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Promoting Healthy Lifestyles in High School Adolescents
Open accessAbstract
Background Although obesity and mental health disorders are two major public health problems in adolescents that affect academic performance, few rigorously designed experimental studies have been conducted in high schools.Purpose The goal of the study was to test the efficacy of the COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, Nutrition) Program, versus an attention control program (Healthy Teens) on: healthy lifestyle behaviors, BMI, mental health, social skills, and academic performance of high school adolescents immediately after and at 6 months post-intervention.Design A cluster RCT was conducted. Data were collected from January 2010 to May of 2012 and analyzed in 2012-2013.Setting/participants A total of 779 culturally diverse adolescents in the U.S. Southwest participated in the trial.Intervention COPE was a cognitive-behavioral skills-building intervention with 20 minutes of physical activity integrated into a health course, taught by teachers once a week for 15 weeks. The attention control program was a 15-session, 15-week program that covered common health topics.Main outcome measures Primary outcomes assessed immediately after and 6 months post-intervention were healthy lifestyle behaviors and BMI. Secondary outcomes included mental health, alcohol and drug use, social skills, and academic performance.Results Post-intervention, COPE teens had a greater number of steps per day (p=0.03) and a lower BMI (p=0.01) than did those in Healthy Teens, and higher average scores on all Social Skills Rating System subscales (p-values <0.05). Teens in the COPE group with extremely elevated depression scores at pre-intervention had significantly lower depression scores than the Healthy Teens group (p=0.02). Alcohol use was 12.96% in the COPE group and 19.94% in the Healthy Teens group (p=0.04). COPE teens had higher health course grades than did control teens. At 6 months post-intervention, COPE teens had a lower mean BMI than teens in Healthy Teens (COPE=24.72, Healthy Teens=25.05, adjusted M=-0.34, 95% CI=-0.56, -0.11). The proportion of those overweight was significantly different from pre-intervention to 6-month follow-up (chi-square=4.69, p=0.03), with COPE decreasing the proportion of overweight teens, versus an increase in overweight in control adolescents. There also was a trend for COPE Teens to report less alcohol use at 6 months (p=0.06).Conclusions COPE can improve short- and more long-term outcomes in high school teens.Trial registration This study is registered at www.clinicaltrials.gov NCT01704768.
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“There was less support for moderate-intensity interventions in reducing depression symptoms, with only two positive studies from seven39 42 and only one positive study for anxiety59 and stress59 from the four that measured these outcomes.”
From Physical activity and exercise in youth mental health promotion: a scoping review (2020) · cites this paper as [42]
Experimental — accuracy not yet measuredIn the citing paper
“Social skills improved following a likely moderate-intensity intervention in university students with high anxiety sensitivity, compared with health education.42”
From Physical activity and exercise in youth mental health promotion: a scoping review (2020) · cites this paper as [42]
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“Only five studies included follow-up assessments39 42 46 50 56 and none assessed whether PA/exercise prevented the onset of future episodes of threshold mental disorder, rendering longer-term preventive effects unknown.”
From Physical activity and exercise in youth mental health promotion: a scoping review (2020) · cites this paper as [42]
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“As only nine studies included a comparison group that delivered an intervention41 42 45 46 50 52 59 61 75—the remaining included a wait-list or additional PA/exercise group—in the majority of studies it remains unknown if the observed effects are due to PA/exercise or from non-specific time/attention effects.”
From Physical activity and exercise in youth mental health promotion: a scoping review (2020) · cites this paper as [42]
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Brown, T. J., Moore, T. H., Hooper, L., Gao, Y., Zayegh, A. M., Ijaz, S., Elwenspoek, M. M. C., Foxen, S. C., Magee, L., O’Malley, C. L., et al. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001871.pub4 · Cited by 3,054
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Physical activity and exercise in youth mental health promotion: a scoping review
Pascoe, M., Bailey, A. P., Craike, M., Carter, T., Patten, R., Stepto, N., & Parker, A. (2020) · BMJ Open Sport & Exercise Medicine · doi:10.1136/bmjsem-2019-000677 · Cited by 332
Metadata
- Authors
- Melnyk, B. M., Jacobson, D., Kelly, S., Belyea, M., Shaibi, G., Small, L., O’Haver, J., & Marsiglia, F. F.
- Affiliations
- The Ohio State University (US)
- Phoenix Children's Hospital (US)
- Arizona State University (US)
- Corresponding author
- Melnyk, Bernadette M.
- ORCID
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 45
- Issue
- 4
- Pages
- 407-415
- ISSN
- 0749-3797 (ISSN-L)
- PMC
- PMC4285557
- OpenAlex
- W176301900
- Cited by
- 183
- References
- 53
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 13 · 2023: 5 · 2022: 18 · 2021: 14 · 2020: 29 · 2019: 12 · 2018: 13 · 2017: 4 · 2016: 18 · 2015: 19 · 2014: 11 · 2013: 3
- FWCI
- 17.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Nursing Research (R01NR012171)
- National Institute on Minority Health and Health Disparities (P20MD002316)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › School Health and Nursing Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Adolescent Health and Behaviors
- Keywords
- healthy lifestyle intervention, high school adolescents, obesity prevention, body mass index, depression, social skills, physical activity, alcohol consumption, drug use, academic performance, cognitive-behavioral intervention, school-based health education, nutrition education, teacher-delivered intervention, step count, overweight, mental health promotion
- MeSH terms
- Adaptation, Psychological, Adolescent, Adolescent Behavior, Diet, Female, Health Promotion, Humans, Interpersonal Relations, Health Knowledge, Attitudes, Practice, Life Style, Male, Mental Health, Power, Psychological, Stress, Psychological, Health Behavior, Exercise, Body Mass Index
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