PROGRAM SUMMARY

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Supporting Teens for A healthieR Tomorrow (START) Now is a high school-based program that targets the primary prevention of obesity and overweight among teens aged 14 to 18 in Westmoreland County, Pennsylvania. The START Now pilot program will be implemented at Penn-Trafford High School (PTHS) during the August 2021 – May 2022 school year. Following pilot program evaluation, START Now may be adapted and extended to other Westmoreland County high schools.

Theoretical Basis

The START Now program is rooted in Social Cognitive Theory (SCT) and is designed to facilitate behavior change by targeting the individual, interpersonal, and environmental levels of influence per the social ecological model (Contento, 2016). Thus, START Now has three key components: a nutrition education curriculum designed to increase teens’ knowledge, skills, and self-efficacy around healthy eating and adequate physical activity, a nutrition education component for parents, and a component focused on improving the healthfulness of the school food environment.

Student Nutrition Education

Individually, adolescents require functional knowledge and skills to develop healthy habits, along with the self-efficacy to do so (Contento, 2016). START Now will speak to students directly through its nutrition education curriculum, rather than relying on knowledge transfer through parents or others; this is important due to teens’ growing autonomy and intrinsic motivation (Weihrauch-Blüher et al., 2018). The START Now student curriculum includes 12 face-to-face, 50-minute lessons across four modules focused on healthful eating and increased physical activity. The modules (Nutrition Fundamentals, Energy Balance, Creating Healthy Meals, and Real Life Choices) begin with basic knowledge and skills and progress to more complex practice and application. The interactive curriculum will be delivered by trained START Now program facilitators during PTHS health classes over a four-week period, with three lessons taught per week. Consistent with SCT, program facilitators will promote personal agency, independent decision-making, and critical thinking skills among student participants, and students will be provided with opportunities for both observational and hands-on learning (Contento, 2016). As part of the curriculum, students will also participate in a Healthy Habits Challenge, which will require them to set individual SMART goals, track their progress, and offer social support to one another (Contento, 2016). In total, 120 classroom-based lessons will be delivered to 300 PTHS students during the 2021-2022 school year.

Parent Nutrition Education

Interpersonally, teens remain influenced by their family environments and often make dietary choices based on what’s available at home. Thus, START Now will also provide adult-directed nutrition education to encourage the parents of student participants to become actively involved in the program. The parent component will include face-to-face educational sessions and digital newsletters, delivered via email or text. During the PTHS pilot, program staff will deliver 12 adult nutrition education sessions (two sessions per parent) and 1,200 weekly newsletters (four per parent). The 75-minute educational sessions will be held on school grounds outside of regular school hours, and parents will gain knowledge and skills to help their teen(s) eat healthfully and increase physical activity. Ultimately, parents should apply these learnings by making healthful changes at home.

Environmental Change

At the environmental level, START Now aims to improve teens’ access to healthy food choices  at school. The START Now program team will partner with school staff, administrators, food service, and students to identify opportunities to improve the school’s food environment. These may include improved food offerings, application of behavioral economics in the cafeteria, and/or changes to school food policy. As result of START Now, at least two such changes will be implemented. Additionally, START Now will sponsor the formation of a student-led coalition (one per school) that will advocate for further improvements to the school food environment; the coalition may also help to reshape social norms. START Now program staff will actively promote the coalition, encourage student participation, and offer ongoing support and guidance.

 

References

Contento, I. R. (2016). Nutrition education: Linking research, theory, and practice (3rd ed.). Jones & Bartlett Learning.

Saunders, R. P., Evans, M. H., & Joshi, P. (2005). Developing a process-evaluation plan for assessing health promotion program implementation: A how-to guide. Health Promotion Practice6(2), 134–147. https://doi.org/10.1177/1524839904273387

Weihrauch-Blüher, S., Kromeyer-Hauschild, K., Graf, C., Widhalm, K., Korsten-Reck, U., Jödicke, B., Markert, J., Müller, M. J., Moss, A., Wabitsch, M., & Wiegand, S. (2018). Current guidelines for obesity prevention in childhood and adolescence. Obesity Facts11(3), 263–276. https://doi.org/10.1159/000486512

 

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