Testing an adapted obesity prevention intervention in under resourced schools: a pilot clustered randomized controlled trial.

Journal: Scientific reports
Published Date: Aug 28, 2025

Abstract

The purpose of this pilot study was to test an adapted childhood obesity prevention intervention called Preventing Obesity Using Digital-Assisted Movement and Eating (ProudMe) in under-resourced schools. Six schools were cluster-randomized to ProudMe (n = 33; at three schools) or waitlist control (n = 46; at three schools) conditions. ProudMe aimed to improve participants' health behaviors and weight status through interventions in the school cafeteria (i.e., ProudMe Cafeteria), physical education (PE) (i.e., ProudMe PE), and through artificial-intelligence- (AI-) assisted behavioral counseling (i.e., ProudMe Tech), and staff professional development (i.e., ProudMe PD). Two implementation outcomes including penetration and fidelity were captured through mixed methods. We drew upon the Consolidated Framework for Implementation Research (CFIR) to identify facilitators and barriers underlying implementation. The intervention only resulted in highly positive implementation outcomes in the cafeterias, which subsequently resulted in improved cafeteria scores. Implementation outcomes were less desirable in ProudMe PE with moderate penetration and fidelity. ProudMe PD was well attended but ProudMe Tech was under-utilized. The pilot intervention as a whole did not show significant effects on student-level outcomes (p > 0.05). Multiple facilitators and barriers across CFIR domains emerged as influential factors for the pilot intervention's implementation and preliminary effectiveness. This study generated mixed evidence concerning the ProudMe intervention. The lessons learned inform future intervention refinement.

Authors

  • Yuxin Nie
    School of Kinesiology, Louisiana State University, Baton Rouge, LA, 70803, USA.
  • Qiaoyin Tan
    School of Kinesiology, Louisiana State University, Baton Rouge, LA, 70803, USA.
  • Paul Son
    School of Kinesiology, Louisiana State University, Baton Rouge, LA, 70803, USA.
  • Amanda E Staiano
    Pediatric Obesity and Health Behavior Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA.
  • Richard R Rosenkranz
    Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV, 89154, USA.
  • Katherine E Spring
    Pediatric Obesity and Health Behavior Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA.
  • Mónica Suárez-Reyes
    Pediatric Obesity and Health Behavior Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA.
  • Renee A Underwood
    Pediatric Obesity and Health Behavior Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA.
  • Jared N Androzzi
    Department of Physical Education, Sport and Human Performance, Winthrop University, Rock Hill, SC, 29733, USA.
  • Fahui Wang
    Department of Geography and Anthropology, Louisiana State University, Baton Rouge, LA, 70803, USA.
  • Senlin Chen
    School of Kinesiology, Louisiana State University, Baton Rouge, LA, 70803, USA. senlinchen@lsu.edu.

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