A School-Based Program for Overweight and Obese Adolescents: A Randomized Controlled Trial.
Lori Pbert, Susan Druker, Bruce Barton and 5 others
PMID 27619760WHAT IT FOUND
The primary outcome, BMI, did not improve.
The school nurse counseling plus after-school exercise program failed to reduce BMI, body fat, or waist circumference compared to control visits. It only slightly increased self-reported breakfast and physical activity days.
Key findings
01Students in the intervention showed no significant differences in BMI, percent body fat, or waist circumference compared to controls at follow-up.
02The program improved self-reported breakfast consumption by 0.81 days/week and physical activity days by 0.89 days/week, but did not change other obesogenic behaviors like screen time or diet quality.
03Half of the students attended zero after-school exercise classes, limiting the intervention's intensity, while barriers included homework, sibling care, and dislike of group exercise.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The control condition was active (12 nurse visits), not usual care, which may have diluted the observed effect of the intervention. Poor participation in the after-school exercise component (50% attended zero classes) meant the intervention was less intensive than designed. Behavioral outcomes relied on self-report, which may be inaccurate. The study included only 8 schools in one geographic area, limiting generalizability. The sample size was determined by budget feasibility rather than power calculations for the specific complex intervention.
The easy way to misread this
Do not interpret the lack of BMI change as proof that school nurse counseling is useless. The control group also received substantial nurse contact (12 visits), so this study compares two nurse-led approaches, not nurse-led care against no care.