The Effects of Goal Setting on Health Outcomes: An Evaluation of 2015 Camp Strong4Life Público

Abstract

Background: 35% of children in Georgia are overweight or obese. This growing epidemic is concerning because of the health, social, and economic consequences. Evidence supports a range of obesity prevention and control interventions including school programs, policy change, and immersive programs. Camp Strong4Life, a healthy lifestyles summer camp, uses educational programming and skills building to improve the habits of campers and their families. Goal setting is used in many behavior change programs, however, its effectiveness in improving health outcomes in children has limited support. This study aims to assess the effect of goal setting on health related outcomes.

Methods: This analysis includes anthropometric, quality of life (QOL), sugar-sweetened beverage (SSB) consumption, physical activity, and goals data for youth 9 to 17 years old with a BMI greater than the 85^th percentile. Complete data was available for 52 youth who attended the 1-week camp in June/July 2015 and completed both baseline and follow-up over a 4-month period. T-tests were used to determine changes in health outcomes among goal achievers and non-achievers. A multivariate linear regression model was created to assess correlates of change in BMI z-score.

Results: The mean age of campers was 12.3 years; most were female (69.2%) and African American (69.2%). Physical activity goal achievers (n=31) saw significant reductions in BMI z-score, fat percent, and SSB consumption, and improvements in QOL and light physical activity (p<0.05). Compared to non-achievers (n=21), youth achieving physical activity goals showed significant reductions in BMI z-score and sedentary minutes per day (p<0.05). Nutrition goal achievers (n=35) saw significant improvements in QOL, SSB consumption, and light activity (p<0.05). There were no significant differences in outcomes between nutrition goal achievers and non-achievers. The multivariate model found age, registrant type, QOL, and physical activity goal progress as significant correlates of change in BMI z-score.

Discussion: This study indicates that Strong4Life campers showed significant improvements in anthropometric, QOL, nutrition, and physical activity behaviors, particularly among youth reporting to have achieved their physical activity goals, providing support for the use of goal setting in behavioral interventions. Caution must be used in generalizing these findings because of small sample size.

Table of Contents

Chapter 1: Introduction.........................................................................................1

1.1 Childhood Obesity Epidemic.............................................................................1

1.2 Strong4Life......................................................................................................2

1.3 Overview of the Study.......................................................................................2

1.4 Overview of the Literature.................................................................................3

1.4.1 Evidence-Based Interventions.........................................................................3

1.4.2 Goal Setting Theory........................................................................................5

1.4.3 Correlates of Weight Loss................................................................................7

1.5 Study Purpose, Research Questions, and Public Health Significance......................7

Chapter 2: Literature Review....................................................................................9

2.1 Interventions for childhood obesity.....................................................................9

2.2 Evaluation of goal setting..................................................................................15

2.3 Correlates of weight loss in children...................................................................18

2.4 Strong4Life.......................................................................................................20

2.5 Gaps in the Literature........................................................................................23

Chapter 3: Methods.................................................................................................24

3.1 Population........................................................................................................24

3.2 Sample.............................................................................................................24

3.3 Data Collection.................................................................................................24

3.4 Data Collection Instruments..............................................................................26

3.5 Data Analysis....................................................................................................28

Chapter 4: Results...................................................................................................36

4.1 Demographic Variables.......................................................................................36

4.2 Goal Variable......................................................................................................37

4.3 Outcome Variables.............................................................................................45

4.4 Multivariate Analysis..........................................................................................47

4.5 Sensitivity Analysis.............................................................................................48

Chapter 5: Discussion...............................................................................................51

References.............................................................................................................. 64

Appendix 1: Survey Instruments...............................................................................71

InBody 230 Biometric Assessment.............................................................................71

PedsQL: Quality of Life.............................................................................................72

Beverage Questionnaire............................................................................................73

Nutrition Quest Physical Activity Block Screener........................................................75

Appendix 2: Data Analysis Conversion Tables.............................................................76

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Nutrition Health Sciences, Public Health
Palavra-chave	Strong4Life Physical Activity Goal Setting Adolescent Health Nutrition Child Health Summer Camp Children's Healthcare of Atlanta Quality of Life
Committee Chair / Thesis Advisor	Lobelo, Roberto L, Emory University
Committee Members	Keong, Farrah, Children's Healthcare of Atlanta Welsh, Jean A., Emory University
Partnering Agencies	Hospital or other health care provider

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