Purpose: Although type 1 diabetes had once been more prevalent in children than type 2 diabetes, over the last decade this has changed due to obesity, inactivity, and high fat-low fiber diets (Libson & Arslanian, 2003). Adolescents with high self-efficacy are more likely to make healthy choices such as regularly engaging in physical activity, than their peers (Motl et al., 2002). The Internet has become a viable means of disseminating information such as podcasts (web-based audio and video viewed on MP3 players) to adolescents (Nordmeyer & Castelli, 2008). Accordingly, the purpose of this study was to determine which type of school program resulted in the greatest impact of web-based materials on healthy eating and physical activity engagement as diabetes prevention in adolescents.
Methods: Once informed consent was secured, 165 (67 Males) students in the 6th & 7th grade were asked to review web materials in two forms: (a) non-interactive (text and images only) and (b) interactive (videos, games and podcasts) formats that were created for the Healthy Outcomes for Teens (HOT) project. Using stratified random assignment, the participants viewed the materials as part of an after school computer program, pull out from physical education classes, or as part of the health education curriculum. Regardless of the assignment, students logged onto the website with a unique identification number and password. All students completed a pretest containing several parts (knowledge test and self-efficacy, eating behaviors, and demographic surveys), five modules, and a post-test. Additionally, fidelity logs were kept at each program, while subgroups of 3-5 participants were involved in focus group interviews.
Analysis/Results: Pre/post test data were compared using ANOVAs, but were previously reported as part of the large-scale project (Chapman-Novakowski, Castelli, Sherer, Evans, & Goss, 2008). Fidelity logs were coded and reduced to frequency counts. Focus group interviews were transcribed verbatim and coded for patterns. According to these data, the most consistent attendance and greatest engagement resulted in the health education classes. Participants in this class reported accessing and using the HOT project materials more often on their own time than the other groups.
Conclusions: Findings suggest that healthy messages for teens are best delivered during school as part of an intact curriculum that has an accountability system (i.e., grades), over after school programming or as part of physical education held in the computer lab. Further, interactive web-based media containing healthy messages was positively received by the adolescents.