment of the Adolescent Physical Activity Perceived Benefits and Barriers Scales
Robbins, L. B., Wu, T., Sikorskii, A. E., & Morley, B. (2008) · Journal of Nursing Measurement · doi:10.1891/1061-3749.16.2.98 · Cited by 43 · see citing works
“…this recommendation and some evidence that counseling can be effective in increasing youth involvement in moderate to vigorous physical activity (Patrick et al., 2001, 2006), many health care professionals are hesitant to initiate counseling due to perceived lack of confidence as counselors…”
BackgroundReliability of 24-Hour Dietary Recalls as a Measure of Diet in African-American Youth
George, S. M. S., Horn, M. L. V., Lawman, H. G., & Wilson, D. K. (2016) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2016.05.011 · Cited by 43 · see citing works
“These methods also require a high degree of technical expertise and are not widely used, particularly within the context of examining dietary changes in randomized controlled studies, which have largely relied on averaging across recalls.(3) It is therefore of great interest to examine the reliability of commonly used…”
Hoare, E., Fuller‐Tyszkiewicz, M., Skouteris, H., Millar, L., Nichols, M. S., & Allender, S. E. (2015) · BMJ Open · doi:10.1136/bmjopen-2014-006586 · Cited by 41 · see citing works
Thompson, D. I., Cullen, K. W., Boushey, C. J., & Konzelmann, K. L. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.1889 · Cited by 40 · see citing works
Clinical Preventive Services for Adolescents
Solberg, L. I., Nordin, J. D., Bryant, T. L., Kristensen, A. H., & Maloney, S. K. (2009) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2009.06.017 · Cited by 38 · see citing works
Taveras, E. M., Gortmaker, S. L., Mitchell, K. F., & Gillman, M. W. (2008) · Obesity · doi:10.1038/oby.2008.264 · Cited by 35 · see citing works
“Although research is needed on effective clinical approaches for the prevention and management of childhood overweight that can be implemented by primary care clinicians (6), a recent pediatric primary care based intervention to improve diet and physical activity among adolescents offers hope that such interventions c…”
BackgroundGanann, R., Fitzpatrick‐Lewis, D., Ciliska, D. K., & Peirson, L. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-711 · Cited by 35 · see citing works
“Three studies implemented interventions in primary care settings plus the home [25,62,63].”
BackgroundObesity Among Latino Children Within a Migrant Farmworker Community
Rosado, J. I., Johnson, S. B., McGinnity, K., & Cuevas, J. P. (2013) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2012.11.019 · Cited by 34 · see citing works
Individual and Household Predictors of Adolescents’ Adherence to a Web-Based Intervention
Mâsse, L. C., Watts, A. W., Barr, S. I., Tu, A. W., Panagiotopoulos, C., Geller, J., & Chanoine, J. (2014) · Annals of Behavioral Medicine · doi:10.1007/s12160-014-9658-z · Cited by 34 · see citing works
“To address this knowledge gap, this study examined factors that predict adolescents’ adherence to an efficacious Webbased lifestyle intervention [8, 17] targeted at overweight/ obese adolescents and their family.”
BackgroundInfluentialGoal feedback from whom? A physical activity intervention using an N-of-1 RCT
Brannon, E. E., Cushing, C. C., Walters, R. W., Crick, C., Noser, A. E., & Mullins, L. L. (2017) · Psychology and Health · doi:10.1080/08870446.2017.1385783 · Cited by 32 · see citing works
“Receiving targeted feedback on health behaviours by a healthcare professional has also demonstrated significant changes in improving adolescent health behaviours (Patrick et al., 2001, 2006).”
BackgroundAdams, M. A., Norman, G. J., Hovell, M. F., Sallis, J. F., & Patrick, K. (2009) · Health Psychology · doi:10.1037/a0012989 · Cited by 34 · see citing works
“The comparison group received a physical activity and diet intervention promoting physical activity and healthy eating behaviors (Patrick et al., 2006).”
BackgroundSelf-citationCovariation of Adolescent Physical Activity and Dietary Behaviors Over 12 Months
Rosenberg, D. E., Norman, G. J., Sallis, J. F., Calfas, K. J., & Patrick, K. (2007) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2007.05.018 · Cited by 34 · see citing works
Self-citationSmart Choices for Healthy Families
Pinard, C. A., Hart, M. H., Hodgkins, Y., Serrano, E. L., McFerren, M. M., & Estabrooks, P. A. (2012) · Health Education & Behavior · doi:10.1177/1090198111425686 · Cited by 34 · see citing works
“Creating a balance between feasibility and dose of the behavior change strategies is an area that requires more research, perhaps following a steppedcare approach that allows participants who are having more difficulty to receive a higher level of intervention support (Patrick et al., 2006).”
BackgroundKnowlden, A. P., & Conrad, E. J. (2017) · Health Education & Behavior · doi:10.1177/1090198117732604 · Cited by 34 · see citing works
Latent Growth Curve Modeling of Adolescent Physical Activity
Roesch, S. C., Norman, G. J., Adams, M. A., Kerr, J., Sallis, J. F., Ryan, S., Calfas, K. J., & Patrick, K. (2009) · Journal of Health Psychology · doi:10.1177/1359105308100216 · Cited by 32 · see citing works
“Details about the recruitment process have been previously published (Patrick et al., 2006).”
BackgroundMethodSelf-citationRaising an Active and Healthy Generation: A Comprehensive Public Health Initiative
Pate, R. R., & Dowda, M. C. (2018) · Exercise and Sport Sciences Reviews · doi:10.1249/jes.0000000000000171 · Cited by 31 · see citing works
- Authors
- Patrick, K., Calfas, K. J., Norman, G. J., Zabinski, M. F., Sallis, J. F., Rupp, J., Covin, J., & Cella, J.
- Affiliations
- University of California San Diego (US)
- Kaiser Permanente (US)
- Venue
- Archives of Pediatrics & Adolescent Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2006-02-01
- Volume
- 160
- Issue
- 2
- Pages
- 128
- ISSN
- 1072-4710 (ISSN-L)
- OpenAlex
- W2134620602
- Cited by
- 208
- References
- 52
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 1 · 2022: 7 · 2021: 9 · 2020: 11 · 2019: 3 · 2018: 7 · 2017: 9 · 2016: 22 · 2015: 10 · 2014: 12 · 2013: 24 · 2012: 15
- FWCI
- 10.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Pediatrics and Adolescent Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Kaiser Permanente
- University of California, San Diego
- National Cancer Institute (R01CA098861, R01CA081495)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- adolescent physical activity, sedentary behavior, nutrition behavior, fruit and vegetable intake, dietary fat intake, home-based counseling, telephone counseling, primary care intervention, goal setting, sun protection, body mass index, accelerometer-measured activity, computer-based testing, saturated fat intake, health behavior change, school-based intervention, family intervention, community-based intervention
- MeSH terms
- Adolescent, Child, Feeding Behavior, Female, Home Care Services, Humans, Male, Motor Activity, Primary Health Care, Health Behavior
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