Changes in Youth and Adolescent BMI After a Family-Based, Healthy Weight Summer Camp

Date of Award

Summer 6-13-2015

Degree Type

Thesis

Degree Name

Master of Science (MS)

Department

Nutrition

First Advisor

Sarah T. Henes

Second Advisor

Anita Nucci

Third Advisor

Jean Welsh

Abstract

Background: Childhood obesity is a growing problem in the United States. Several factors have been identified as contributors to childhood overweight and obesity, many of which are significantly influenced by parents and the home environment. Many types of interventions have been successful in reducing obesity prevalence in children including family interventions and overnight camps. These interventions tend to be very long in duration and requirement significant investments in time by parents and staff. The purpose of this study was to 1) evaluate changes in BMI after a one week family-based healthy weight camp for overweight and obese youth and 2) to determine if changes in BMI were associated with reported changes in the home environment.

Methods: A secondary analysis of data that were previously collected by researchers and staff of Camp Strong4Life in 2014. Participants in this study included overweight and obese youth aged 8-17 years and at least one parent or caregiver. Overweight and obese youth were defined as BMI ≥85th percentile as plotted on Center for Disease Control and Prevention (CDC) age and gender specific growth charts. Data collected included height, weight, age, gender, race, BMI z-score and BMI percentile of youth pre- and post the healthy weight camp intervention. A validated home environment survey was completed by each camper’s parent or care-giver for both the pre-camp Welcome Weekend and post-camp Reunion Weekend. The Home Environment Survey was categorized into eight scales for analysis. Means of Welcome Weekend and Reunion Weekend scores and pre-post camp BMI and BMI z-score were compared using the paired t-test if normally distributed and the Wilcoxon signed rank test if not normally distributed. Pearson correlations were used to compare changes in BMI and the home environment if changes were normally distributed. Spearman correlations were used if changes were not normally distributed.

Results: Complete data were available for 37 campers. The sample of campers had a mean age of 12.5 (± .03) years and was predominantly female (81.1%) and African American (67.6%). BMI was normally distributed with a mean of 33.8( ± 7.36). All participant BMIs were greater than the 90thpercentile for age. There was no statistically significant change in BMI although both BMI percentile and BMI z-score showed significant decreases (p = .001, p

Conclusion: This study showed that a one week family based healthy weight camp was effective at maintaining BMI while decreasing BMI percentile and BMI z-score for obese

youth aged 8- 17 years. This study was unable to detect changes in the home environment. The positive association between changes in Sweet and Snack Availability/Accessibility scores and changes in BMI z score would initially suggest that making favorable changes in the Sweet and Snack home environment would lead to an increase in BMI percentile and z-score. Several factors were identified that may have contributed to this unexpected result including reporting bias, errors in measurement, and survey design. Future sessions of camp should consider the use of a survey more tailored to the curriculum of camp to better assess changes in the environment and behavior and also to reduce potential reporting bias. A longer follow-up period may also be beneficial in showing greater or sustained changes in BMI, BMI percentile, and BMI z-score.

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