$3.6 Million Nursing Research Project Promotes Exercise for Girls

With the help of a $3.6 million federal grant, a Michigan State University nursing researcher is expanding a pilot program statewide to help middle school girls – particularly minority girls in urban, low socioeconomic settings – increase their physical activity.

The five-year Girls on the Move project, led by Lorraine Robbins and funded by the National Heart , Lung, and Blood Institute – focuses on individual and web-based counseling sessions with school nurses and an after-school physical activity club.

A very low percentage of middle school girls meet physical activity recommendations, Robbins said, and as they progress from sixth- to eighth-grade, moderate to vigorous physical activity usually declines, contributing to weight gain. The decline is particularly evident among urban, minority girls of low socioeconomic status.

School nurses are well positioned to drive school-based health programs such as those targeting physical activity. Robbins said, "Nurses can adequately counsel students on increasing physical activity by exploring their personal, and sometimes unique, perceptions and providing support for positive change.”

Robbins' pilot program focused on two middle schools in the Lansing School District. Now, the 17-week intervention will expand to schools in Jackson, Flint, Ypsilanti, Detroit, Muskegon, and Kalamazoo, in addition to Lansing.

"Our long-term goal is to increase moderate to vigorous physical activity as a means to address the high overweight and obesity prevalence among adolescent girls, thus reducing the risk for cardiovascular health problems,” she said.

The Girls on the Move intervention has three main components: (1) motivational, individually tailored counseling sessions with a school nurse; (2) an interactive web-based counseling session during which each girl receives motivational, individually tailored feedback messages; and (3) a group-level component made up of a 90-minute physical activity club offered after school four days a week.

During the counseling sessions, the feedback is individually tailored based on each girl's responses to computerized questionnaires on physical activity, Robbins said.

The aim is to evaluate the ability of the program to increase middle school girls' physical activity and improve cardiovascular fitness, body mass index and percent body fat.

Co-investigators on the grant include Karin Pfeiffer from MSU's Department of Kinesiology, Kim Maier from the College of Education's Measurement & Quantitative Methods program, and Ken Resnicow and Lawrence An from the University of Michigan.

Robbins said the success of the pilot program at the two Lansing schools led to the new federal funding. Compared to the control school, students at the intervention school showed trends toward greater improvement in all physical measures: minutes of moderate to vigorous physical activity per hour, cardiovascular fitness, body mass index, percent body fat and waist circumference.

In addition, she added, as rapport was established with the school nurse, the girls became more willing to share their thoughts and express concerns, including those related to their general health and well-being.

"This occurrence provided an unanticipated, but important, opportunity for the nurse to intervene,” Robbins said.

"Girls on the Move Intervention,” is supported by the National Heart, Lung, and Blood Institute. NIH Grant #: R01HL109101.