{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:56:17Z","timestamp":1791561377717,"version":"4.3.4"},"reference-count":55,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Childhood obesity remains a major concern in the US, with increases in body mass index (BMI) observed during and after the COVID-19 pandemic. Scalable behavioral interventions are needed to support obesity prevention in community settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To evaluate the efficacy of a community-based behavioral intervention (H\n                      <jats:sub>2<\/jats:sub>\n                      GO!) on BMI\n                      <jats:italic>z<\/jats:italic>\n                      scores (\n                      <jats:italic>z<\/jats:italic>\n                      BMIs) among school-aged children.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This cluster randomized clinical trial was conducted from September 2020 to June 2025 across 11 Boys &amp;amp;amp; Girls Club sites in Massachusetts. Sites were pair-matched and randomized to intervention or usual care condition. Participants included children aged 8 to 13 years and their parents or caregivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Twelve group-based sessions delivered in person over 6 weeks by trained Boys &amp;amp;amp; Girls Club staff using behavioral strategies to reduce sugar-sweetened beverage intake and increase water consumption through health sessions, youth-created narratives, and parent-child activities. Comparison sites received usual programming.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>\n                      Outcomes were assessed at baseline and at 2, 6, and 12 months using intention-to-treat analyses. The primary outcome was 12-month change from baseline in child\n                      <jats:italic>z<\/jats:italic>\n                      BMI, derived from staff-measured height and weight using standardized protocols. Secondary outcomes included child sugar-sweetened beverage and water intake measured using a validated questionnaire.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 437 child participants (mean [SD] age, 10.1 [1.2] years; 219 girls [50.1%]), 0.2% were American Indian or Alaska Native, 1.8% were Asian, 15.8% were Black or African American, 42.6% were Hispanic or Latino, and 29.5% were White; 297 (68%) were eligible for free or reduced-price lunch. At baseline, 74 children (16.9%) had overweight, and 161 (36.8%) had obesity. From baseline to 12 months, the mean\n                      <jats:italic>z<\/jats:italic>\n                      BMI did not statistically significantly decrease (\u22120.11 [95% CI, \u20130.25 to 0.02]) in the intervention group and did not statistically significantly increase (0.08 [95% CI, \u20130.04 to 0.20]) in the comparison group; however, the estimated between-group difference in the adjusted mean\n                      <jats:italic>z<\/jats:italic>\n                      BMI change from baseline was statistically significant: \u22120.19 (95% CI, \u22120.38 to \u22120.01;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.04). Between-group differences in sugar-sweetened beverage and water intake were not significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>\n                      In this cluster randomized clinical trial, a community-based behavioral intervention was associated with a statistically significant between-group difference in\n                      <jats:italic>z<\/jats:italic>\n                      BMI change among school-aged children. Findings support the potential of community-based behavioral interventions in obesity prevention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov Identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT04265794?term=NCT04265794%20&amp;amp;amp;viewType=Card&amp;amp;amp;rank=1\">NCT04265794<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.38188","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:30:28Z","timestamp":1791559828000},"page":"e2638188","source":"Crossref","is-referenced-by-count":0,"title":["A Community-Based Behavioral Intervention and Body Mass Index in School-Aged Children"],"prefix":"10.1001","volume":"9","author":[{"given":"Monica L.","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts"},{"name":"Department of Health Policy and Management, Harvard T.H. 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