Project Summary/Abstract
Over one-third of children in the U.S. are overweight or obese and at risk for short-term and long-term health
consequences, including diabetes, hypertension, heart disease and certain types of cancer. Substantial
evidence exists on reducing sugar-sweetened beverage (SSB) consumption as a critical dietary target for
childhood obesity prevention. Efficacious behavioral interventions targeting SSBs are lacking, particularly
among low-income and ethnic minority early and pre-adolescent youth who have higher SSB intake and
obesity risk. Youth empowerment interventions hold potential for catalyzing behavior change in childhood
obesity intervention contexts and may be particularly engaging for low-income and ethnic minority youth.
However, few studies of youth empowerment health interventions have utilized rigorous study designs or
examined empowerment as a mediator/mechanism of change. To this gap, we worked collaboratively with
Boys and Girls Clubs of America (BGCs), a national system of afterschool care that reaches 4 million youth
annually, to develop and pilot-test a community-based youth empowerment intervention on reducing SSB
intake and preventing childhood obesity. Grounded in Empowerment Theory, the intervention targets SSB
consumption through health sessions that empower youth through developing their confidence and skills;
narrative sessions that empower youth through cultivating critical thinking, and youth-led activities that
empower youth through opportunities to produce change within their families. The resulting H2GO! intervention
is designed to be delivered within BGCs by BGC staff. Building on our successful pilot study of H2GO!, we are
now positioned to test the efficacy of the H2GO! intervention in collaboration with the BGC network in MA,
which collectively serves over 160,000 children each year. Using a cluster-randomized design, a total of 10
BGC sites will be randomly assigned to the H2GO! intervention or a wait-list, usual care condition. A total of
450 parent-child pairs (N=45 parent-child pairs per site) will be enrolled. Data will be collected at baseline, 2
months, 6 months, and 12 months and include child anthropometrics, SSB and water intake, and youth
empowerment. Specific aims of the proposal include: 1) test the efficacy of the H2GO! intervention on child BMI
z scores using a cluster randomized controlled trial; 2) test the efficacy of the H2GO! intervention on child SSB
and water intake; 3) examine youth empowerment as a mediator of intervention effects. Findings from this
proposal will provide evidence of youth empowerment as an approach to reduce SSB intake and obesity risk
and contribute to a long-term goal of producing an intervention model for childhood obesity prevention that is
well-positioned for dissemination through youth-based settings.
