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Randomized Controlled Trial
. 2010 Nov;164(11):1007-14.
doi: 10.1001/archpediatrics.2010.196.

The Memphis Girls' health Enrichment Multi-site Studies (GEMS): an evaluation of the efficacy of a 2-year obesity prevention program in African American girls

Robert C Klesges  1 , Eva Obarzanek, Shiriki Kumanyika, David M Murray, Lisa M Klesges, George E Relyea, Michelle B Stockton, Jennifer Q Lanctot, Bettina M Beech, Barbara S McClanahan, Deborah Sherrill-Mittleman, Deborah L Slawson
Affiliations
Randomized Controlled Trial

The Memphis Girls' health Enrichment Multi-site Studies (GEMS): an evaluation of the efficacy of a 2-year obesity prevention program in African American girls

Robert C Klesges et al. Arch Pediatr Adolesc Med. 2010 Nov.

Abstract

Objective: To determine the efficacy of a 2-year obesity prevention program in African American girls.

Design: Memphis GEMS (Girls' health Enrichment Multi-site Studies) was a controlled trial in which girls were randomly assigned to an obesity prevention program or alternative intervention.

Setting: Local community centers and YWCAs (Young Women's Christian Associations) in Memphis, Tennessee.

Participants: Girls aged 8 to 10 years (N = 303) who were identified by a parent or guardian as African American and who had a body mass index (BMI) at or higher than the 25th percentile for age or 1 parent with a BMI of 25 or higher.

Interventions: Group behavioral counseling to promote healthy eating and increased physical activity (obesity prevention program) or self-esteem and social efficacy (alternative intervention).

Main outcome measure: The BMI at 2 years.

Results: The BMI increased in all girls with no treatment effect (obesity prevention minus alternative intervention) at 2 years (mean, 0.09; 95% confidence interval [CI], -0.40 to 0.58). Two-year treatment effects in the expected direction were observed for servings per day of sweetened beverages (mean, -0.19; 95% CI, -0.39 to 0.09), water (mean, 0.21; 95% CI, 0.03 to 0.40), and vegetables (mean, 0.15; 95% CI,-0.02 to 0.30), but there were no effects on physical activity. Post hoc analyses suggested a treatment effect in younger girls (P for interaction = .08). The mean BMI difference at 2 years was -2.41 (95% CI, -4.83 to 0.02) in girls initially aged 8 years and -1.02 (95% CI, -2.31 to 0.27) in those initially aged 10 years.

Conclusions: The lack of significant BMI change at 2 years indicates that this intervention alone is insufficient for obesity prevention. Effectiveness may require more explicit behavior change goals and a stronger physical activity component as well as supportive changes in environmental contexts.

Trial registration: ClinicalTrials.gov NCT00000615.

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Figures

Figure 1
Figure 1
GEMS participant recruitment, randomization, and follow-up
Figure 2
Figure 2
Predicted mean body mass index (BMI) from post-hoc repeated measures analysis of 3-way interaction for age, visit, and treatment group
See this image and copyright information in PMC

Comment in

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