1 Johns Hopkins University, United States; 2 University of Wisconsin, United States; 3 Federal University of Sao Paulo, Brazil.
Peer-led interventions may be an effective means of addressing the childhood obesity epidemic. In July 2014, we initiated wave 1 of a multi-level multi-component obesity prevention intervention in Baltimore, MD, USA - B’More Healthy Communities for Kids (BHCK). As a key aspect of the intervention delivery in afterschool programs (7), we trained 16 Baltimore college students to be youth leaders and deliver an experiential nutrition education and cooking skills program to African-American children (10-14 years old). While many community programs have focused only on program efficacy, very few have looked at the long-term viability of the program success. We conducted a formative evaluation to inform future scaling-up and sustainability of the youth leader program in all recreation centers in Baltimore. We used a mixed-methods approach to gather relevant information and enable the community to participate in the refinement of the program. We conducted in-depth interviews with recreation center directors (n=7), BHCK youth-leaders (n=12), and focus groups with youth leaders and teens from the community (in progress). Process evaluation measurements assessed reach, dose, and fidelity of the curriculum lessons, and also the environment at the recreation center, including food source, food and beverage availability, and opportunities for physical activity. Recreation center directors perceived many benefits of the program to children and their families pertaining to nutrition knowledge and behavior. They identified the initial low engagement of the children as a key initial challenge, but noted a greater commitment throughout the implementation of the program. Youth leaders perceived improvements in their eating behaviors and in their leadership skills. Our findings indicate that the youth-leader program was successfully implemented and conducted in 7 recreation centers. Based on it, we are expanding the youth leader program from wave 1 and developing a sustainable version for implementation within Baltimore City recreation centers.