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Randomized Controlled Trial
. 2025 Aug 28;15(1):31678.
doi: 10.1038/s41598-025-16754-3.

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

Yuxin Nie  1 , Qiaoyin Tan  1 , Paul Son  1 , Amanda E Staiano  2 , Richard R Rosenkranz  3 , Katherine E Spring  2 , Mónica Suárez-Reyes  2   4 , Renee A Underwood  2   5 , Jared N Androzzi  6 , Fahui Wang  7 , Senlin Chen  8
Affiliations
Randomized Controlled Trial

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

Yuxin Nie et al. Sci Rep. .

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.

Keywords: Children; Health disparity; Implementation science; Mixed methods; Type II hybrid effectiveness-implementation design.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Informed consent: All authors provided consent to the publication of this manuscript. Participants provided consent for the publication of anonymized data collected from the study. Institutional review board statement: his study was conducted in accordance with the Declaration of Helsinki and was approved by the Louisiana State University Institutional Review Board (protocol code IRBAM-21-0702). Written informed consent was obtained from each of the participants involved in the study.

Figures

Fig. 1
Fig. 1
Cafeterias’ mean scores by time and condition. Solid line: ProudMe; broken line = control.
Fig. 2
Fig. 2
Cafeterias scores in the eight scoring categories by time and condition. Solid line: ProudMe; broken line = control.
Fig. 3
Fig. 3
Changes for ProudMe (n = 33) and Control (n = 46) in anthropometric outcomes (BMI, BMIz, BMI percentile = BMIp, WC) by condition. BMI = body mass index; WC = waist circumference; dif = posttest – pretest difference.
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References

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