Program

Sep 27, 2011

OVERVIEW

The Stanford GEMS (Girl’s health Enrichment Multi-site Studies) pilot study is
designed to test the potential positive outcomes of two programs: an
after-school dance classes and a family-based intervention, Sisters Taking
Action to Reduce Television (START) to reduce television viewing. Both
initiatives are intended to reduce weight gain among African-American girls.
The purpose of this study is to develop a culturally relevant activity, dance,
that will connect with the target population and reduce television viewing time
because of its association with obesity. The intervention was found to have a
significant impact on concerns about weight and television consumption among
African-American girls as compared with the control group. However, no impacts
were found for body mass index or waist circumference after 12 weeks.

DESCRIPTION OF PROGRAM

Target population:
Eight- to ten-year-old African-American girls from low-income households

Stanford GEMS is a multi-component program based on social cognitive
theoryinvolving after-school dance classes and a family-based intervention.
Each daily dance session lasts for up to two and a half hours and provides the
girls with more than just a workout. The session begins with a healthy snack,
followed by an hour-long homework period and a 45-60 minute moderate-to-vigorous
dance session. The session concludes with a 30-minute GEMS talk exploring the
meaning of dance in the girls’ lives and the importance of dance in the
African-American community and culture. The entire session is run by female
African-American college students and recent college graduates. Additionally, to
address the issue of television use, a female African-American intervention
specialist schedules lesson times with the girl and her family to discuss
healthy lifestyle choices and set behavioral goals. Behavioral goals include
self-monitoring, a 2-week TV-turnoff, budgeting viewing hours, and “intelligent
viewing”.

EVALUATION OF PROGRAM

Robinson, T. N., Killen, J. D., Kraemer, H. C., Wilson, D. M., Matheson, D. M.,
Haskell, W. L., … Varady, A. (2003). Dance and reducing television viewing to
prevent weight gain in African-American girls: The Stanford GEMS pilot study. Ethnicity & Disease, 13,65-77.

Evaluated population: The sample included 61 eight- to ten-year-old African-American girls from
low-income households in Oakland and East Palo Alto, California. All girls,
regardless of which treatment they were randomly assigned to, met all
eligibility criteria: a body mass index (BMI) greater or equal to the 50th
percentile for their age, and/or at least one overweight parent/guardian (BMI
greater or equal to 25 kg/m2). If girls were diagnosed with a
medical condition affecting their growth, were taking medications affecting
growth, had a condition limiting their participation in any part of the project,
if they were homeless, or if they were planning to move from the San Francisco
Bay area within the next three months, they were not eligible to participate in
the study.

Of the participants, 72 percent reported total household incomes less than
$40,000 per year; less than 20 percent of the families owned their homes; 56
percent lived in female-headed households; and only 21 percent lived in
households where an adult had graduated from college.

Approach:
Girls were randomly assigned to the treatment group or to the active control
group. Only 1.6
percent of the treatment group was lost-to-follow up. Data were collected on
BMI, waist circumference, sexual maturation (measured by self-assessment),
insulin levels, glucose levels, cholesterol levels, dietary intake, physical
activity, grades, media use, body image, and self-esteem.

The active control intervention was delivered by volunteers from the
African-American task forces of the local chapters of American Heart Association
and the American Diabetes Association. The subjects in this group received
parent newsletters and 11 newsletters sent to the subject’s house addressing
healthy lifestyles.

Results: There was a statistically significant decrease in total household TV use (effect
size = .73), nights per week that girls ate dinner with the TV on (effect size =
.59), and concerns with weight for girls in the treatment group compared with
those in the control group (effect size = .60). There was a marginally
significant increase in grades for girls in the treatment group compared with
those in the control group (effect size = .51). The pilot study was not
designed to assess BMI, and accordingly, there was not a significant impact on
BMI. At the 12-week follow-up, no significant impacts were found for waist
circumference, physical activity, or caloric intake. A non-significant trend was
noted for BMI and waist circumference, with controls increasing faster than
girls in the treatment group.

SOURCES FOR MORE INFORMATION

References

Robinson, T. N., Killen, J. D., Kraemer, H. C., Wilson, D. M., Matheson, D. M.,
Haskell, W. L., … Varady, A. (2003). Dance and reducing television viewing to
prevent weight gain in African-American girls: The Stanford GEMS pilot study. Ethnicity & Disease, 13,65-77.

Contact Information

Thomas N. Robinson, MD, MPH
Stanford University School of Medicine
Hoover Pavilion, N229
211 Quarry Road
Stanford California 94305
tom.robinson@stanford.edu
650-723-5331

KEYWORDS:
Children, Females Only, Black/African-American, Urban, Community-based,
After-School Program, Obesity, Parent or Family Component, Academic
Achievement/Grades, Nutrition, Self-esteem/Self-concept.

Program information last updated on 09/27/11

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