Document text
Principal Investigator: Robert G Weaver
Organization: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
Fiscal Year: 2024
Award: $605,896
Funding agency: National Institute of Diabetes and Digestive and Kidney Diseases
Summer is a period of accelerated BMI gain for children (5-12yrs). Studies show that virtually all increases in BMI occur
during the summer, no matter children’s’ weight status (i.e., normal weight, overweight, or obese) at summer entry. Our
research team recently developed the Structured Days Hypothesis (SDH), which may explain accelerated summer BMI
gain. The SDH posits that structure, defined as pre-planned, segmented, and adult-supervised compulsory
environments, protect children against obesogenic behaviors and prevent excessive BMI gain. The SDH draws upon
the ‘filled-time perspective’, which posits that time filled with favorable activities cannot be filled with unfavorable
activities. In the context of the SDH, this means that children engage in more obesogenic behaviors that lead to
increased weight gain during times that are less-structured (e.g., summer days) compared to times that are more
structured (e.g., school days). Based on the SDH, pre-existing community-operated summer day camps (e.g., B&G
Club, YMCA), may exert a positive influence on summer BMI gain by limiting children’s engagement in obesogenic
behaviors. Recent preliminary studies show that children engage in healthier behaviors on days that they attend summer
day camps, and that BMI gain does not accelerate for these children. A major weakness in the rigor of these preliminary
studies is that they cannot identify the dose-response relationship between structured summer programming and
summer BMI gain. Dose-response studies can definitively identify the smallest dose at which a useful effect is observed
while simultaneously revealing the maximum dose beyond which there is no further beneficial effect. In the same way
determining the effective dose of structure to mitigate negative health outcomes is necessary to inform feasible, scalable
interventions and health policy. The proposed randomized dose-response study will identify the dose-response
relationship between amount of summer programming and summer BMI gain. The impact of 4 weeks (n=90, 20 days),
6 weeks (n=90, 30 days), and 8 weeks (n=90, 40 days) of summer programming compared to no program (n=90) will
be evaluated. We will also conduct comprehensive implementation monitoring to evaluate implementation, and to
identify factors associated with children’s summer BMI gain and obesogenic behaviors. The aims of the study are to:
Aim 1. Evaluate structured summer programming’s impact on children’s BMI gain and obesogenic behaviors.
Aim 2. Evaluate implementation and contextual factors and their relationship with children’s summer BMI gain and
obesogenic behaviors. Aim 3. Determine the cost effectiveness of 4, 6, 8 weeks of summer programming for mitigating
accelerated summer BMI gain. This work is significant as it addresses a critical public health goal – reducing obesity –
through programing during a timeframe – summer vacation – when substantial, long-lasting negative effects occur. This
application is innovative because of the focus on identifying the dose-response relationship between structured summer
programming and summer BMI gain. This innovation addresses a weakness in the rigor of previous studies and is
critical for identifying the ideal dose of summer programming for mitigating accelerated summer BMI gain.
Terms: <0-11 years old><21+ years old><8 year old><8 years of age><Acceleration><Address><Adult><Adult Human><Application Context><Assess implementation><BMI><BMI percentile><BMI z-score><Behavior><Body mass index><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Child><Child Youth><Children (0-21)><Communities><Development><Diet><Dose><Environment><Health><Health Policy><Implementation assessment><Individual Adjustment><Intervention><Intervention Strategies><Monitor><Nutrient><Obesity><Obesity Epidemic><Outcome><Over weight><Overweight><Participant><Pharmaceutical Agent><Pharmaceuticals><Pharmacologic Substance><Pharmacological Substance><Phase 3 Clinical Trials><Phase III Clinical Trials><Physical activity><Public Health><Quasi-experiment><Quasi-experimental analysis><Quasi-experimental approach><Quasi-experimental design><Quasi-experimental methods><Quasi-experimental research><Quasi-experimental study><Quasi-experimental technique><Quetelet index><Randomized><Research><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Schedule><Schools><Selection Bias><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Sleep><Structure><Testing><Time><Weight><Weight Gain><Weight Increase><Work><adiposity><adulthood><age 8 years><body weight gain><body weight increase><child adiposity><child obesity><childhood adiposity><childhood obesity><contextual factors><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><corpulence><cost effectiveness><developmental><diet supplement><dietary supplements><diets><dosage><eight year old><eight years of age><evaluate implementation><evaluation of implementation><group intervention><health care policy><health goals><healthcare policy><implementation determinants><implementation evaluation><implementation factors><implementation outcomes><innovate><innovation><innovative><interventional strategy><kids><novel><nutritional supplement><obese children><obesigenic><obesity during childhood><obesity in children><obesogenic><pediatric obesity><pharmaceutical><phase III protocol><prevent><preventing><programs><randomisation><randomization><randomly assigned><response><school disruption><screen time><sedentary><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><television watching><tv watching><virtual><weights><wt gain><youngster>