"Wellness Champions for Change," a multi-level intervention to improve school-level implementation of local wellness policies: Study protocol for a cluster randomized trial

Affiliations

¹ University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA. Electronic address: hlane@som.umaryland.edu.
² University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA. Electronic address: rdeitch@som.umaryland.edu.
³ University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Epidemiology and Public Health, 737 West Lombard Street, Baltimore, MD 21201, USA. Electronic address: yan.wang@som.umaryland.edu.
⁴ University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Epidemiology and Public Health, 737 West Lombard Street, Baltimore, MD 21201, USA; RTI International, Research Triangle Park, NC 27709, USA. Electronic address: mblack@som.umaryland.edu.
⁵ University of Southern California, Departments of Preventive Medicine and Psychology, 2001 N. Soto St., Los Angeles, CA 90032, USA. Electronic address: dunton@usc.edu.
⁶ University of Maryland College Park, Department of Communication, College of Arts and Humanities, College Park, MD 20742, USA. Electronic address: laldoory@umd.edu.
⁷ Boise State University, College of Education, 1910 University Drive, #1740, Boise, ID 83725, USA. Electronic address: lindseyturner1@boisestate.edu.
⁸ University of Maryland School of Medicine, Department of Family and Community Medicine, Center for Integrative Medicine, 520 W. Lombard Street, East Hall, Baltimore, MD 21201, USA. Electronic address: Elizabeth.parker@som.umaryland.edu.
⁹ University of Maryland Extension, Department of Agriculture and Natural Resources, 1114 Shawan Road, Cockeysville, MD 21030, USA. Electronic address: shenley@umd.edu.
¹⁰ University of Maryland College Park, Department of Epidemiology and Biostatistics, School of Public Health, College Park, MD 20742, USA. Electronic address: bsaksvig@umd.edu.
¹¹ University of Maryland College Park, Department of Nutrition and Food Science, College of Agriculture and Natural Resources, College Park, MD 20742, USA. Electronic address: hjsong@umd.edu.
¹² University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Epidemiology and Public Health, 737 West Lombard Street, Baltimore, MD 21201, USA. Electronic address: ehager@som.umaryland.edu.

PMID: 30342257
PMCID: PMC6594543
DOI: 10.1016/j.cct.2018.10.008

"Wellness Champions for Change," a multi-level intervention to improve school-level implementation of local wellness policies: Study protocol for a cluster randomized trial

Hannah G Lane et al. Contemp Clin Trials. 2018 Dec.

. 2018 Dec:75:29-39.

doi: 10.1016/j.cct.2018.10.008. Epub 2018 Oct 18.

Authors

Affiliations

¹ University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA. Electronic address: hlane@som.umaryland.edu.
² University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA. Electronic address: rdeitch@som.umaryland.edu.
³ University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Epidemiology and Public Health, 737 West Lombard Street, Baltimore, MD 21201, USA. Electronic address: yan.wang@som.umaryland.edu.
⁴ University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Epidemiology and Public Health, 737 West Lombard Street, Baltimore, MD 21201, USA; RTI International, Research Triangle Park, NC 27709, USA. Electronic address: mblack@som.umaryland.edu.
⁵ University of Southern California, Departments of Preventive Medicine and Psychology, 2001 N. Soto St., Los Angeles, CA 90032, USA. Electronic address: dunton@usc.edu.
⁶ University of Maryland College Park, Department of Communication, College of Arts and Humanities, College Park, MD 20742, USA. Electronic address: laldoory@umd.edu.
⁷ Boise State University, College of Education, 1910 University Drive, #1740, Boise, ID 83725, USA. Electronic address: lindseyturner1@boisestate.edu.
⁸ University of Maryland School of Medicine, Department of Family and Community Medicine, Center for Integrative Medicine, 520 W. Lombard Street, East Hall, Baltimore, MD 21201, USA. Electronic address: Elizabeth.parker@som.umaryland.edu.
⁹ University of Maryland Extension, Department of Agriculture and Natural Resources, 1114 Shawan Road, Cockeysville, MD 21030, USA. Electronic address: shenley@umd.edu.
¹⁰ University of Maryland College Park, Department of Epidemiology and Biostatistics, School of Public Health, College Park, MD 20742, USA. Electronic address: bsaksvig@umd.edu.
¹¹ University of Maryland College Park, Department of Nutrition and Food Science, College of Agriculture and Natural Resources, College Park, MD 20742, USA. Electronic address: hjsong@umd.edu.
¹² University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Epidemiology and Public Health, 737 West Lombard Street, Baltimore, MD 21201, USA. Electronic address: ehager@som.umaryland.edu.

PMID: 30342257
PMCID: PMC6594543
DOI: 10.1016/j.cct.2018.10.008

Abstract

Schools are a recommended place for childhood obesity prevention. Local Wellness Policies (LWPs) establish guidelines for schools to provide opportunities for students to access nutritious foods and be physically active. Little is known about the impact of LWPs, when implemented, on students' behavior and body mass index (BMI). The Wellness Champions for Change trial assesses the student-level impact of providing theory-based training and technical assistance to help schools implement LWPs. This 3-arm, cluster randomized controlled trial will take place in 30 low- or middle-income schools (15 elementary and 15 middle) in five Maryland school districts. Ten schools will receive both Wellness Champions for Change (WCC), which involves training teacher-led wellness teams, and Wellness Champions for Change-Student (WCC-S), which engages students as wellness team members. Ten schools will receive WCC only, and ten control schools will receive a delayed intervention. The RE-AIM framework will guide evaluation. Student Effectiveness measures will include BMI z-scores, self-reported diet patterns, and objectively-measured physical activity. The sample size (1080 students across 30 schools, followed for 2.5 years) will enable power (>0.8) to detect BMI z-score differences. A three-level linear mixed model that accounts for clustering will be used to assess Effectiveness. A mixed methods approach will assess school- and district-level Reach, Adoption, and Implementation. If effective, this approach will represent a sustainable, multi-level, school-based strategy to prevent childhood obesity. The evaluation framework will allow for the description of factors necessary to broadly disseminate this approach for obesity prevention on a large scale.

Keywords: Child/adolescent; Childhood obesity prevention; Healthy eating; Local Wellness Policies; Physical activity; School-based obesity intervention.

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Figures

**Fig. 1.**
Wellness Champions for Change planned randomization design.

**Fig. 2.**
Study design and flow of participants through Wellness Champions for Change trial.

**Fig. 3.**
Wellness Champions for Change (WCC) and Wellness Champions for Change-Student (WCC-S) theoretical framework and intervention description.

See this image and copyright information in PMC

References

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1. Wechsler H, Devereaux RS, Davis M, Collins J. Using the school environment to promote physical activity and healthy eating. Preventive Medicine 2000;31(2):S121–S137.

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"Wellness Champions for Change," a multi-level intervention to improve school-level implementation of local wellness policies: Study protocol for a cluster randomized trial

Affiliations

"Wellness Champions for Change," a multi-level intervention to improve school-level implementation of local wellness policies: Study protocol for a cluster randomized trial

Authors

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical