Background
Although obesity and mental health disorders are two major public health problems
in adolescents that affect academic performance, few rigorously designed experimental
studies have been conducted in high schools.
Purpose
The goal of the study was to test the efficacy of the COPE (Creating Opportunities
for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, Nutrition)
Program, versus an attention control program (Healthy Teens) on: healthy lifestyle
behaviors, BMI, mental health, social skills, and academic performance of high school
adolescents immediately after and at 6 months post-intervention.
Design
A cluster RCT was conducted. Data were collected from January 2010 to May of 2012
and analyzed in 2012–2013.
Setting/participants
A total of 779 culturally diverse adolescents in the U.S. Southwest participated in
the trial.
Intervention
COPE was a cognitive–behavioral skills-building intervention with 20 minutes of physical
activity integrated into a health course, taught by teachers once a week for 15 weeks.
The attention control program was a 15-session, 15-week program that covered common
health topics.
Main outcome measures
Primary outcomes assessed immediately after and 6 months post-intervention were healthy
lifestyle behaviors and BMI. Secondary outcomes included mental health, alcohol and
drug use, social skills, and academic performance.
Results
Post-intervention, COPE teens had a greater number of steps per day (p=0.03) and a lower BMI (p=0.01) than did those in Healthy Teens, and higher average scores on all Social Skills
Rating System subscales (p-values <0.05). Teens in the COPE group with extremely elevated depression scores
at pre-intervention had significantly lower depression scores than the Healthy Teens
group (p=0.02). Alcohol use was 12.96% in the COPE group and 19.94% in the Healthy Teens group
(p=0.04). COPE teens had higher health course grades than did control teens. At 6 months
post-intervention, COPE teens had a lower mean BMI than teens in Healthy Teens (COPE=24.72,
Healthy Teens=25.05, adjusted M=−0.34, 95% CI=−0.56, −0.11). The proportion of those
overweight was significantly different from pre-intervention to 6-month follow-up
(chi-square=4.69, p=0.03), with COPE decreasing the proportion of overweight teens, versus an increase
in overweight in control adolescents. There also was a trend for COPE Teens to report
less alcohol use at 6 months (p=0.06).
Conclusions
COPE can improve short- and more long-term outcomes in high school teens.
Trial registration
This study is registered at www.clinicaltrials.gov NCT01704768.
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© 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
