Projects: Adolescents


PACE+: Counseling Adolescents for Exercise and Nutrition

In September 2000 we began our randomized trial of PACE+ among 878 male and female adolescent patients age 11 through 15. Participants were randomly assigned within primary care practices to two successive one-year "doses" of PACE+ or to a comparison condition involving counseling for sun protection behaviors. PACE+ for adolescents assesses four behaviors: 1) total dietary fat consumption (DF); 2) fruits & vegetable consumption (FV); 3) moderate and vigorous physical activity (PA); and 4) sedentary habits (SH). The intervention includes computerized behavior assessment and goal setting, counseling by a health care provider, and extensive manual-based telephone counseling based on stage of change. Phone counseling, mailed and print materials guide adolescents to use cognitive and behavioral skills to make changes in behaviors.

We successfully recruited an ethnically diverse sample of 878 adolescents (40% non-white which approximates the demographics of San Diego). Following the intervention protocol for both study groups, 93% (818) of randomized participants began the intervention by completing a visit to their primary care provider. Study dropout rates have been 7% between the start of the intervention and the 6-month assessments and 2% between 6-month and the 12-month assessments.

Preliminary outcomes at 6-months demonstrate the effectiveness of PACE+. Significant stage progress from pre-action to action or maintenance stages was found for PA (p < .05), FV (p < .001), DF (p <.05). PA measured with accelerometers indicated positive treatment effects for minutes of vigorous activity (p <.05) but not moderate activity. Treatment effects were also found for self-reported measures of SH (p <.01), FV (p < .01), and DF (p <.05).