{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T04:35:16Z","timestamp":1780461316432,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,9,12]],"date-time":"2016-09-12T00:00:00Z","timestamp":1473638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R21 HL110208"],"award-info":[{"award-number":["R21 HL110208"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of School Health"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Given the dramatic increase in adolescent overweight and obesity, models are needed for implementing weight management treatment through readily accessible venues. We evaluated the acceptability and efficacy of a school\u2010based intervention consisting of school nurse\u2010delivered counseling and an afterschool exercise program in improving diet, activity, and body mass index (BMI) among overweight and obese adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A pair\u2010matched cluster\u2010randomized controlled school\u2010based trial was conducted in which 8 public high schools were randomized to either a 12\u2010session school nurse\u2010delivered cognitive\u2010behavioral counseling intervention plus school\u2010based after school exercise program, or 12\u2010session nurse contact with weight management information (control). Overweight or obese adolescents (N = 126) completed anthropometric and behavioral assessments at baseline and 8\u2010month follow\u2010up. Main outcome measures included diet, activity, and BMI. Mixed effects regression models were conducted to examine differences at follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>At follow\u2010up, students in intervention compared with control schools were not different in BMI, percent body fat, and waist circumference. Students reported eating breakfast (adjusted mean difference 0.81 days; 95% confidence interval [CI] 0.11\u20101.52) on more days\/week; there were no differences in other behaviors targeted by the intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>While a school\u2010based intervention including counseling and access to an after\u2010school exercise program is theoretically promising with public health potential, it was not effective in reducing BMI or key obesogenic behaviors. Our findings are important in highlighting that interventions targeted at the individual level are not likely to be sufficient in addressing the adolescent obesity epidemic without changes in social norms and the environment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/josh.12428","type":"journal-article","created":{"date-parts":[[2016,9,12]],"date-time":"2016-09-12T23:01:00Z","timestamp":1473721260000},"page":"699-708","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["A School\u2010Based Program for Overweight and Obese Adolescents: A Randomized Controlled Trial"],"prefix":"10.1111","volume":"86","author":[{"given":"Lori","family":"Pbert","sequence":"first","affiliation":[{"name":"Division of Preventive and Behavioral Medicine University of Massachusetts Medical School  55 Lake Avenue North Worcester MA 06155"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Druker","sequence":"additional","affiliation":[{"name":"Division of Preventive and Behavioral Medicine University of Massachusetts Medical School  55 Lake Avenue North Worcester MA 06155"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Barton","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences University of Massachusetts Medical School  55 Lake Avenue North Worcester MA 06155"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin L.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Psychology Rosalind Franklin University of Medicine and Science  North Chicago IL 60064\u20103095"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Olendzki","sequence":"additional","affiliation":[{"name":"Division of Preventive and Behavioral Medicine University of Massachusetts Medical School  55 Lake Avenue North Worcester MA 06155"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary A.","family":"Gapinski","sequence":"additional","affiliation":[{"name":"Massachusetts Department of Public Health  Boston MA 02108\u20104619"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Kurtz","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences University of Massachusetts Medical School  55 Lake Avenue North Worcester MA 06155"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavroula","family":"Osganian","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of General Pediatrics Research Children's Hospital  Boston MA 02115"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,9,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.2012"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2000.105141"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(96)80124-7"},{"key":"e_1_2_6_5_1","first-page":"A306","article-title":"Insulin resistance and defective glucose\u2010insulin coupling in ketosis\u2010prone type 2 diabetes at African\u2010American children","volume":"46","author":"Willie SM","year":"1998","journal-title":"Diabetes"},{"issue":"18","key":"e_1_2_6_6_1","first-page":"2042","article-title":"Association of adolescent obesity with risk of severe obesity in adulthood","volume":"304","author":"The NS","year":"2010","journal-title":"JAMA"},{"key":"e_1_2_6_7_1","unstructured":"Whitlock EA O'Connor EP Williams SB Beil TL Lutz KW. 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