Healthier Troops in a SNAP (Scouting Nutrition & Activity Program)

Highlights
Program Title Healthier Troops in a SNAP (Scouting Nutrition & Activity Program)
Purpose Designed to increase physical activity and promote healthy dietary habits to reduce obesity. (2010)
Program Focus Awareness building, Behavior Modification and Motivation
Population Focus School Children
Topic Physical Activity, Diet/Nutrition
Age Adolescents (11-18 years), Children (0-10 years)
Gender Female
Race/Ethnicity Alaskan Native, American Indian, Asian, Black, not of Hispanic or Latino origin, Hispanic or Latino, Pacific Islander, White, not of Hispanic or Latino origin
Setting Community, Home-based
Origination United States
Funded by Sunflower Foundation: Health Care for Kansans (Grant number(s) not available.)
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RE-AIM Scores
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Details about Reach
Reach
100.0%
Details about Effectiveness
Effectiveness
66.7%
Details about Adoption
Adoption
83.3%
Details about Implementation
Implementation
71.4%
The Need
In the United States, childhood obesity rates have risen steadily over the past 40 years. According to National Health and Nutrition Survey data for 2007-2008, 31.7% of children and adolescents aged 2-9 are now overweight or obese (at or above 85th percentile of BMI for age), and 16.9% are obese (at or above the 95th percentile). The increase in obesity prevalence poses a serious public health concern. Complications commonly associated with overweight and obesity include an increased risk of cardiovascular problems; dysfunction of the lungs or airways, including asthma; metabolic diseases, such as type 2 diabetes; gastroenterological conditions, such as nonalcoholic fatty liver; orthopedic problems; and an array of psychosocial issues. Systematic reviews have generally not supported the effectiveness of obesity prevention interventions, which are often delivered in school settings or community settings such as churches and youth clubs. The ability to bridge from institutional settings such as schools to the home environment has been elusive for obesity prevention. In addition, despite the large number of obesity prevention interventions that have been developed, there are no published reports of randomized controlled trials specifically targeting the promotion of healthful Girl Scout meeting environments or family meals.
The Program

Healthier Troops in a SNAP (Scouting Nutrition & Activity Program) is a health promotion and obesity prevention program administered through Junior Girl Scout troops (for girls in grades 4-5) registered with the Girl Scouts of the USA. The intervention has three main components: (1) an interactive educational curriculum delivered by troop leaders; (2) troop meeting policies implemented by troop leaders; and (3) badge assignments completed at home by Girl Scouts with parental assistance. The focus of all three components is on physical activity, healthful eating, family meals, limiting television viewing, and choosing water over sugar-sweetened beverages. The educational curriculum consists of seven modules, delivered over the course of about 4 months. Each module includes discussion points for talking with girls about intervention target behaviors; a worksheet for goal setting and self-monitoring; a description of a recreational physical activity to be completed during the troop meeting (e.g., walking, dancing, yoga, active games); a fruit or vegetable snack recipe; suggestions for family meal role-playing (e.g., planning meals, practicing asking skills and good manners, clean-up); and a take-home assignment. The modules require 30-90 minutes to deliver, with flexibility allowed for specified program activities and module order. Badge assignments are completed at home by Girl Scouts with parental assistance. 

Healthier Troops in a SNAP was created for and evaluated with Junior Girl Scout Troops. A modified version of the curriculum also has been developed for use with Brownies (i.e., for girls in grades 2-3).  The study reviewed for this summary evaluated the original eight-module version of the curriculum. In response to feedback from troop leaders participating in the study, the curriculum has been consolidated into a seven-module format to take up less of the Girl Scout troops' yearly meeting programming. 

Community Preventive Services Task Force Finding
Guide to Community Preventive Services This program uses the following intervention approach for which the Community Preventive Services Task Force finds insufficient evidence: family-based social support interventions (Physical Activity). Insufficient evidence means the available studies do not provide sufficient evidence to determine if the intervention is or is not effective. This does not mean that the intervention does not work. It means that additional research is needed to determine whether the intervention is effective.

To expand understanding of this intervention category consider communicating with members from NCI's Research to Reality (R2R) community of practice who may be able to help you with your research efforts. Following is a link to start an online discussion with the R2R community of practice, after completing registration on the R2R site: https://researchtoreality.cancer.gov/discussions.

Time Required
Healthier Troops in a SNAP is delivered in 30- to 90-minute sessions over a 4-month period during Girl Scout Junior troop meetings. Participating girls may earn badges by working on assignments at home at their own pace.
Intended Audience
The intended audience for this intervention is girls who are Girl Scout Juniors (grades 4-5).
Suitable Settings
This intervention is implemented during Girl Scout troop meetings, with some take-home activities for girls to work on with their parents. Troop meetings need to occur in facilities that allow physical activity and food preparation.
Required Resources
The curriculum can be downloaded free from the program website.  Troop leaders must procure any food items to be prepared during meetings as well as the badges awarded to participating Girl Scouts.

For costs associated with this program, please contact the developer, Richard Rosenkranz. (See products page on the RTIPs website for contact information).
About the Study

Seven Girl Scout troops were stratified by size into large (n=4) and small (n=3) troops and then randomized within strata to either the intervention condition (received the SNAP program), in which there were 3 troops, 34 girls in total or the standard-care control condition in which there were 4 troops, 42 girls in total.. Girls ranged in age from 9 to 13 years (mean: 10.5 years); 77.6% of the sample was Non-Hispanic Caucasian, and 22.4% were racial/ethnic minority.

The primary outcome was child body mass index (BMI). Secondary outcomes included accelerometer-assessed physical activity levels during troop meetings and self-reported health behaviors, including fruit and vegetable consumption, habitual physical activity, sugar-sweetened beverage consumption, frequency of eating while watching television, and frequency of family meals.

To assess physical activity levels in troop meetings, a trained research assistant observed each troop during seven troop meetings over a period of about 7 months. The research assistant placed an accelerometer on each girl's right hip, using an adjustable elastic belt. The assistant recorded the starting time and the identification number of the accelerometer worn by each girl. Scouts wore the accelerometer for the duration of their meeting attendance. Using a 30-second epoch, raw accelerometer counts were processed through a customized software program for determination of time spent in moderate-to-vigorous, vigorous, moderate, light, and sedentary physical activity levels.

Key Findings


Graph of Study Results

  • During troop meetings, girls in intervention troops spent a significantly smaller percentage of Girl Scout meeting time engaged in sedentary activity (p=.011) and a significantly greater percentage of time engaged in moderate (p=.004) and moderate-to-vigorous physical activity (p<.001) compared with girls in control troops. No significant group differences were found for light or vigorous physical activity. 

Additional Findings

  • No significant differences in BMI and self-reported health behaviors were observed between intervention and control groups.
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Updated: 05/09/2016
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