Challenge!

About Us

Challenge! was a home- and community-based health promotion/obesity prevention program targeting urban African American adolescents in Baltimore City. The effectiveness of Challenge! was studied as a randomized controlled trial with support from the Maternal and Child Health Bureau (grants R40MC00241 and R40MC04297), the General Clinical Research Centers Program (grant M01 RR16500), the Annie E. Casey Foundation, the Thomas Wilson Sanitarium for Children of Baltimore City and General Mills Champions for Healthy Kids.

The primary goal of Challenge! was to prevent overweight and the accumulation of excess body fat during adolescence. Secondary goals were to increase physical activity (increase time spent in moderate-vigorous activity and decrease time spent engaging in sedentary behaviors) and to improve diet (increase fruit and vegetable consumption, decrease sweetened beverage intake, decrease consumption of high-fat snack foods).

The Intervention

After formative research within the target community, an intervention was designed to promote healthy eating and increased activity among adolescents. The intervention was implemented over the course of three months and was delivered individually to each teen in their home or community by a college-age, gender-matched mentor (a "personal trainer"). The teens in the intervention group met with their personal trainer weekly to discuss each lesson and to set dietary and activity goals.

Measures

Data collection for Challenge! began in July 2002 and ended in December 2006. At the baseline evaluation, 235 adolescents between the ages of 11-16 were enrolled. Information was collected from the teens and their primary caregivers at baseline, 6 months (post-intervention), and 18 months (1 year post-intervention).

Teen Assessments

Outcome Variables

Body composition (height, weight, bioelectrical impedance analysis, DEXA)
Physical activity (accelerometry, SAPAC)
Diet (Youth/Adolescent FFQ)

Intervening Variables

Demographics (gender, race, DOB, grade)
Maturity (tanner staging)
Self-Esteem (Rosenberg Self-Esteem Scale)
Body Image/ Perception (Contour Drawing Scale)
Body Esteem (Body Esteem Scale for Adolescents and Adults)
Stages of Change
Parenting Style (Authoritative Parenting Index)
EATing Attitudes
Depression (Beck Depression Inventory)
Amherst Health and Activity Study-Student Version
- Support for Physical Activity
- Barriers and Enablers for PA
- PA recall

Caregiver Assessments

Demographics (gender, race, DOB, SES)
Body Composition
- Measured Height and Weight (used to calculate BMI)
- Bioelectrical Impedance Analysis
Self-Esteem (Rosenberg Self-Esteem Scale)
Body Image/ Perception (Contour Drawing Scale)
Body Esteem (Body Esteem Scale for Adolescents and Adults)
Parental Feeding Strategies (Child Feeding Questionnaire)
EATing Attitudes
Depression (Beck Depression Inventory)
Food Security
Retrospective Physical Activity Questionnaire
Home Food Inventory
Physical Activity (Accelerometry)

Principal Investigator

Maureen Black, Ph.D
Principal Investigator
University of Maryland, School of Medicine
mblack@som.umaryland.edu

Team

Co-Investigators

Jean Anliker, Ph.D.
University of Massachusetts, Amherst

Benjamin Caballero, M.D., Ph.D.
Johns Hopkins Bloomberg School of Public Health

Carlo DiClemente, Ph.D.
University of Maryland, Baltimore County

Howard Dubowitz, M.D., M.S.
University of Maryland, School of Medicine

Joel Gittelsohn, Ph.D.
Johns Hopkins Bloomberg School of Public Health

Steve Pitts, Ph.D.
University of Maryland, Baltimore County

Soren Snitker, M.D., Ph.D.
University of Maryland, School of Medicine

Raymond H. Starr, Jr., Ph.D.
University of Maryland, Baltimore County

Margarita S. Treuth, Ph.D.
University of Maryland, Eastern Shore

Project Coordinators

2002-2004: Kat Le, MPH
Wake Forest University, School of Medicine

2004-2006: Lauren Fusillo
MPH University of Maryland, School of Medicine

Intervention Coordinator

S. Sonia Arteaga, Ph.D.
University of Maryland, Baltimore County

Data Collection Coordinator

2002-2004: Emily Yankus
Loyola College

2004-2006: Erin R. Hager
Johns Hopkins Bloomberg School of Public Health

Data Analysts

Scott McNary
Mia Papas
Fatma Shebl

Research Assistants

Casey Breslin
Animari Fermaint
Shannon Fitzmaurice
Kay Gomez
Sue Holt
Adele Israel
Andrea Mitola

Interventionists

Gary Antoine
Ama Emanuel
Erica Hart
Maurice Montgomery
Derek Anderson
Munir Bahar
Danielle Cotton
Shariece Johnson
Michele Clark
Crissy Metzger
Tannyka Coleman
Nicole Parker
Mari Tekle
Yvonne Ezalea
Kira Evans
Huguens Jean
Ernie Lewis
Erick Mgah
Yvone Akumu
Eugene Stovall
Nneka White

Publications

Black, M. M., Arteaga, S. S., Sanders, J., Hager, E. R., Anliker, J. A., Gittelsohn, J., & Wang, Y. College mentors: A View From the Inside of an Intervention to Promote Health Behaviors and Prevent Obesity Among Low-Income, Urban, African American Adolescents. Journal of Health Promotion Practice,(2010, December 29); 1-7. doi:DOI: 10.1177/1524839910385899

Black, M. M., Hager, E. R., Le, K., Anliker, J., Arteaga, S., DiClemente, C., & Gittelsohn, J.Challenge! Health Promotion/Obesity Prevention Mentorship Model Among Urban, Black Adolescents. Journal of Pediatrics,(2010, August);126(2), 280-288.

Snitker S, Le KY, Hager E, Caballero B, Black MM. Influence of Physical Activity and Body Composition on Glucose Homeostasis in a Community Sample of Adolescents. Archives of Pediatric and Adolescent Medicine. 2007 July; 161: 677-683.

Mitola AL, Papas MA, Le K, Fusillo L, Black MM. Agreement with satisfaction in adolescent body size between female caregivers and teens from a low-income African-American community. J Pediatr Psychol. 2007 Jan-Feb; 32(1): 42-51.