- Childhood obesity prevalence is significantly higher among adolescent 12-19 years old than younger age groups. Youth athletes are overlooked by childhood obesity prevention programs. WAVE~Ripples for Change (WAVE) program is a 2-y obesity prevention intervention with high school (HS) soccer players (14-19y) using a mixed virtual- and physical-world learning environment to promote healthy eating, physical activity (PA), and life-skills. The purpose of this dissertation was to evaluate this innovated program by 1) comparing changes in diet and daily PA from WAVE intervention among HS soccer players, while controlling for biological sex, race/ethnicity, and socioeconomic status; 2) collecting data on program fidelity, best practices for intervention implementation, youth and coach engagement in intervention activities, and youth application of knowledge and skills to their lives. To accomplish the objectives, a mixed methods study was conducted.
For the quantitative impact evaluation of WAVE study, pre-post intervention assessment of fruit and vegetable (FV), saturated fat, and added sugar intake, and daily steps were examined. Mean differences were tested using analysis of covariance. Results indicated that The 2-y intervention decreased mean added sugar intake (-12g/d), but intakes of FV and saturated fat were similar to the comparison group. For both groups, PA was significantly higher in-soccer [baseline] than out-of-soccer season [post-intervention]. At baseline, Latino youth had significantly higher added sugar intake (+14g/d) than non-Latinos.
The qualitative evaluation phase of WAVE study involved interviews with program implementation staff, surveys with youth participants and their soccer coaches to program fidelity, best practices for intervention implementation, youth and coach engagement in intervention activities, and youth application of knowledge and skills to their lives. Staff rated program fidelity high (94%), as did volunteers (85%). Best practices included, coach encouragement for athlete participation, use of on-line consent for enrollment, building relationships with HS staff to complete assessments, sending text reminders to youth, and providing incentives. Study results showed: enrollment rate (72%), baseline assessments (89-98%), attendance for sport nutrition lessons (Year 1=90%; Year 2=39%) and team building workshops (TBW) (25-31%). Activities exceeding youth expectations (>90%) included, 1) activities with their soccer team; 2) TBW-cooking; 3) sport nutrition lessons. Knowledge/skills youth applied the most were from TBW-cooking (43%) and gardening (49%). Coaches rated the sport nutrition lessons high and reported athletes showed increased awareness for hydration and fueling during sport.
We found an obesity prevention program that targeted HS soccer players was well received, and offers a promising model for promoting healthy eating, PA, and life-skills. Overall, the FV intakes were maintained over the intervention but were below recommendations, yet higher than those typically reported in the literature for youth and youth athletes. The 2-y intervention decreased added sugar intake, but PA did not meet recommendations when players were out-of- soccer season. Future studies should focus on maintaining PA in youth athletes when they are not engaged in sport, thus, helping them make the transition to being physically active adults lifelong.