The MATCH Program: Long-Term Obesity Prevention Through a Middle School Based Intervention.

BACKGROUND

Motivating Adolescents with Technology to CHOOSE Health™ (MATCH) has been provided for eight years in North Carolina middle schools with high obesity prevalence.

METHODS

Seventh grade teachers in two schools delivered MATCH lessons in 2009, with one control school. In 2013 students were remeasured and completed a health behavior survey. Outcomes include BMI, BMI z-score (zBMI), weight category, and self-reported behaviors. Comparisons used t tests (continuous measures), Fisher's exact test (categorical measures), and linear mixed models (trend between groups).

RESULTS

Of original participants, 104/189 (55%) of MATCH and 117/173 (68%) of control were remeasured. In the control group, retained participants had lower baseline BMI and were higher percent white. Among all participants, zBMI decreased in MATCH (mean change -0.15 with SD = 0.60) and increased in control (mean change 0.04 with SD = 0.52); between groups p = 0.02. In mixed models for the all overweight subgroup, MATCH had a downward trend in zBMI over time that was significantly different from control (slope MATCH -0.0036 versus control 0.0009; p = 0.01). For shifts in weight category: incidence of obesity was lower in MATCH (13%) versus control (39%); remission of overweight to healthy weight was greater in MATCH (40%) versus control (26%). MATCH participants self-reported lower frequency of intake of sweetened beverages and snacks and hours of weekday TV time than control students.

CONCLUSIONS

MATCH participation can result in long-term prevention of obesity compared to control, with differences in self-reported health behavior changes to support an underlying mechanism for the observed BMI differences.