Center for Child Health, Behavior and Development
School and community-based
approaches for physical activity
and nutrition interventions
Jason A. Mendoza, MD, MPH
Associate Professor of Pediatrics
University of Washington
Jan 2015; Nutritional
Sciences Program
Research Overview
Center for Child Health,
Behavior and Development
Cluster RCT of the WSB program
Long-term, efficacy trial, 2012-2017
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n=22 schools and n=400+ students
4 schools in Year 1
6 schools each in Years 2-4
3rd-5th graders
low income schools, matched by school SES and ethnicity
Intervention: WSB program led by staff
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offered 5 days/week, students decide when to walk
start Sept/Oct and end in April/May of each study year
Center for Child Health,
Behavior and Development
Walking school bus
A group of children led to school by parents/adults who
walk together along a set route (active commuting)
Addresses safety concerns: supervised period of physical
activity and pedestrian safety teaching
Pedestrian safety is modeled and taught
Center for Child Health,
Behavior and Development
Cluster RCT of the WSB program
Primary outcome: weekly rate of ACS
Secondary outcomes
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MVPA (accelerometers)
BMI z-score
Pedestrian safety behaviors
Moderators and mediators
• Walkability/built environment (Chanam Lee, Texas A&M and Anne
Vernez Moudon, University of Washington)
• Parent/child self-efficacy and parent outcome expectations
Partners: Seattle & Federal Way Public Schools, Feet First
Center for Child Health,
Behavior and Development
Pilot Bicycle Train RCT
Specific Aims:
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Validate algorithms examining concurrent accelerometry and GPS
data to measure children’s physical activity intensity and duration
while cycling vs. heart rate monitoring and direct observation
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Evaluate among 4th and 5th grade ethnic minority children (n=60) the
feasibility of a pilot cluster RCT of a Bicycle Train program
• Recruitment
• Participation
• Barriers/Facilitators
Partners: SPS, Cascade Bicycle Club, Bike Works
Center for Child Health,
Behavior and Development
Other research projects
Reducing TV viewing to prevent obesity in Hispanic
preschool children
• Current Nutrition MS student, Catherine Karlak, is leading analyses
on TV parenting practices
• Thesis: Examining correlates of TV parenting practices among
Latino preschoolers in Head Start.
Center for Child Health,
Behavior and Development
Other research projects
The role of food insecurity (FI) on CD4+ counts among
pediatric HIV+ patients
• Adolescents and young adults in Houston, TX
• Mendoza JA, Paul ME, Schwarzwald H, et al. Food Insecurity, CD4 Counts, and
Incomplete Viral Suppression Among HIV+ Patients from Texas Children’s Hospital: A
Pilot Study. AIDS and Behavior. 2013;17(5):1683-1687
• 2-6 year old children in Gaborone, Botswana
• Mendoza JA, Matshaba M, Makhanda J, Liu Y, Boitshwarelo M, Anabwani GM. Food
Insecurity and CD4% Among HIV+ Children in Gaborone, Botswana. Journal of
acquired immune deficiency syndromes. 2014;66(4):414-418
• Future studies:
• Cohort study – longitudinal relationship between FI and CD4+
counts
• Intervention stud(ies) to decrease food insecurity and evaluate
impact on CD4+ counts
Center for Child Health,
Behavior and Development
Other research projects
Title: Food insecurity and clinical outcomes among children
with type 1 diabetes mellitus
• Specific Aim: Examine the association of food insecurity with HbA1c
and healthcare utilization
• Ancillary study to the SEARCH for Diabetes in Youth study
• Data collection ongoing through Spring 2014
Center for Child Health,
Behavior and Development
Other research projects
Title: A wearable mHealth device to promote physical
activity among adolescents
• Pilot study’s aim is to assess feasibility
• Intervention: Fitbit Flex & customized Facebook group page
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Goal: 12k steps/day or gradual increase towards target
Rewards/badges
• Planning to adapt for other populations, e.g. pediatric cancer
survivors, teens with ADHD to decrease symptoms
Center for Child Health,
Behavior and Development
Questions?
jason.mendoza@seattlechildrens.org
Center for Child Health,
Behavior and Development