Table 3.
Baseline values, changes, and group differences in physiological, physical activity, diet, screen use and psychosocial secondary outcome measures.
| Changes over 1 year | Changes over 2 years | Changes over 3 years | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Baseline, Mean (SD)a | Slope, Mean (SD)b | Adjusted MMM-HE difference over 1 year (95% CI)c | Standardized Effect Size (Cohen‘s d) | Slope, Mean (SD) b | Adjusted MMM-HE difference over 2 years (95% CI) c | Standardized Effect Size (Cohen‘s d) | Slope, Mean (SD) b | Adjusted MMM-HE difference over 3 years (95% CI) c | Standardized Effect Size (Cohen‘s d) | |||||
| MMM | HE | MMM | HE | MMM | HE | MMM | HE | |||||||
| Systolic Blood Pressure (mmHg) | 96.82 (9.36) | 96.18 (9.76) | 3.00 (7.92) | 3.95 (9.51) | −0.41 (−2.27, 1.45) | d=0.06 | 2.60 (5.23) | 3.35 (5.01) | −0.89 (−3.10, 1.31) | d=0.10 | 2.17 (4.04) | 1.92 (3.81) | 1.34 (−1.33, 4.01) | d=0.13 |
| Diastolic Blood Pressure (mmHg) | 51.88 (5.74) | 52.48 (6.97) | 0.50 (5.67) | 1.68 (7.36) | −1.37 (−2.68, −0.06) | d=0.27 | 0.94 (3.76) | 1.55 (3.85) | −1.45 (−3.03, 0.13) | d=0.24 | 0.65 (2.41) | 0.67 (2.81) | −0.21 (−1.89, 1.47) | d=0.03 |
| Total Cholesterol (mg/dL) | 155.26 (27.72) | 152.58 (29.52) | −7.70 (20.86) | 0.55 (21.72 ) | −6.77 (−11.99, −1.55) | d=0.34 | −2.19 (11.14) | −1.12 (12.76) | −1.22 (−6.87, 4.44) | d=0.05 | −1.66 (7.98) | −0.92 (7.14) | −0.93 (−6.42, 4.56) | d=0.05 |
| HDL-Cholesterol (mg/dL) | 44.57 (10.06) | 44.66 (9.78) | −0.41 (6.45) | 0.24 (5.74) | −0.34 (−1.89, 1.21) | d=0.06 | 0.19 (3.43) | −0.59 (3.92) | 1.73 (−0.12, 3.58) | d=0.24 | 0.26 (2.70) | −0.22 (2.46) | 1.82 (−0.15, 3.79) | d=0.24 |
| LDL-Cholesterol (mg/dL) | 89.71 (23.94) | 89.19 (26.31) | −6.30 (15.95) | −0.67 (16.42 ) | −5.05 (−9.09, −1.02) | d=0.33 | −2.42 (9.17) | −1.42 (9.11) | −1.96 (−6.29, 2.37) | d=0.12 | −2.27 (6.66) | −1.44 (5.76) | −2.12 (−6.41, 2.18) | d=0.13 |
| Triglycerides (mg/dL) | 106.44 (66.37) | 93.63 (45.76) | −5.65 (46.87) | 5.05 (43.14 ) | −5.88 (−16.00, 4.23) | d=0.16 | −0.56 (27.53) | 5.22 (27.15) | −7.25 (−20.20, 5.71) | d=0.15 | 1.27 (20.74) | 3.85 (16.26) | −2.71 (−15.99, 10.57) | d=0.05 |
| Glucose (mg/dL)d | 92.48 (5.80) | 92.21 (5.88) | −0.62 (6.29) | −0.37 (6.03) | −0.20 (−1.66, 1.26) | d=0.03 | −0.55 (3.40) | −0.26 (3.20) | −0.33 (−1.92, 1.26) | d=0.05 | −0.59 (2.73) | −0.70 (2.67) | 0.56 (−1.48, 2.59) | d=0.07 |
| Insulin (uIU/ml) | 15.84 (10.35) | 16.17 (12.40) | 1.45 (9.63) | 0.92 (10.25 ) | 0.55 (−1.85, 2.95) | d=0.06 | 1.82 (5.75) | 1.84 (5.73) | −0.36 (−3.13, 2.41) | d=0.03 | 2.04 (5.32) | 2.26 (4.57) | −0.85 (−4.62, 2.93) | d=0.06 |
| HOMA_IRd | 3.67 (2.51) | 3.72 (2.90) | 0.29 (2.27) | 0.19 (2.58) | 0.08 (−0.47, 0.64) | d=0.04 | 0.38 (1.42) | 0.41 (1.48) | −0.17 (−0.87, 0.54) | d=0.06 | 0.42 (1.23) | 0.49 (1.15) | −0.19 (−1.09, 0.71) | d=0.05 |
| Hemoglobin A1c (percent)d | 5.09 (0.28) | 5.07 (0.26) | −0.05 (0.15) | −0.04 (0.15) | −0.01 (−0.05, 0.03) | d=0.07 | −0.02 (0.09) | −0.01 (0.09) | −0.02 (−0.07, 0.02) | d=0.14 | 0.01 (0.08) | 0.01 (0.06) | −0.02 (−0.07, 0.04) | d=0.08 |
| Alanine Aminotransferase (IU/L) | 28.92 (19.47) | 33.50 (25.39) | 1.18 (30.21) | −2.09 (23.17 ) | 1.56 (−5.01, 8.13) | d=0.06 | −1.07 (8.77) | −0.51 (13.45) | −3.68 (−8.82, 1.46) | d=0.18 | −0.43 (9.72) | −1.14 (9.56) | 0.06 (−6.86, 6.98) | d=0.00 |
| High sensitivity C-Reactive Protein (mg/dL) | 0.23 (0.31) | 0.25 (0.31) | 0.04 (0.35) | 0.03 (0.48) | −0.01 (−0.11, 0.10) | d=0.01 | 0.00 (0.25) | 0.02 (0.23) | −0.05 (−0.16, 0.06) | d=0.11 | −0.01 (0.14) | −0.01 (0.12) | −0.05 (−0.13, 0.04) | d=0.15 |
| Resting Heart Rate (beats per minute) | 84.20 (11.05) | 84.36 (10.57) | 0.90 (11.66) | 1.63 (10.40 ) | −0.84 (−3.26, 1.59) | d=0.09 | −0.29 (6.45) | 0.18 (5.62) | −0.94 (−3.62, 1.74) | d=0.09 | −0.60 (4.07) | −0.38 (4.01) | −0.53 (−3.39, 2.32) | d=0.05 |
| Accelerometer average percent of day spent in moderate-to-vigorous physical activity e | 9.65 (2.89) | 9.71 (3.12) | −0.83 (2.60) | −1.09 (2.17) | 0.29 (−0.28, 0.86) | d=0.13 | −0.94 (1.27) | −0.92 (1.42) | −0.03 (−0.65, 0.59) | d=0.01 | −0.88 (1.01) | −0.77 (1.04) | −0.35 (−1.06, 0.37) | d=0.13 |
| Accelerometer Average percent of day spent sedentary e | 71.35 (5.63) | 71.12 (5.46) | 2.42 (5.38) | 3.00 (4.51) | −0.67 (−1.85, 0.50) | d=0.15 | 2.37 (3.12) | 2.53 (2.93) | −0.19 (−1.64, 1.27) | d=0.03 | 2.39 (2.42) | 2.39 (2.33) | 0.48 (−1.33, 2.28) | d=0.07 |
| Accelerometer average after school minutes of moderate-to-vigorous physical activity (3–6pm weekdays) | 26.08 (13.07) | 25.04 (10.93) | 3.14 (17.60) | −2.74 (10.85 ) | 6.88 (3.69, 10.07) | d=0.57 | −0.73 (8.85) | −1.78 (6.81) | 2.83 (−0.50, 6.16) | d=0.22 | −1.77 (5.88) | −1.48 (4.93) | −0.23 (−3.83, 3.37) | d=0.02 |
| Accelerometer average after school minutes sedentary (3–6pm weekdays) | 108.27 (26.34) | 106.00 (19.61) | −2.89 (30.81) | 9.58 (29.18 ) | −11.95 (−18.78, −5.12) | d=0.47 | 3.64 (17.99) | 8.27 (25.50) | −7.94 (−18.19, 2.31) | d=0.20 | 5.95 (12.98) | 6.82 (10.19) | −0.28 (−7.20, 6.65) | d=0.01 |
| Weekly hours of total screen time | 20.73 (14.61) | 19.82 (18.33) | 0.20 (15.31) | 0.29 (17.14 ) | 0.21 (−3.33, 3.74) | d=0.02 | 0.33 (10.76) | 1.28 (10.11) | −1.16 (−5.79, 3.47) | d=0.06 | 0.36 (8.14) | 1.77 (8.56) | −3.40 (−9.12, 2.32) | d=0.15 |
| Weekly hours of television viewing | 9.48 (8.24) | 8.97 (8.68) | −0.72 (10.23) | 0.25 (8.95) | −0.91 (−3.17, 1.34) | d=0.11 | −1.13 (5.45) | −0.27 (5.20) | −1.33 (−3.36, 0.70) | d=0.17 | −1.30 (3.88) | −0.76 (4.17) | −1.18 (−3.54, 1.18) | d=0.13 |
| Typical household TV use (0 low – 4 high) | 2.15 (0.96) | 2.07 (1.06) | −0.45 (1.07) | −0.45 (0.89) | 0.03 (−0.19, 0.26) | d=0.04 | −0.20 (0.56) | −0.20 (0.53) | 0.05 (−0.19, 0.28) | d=0.05 | −0.10 (0.43) | −0.14 (0.37) | 0.14 (−0.12, 0.40) | d=0.14 |
| Days per week ate breakfast with TV | 1.97 (2.32) | 2.04 (2.35) | −0.78 (2.62) | −0.11 (2.47) | −0.76 (−1.29, −0.24) | d=0.39 | −0.44 (1.44) | −0.39 (1.28) | −0.23 (−0.72, 0.26) | d=0.12 | −0.32 (1.02) | −0.35 (0.85) | −0.10 (−0.62, 0.43) | d=0.05 |
| Days per week ate dinner with TV | 2.54 (2.61) | 2.37 (2.38) | −0.92 (2.85) | −0.33 (2.65) | −0.47 (−1.03, 0.08) | d=0.23 | −0.53 (1.47) | −0.30 (1.51) | −0.31 (−0.83, 0.21) | d=0.15 | −0.41 (0.98) | −0.18 (0.97) | −0.61 (−1.15, −0.08) | d=0.29 |
| Total daily energy intake (Kcal) | 1214.97 (421.96) | 1173.12 (388.53) | −126.69 (416.25) | −12.55 (378.5 2) | −91.27 (−180.01, −2.52) | d=0.26 | −106.76 (262.89) | −42.14 (185.21) | −98.84 (−192.64, −5.05) | d=0.27 | −66.86 (189.82 ) | −26.93 (164.07) | −79.23 (−193.11, 34.64) | d=0.18 |
| Percent of dietary energy from fat | 30.26 (5.80) | 29.97 (5.86) | −2.44 (7.03) | −1.07 (6.99) | −0.94 (−2.48, 0.61) | d=0.16 | −1.18 (4.34) | −0.87 (3.48) | −0.33 (−2.01, 1.35) | d=0.05 | −0.81 (2.83) | −0.06 (2.61) | −1.95 (−3.73, −0.16) | d=0.28 |
| Added sugar (gm) | 33.32 (19.09) | 33.34 (20.27) | −2.52 (22.75) | −0.17 (23.74 ) | −2.34 (−7.75, 3.07) | d=0.12 | −2.73 (14.38) | −0.69 (11.65) | −4.13 (−10.06, 1.80) | d=0.18 | −1.23 (11.97) | −1.38 (9.12) | 0.15 (−7.40, 7.69) | d=0.00 |
| Fiber (gm) | 11.90 (4.43) | 10.89 (4.08) | −0.55 (5.40) | 1.03 (4.81) | −1.02 (−2.25, 0.20) | d=0.23 | −0.80 (2.77) | −0.02 (2.64) | −0.89 (−2.04, 0.26) | d=0.20 | −0.56 (1.97) | −0.10 (2.02) | −0.72 (−2.04, 0.60) | d=0.14 |
| Percent of daily energy consumed while watching screens | 24.32 (20.78) | 22.75 (21.48) | −7.30 (22.43) | 0.21 (21.54 ) | −6.55 (−11.55, −1.55) | d=0.36 | −5.30 (12.61) | 1.15 (12.54) | −11.51 (−16.53, −6.48) | d=0.59 | −3.78 (9.70) | 0.15 (8.97) | −10.71 (−16.42, −5.01) | d=0.48 |
| Sugar sweetened beverages (servings) | 1.16 (0.81) | 1.11 (0.90) | −0.19 (0.87) | −0.04 (1.04) | −0.12 (−0.34, 0.10) | d=0.15 | −0.12 (0.56) | −0.06 (0.53) | −0.08 (−0.33, 0.17) | d=0.08 | −0.08 (0.39) | −0.05 (0.39) | −0.06 (−0.33, 0.22) | d=0.05 |
| Overconcern with weight and shape (5 items, 1 low – 3 high) | 2.11 (0.50) | 2.08 (0.47) | −0.09 (0.52) | −0.15 (0.48) | 0.08 (−0.04, 0.19) | d=0.18 | −0.09 (0.31) | −0.10 (0.27) | 0.05 (−0.08, 0.18) | d=0.09 | −0.08 (0.23) | −0.09 (0.20) | 0.02 (−0.13, 0.16) | d=0.03 |
| School Performance (1 = mostly F’s to 9 = mostly A’s) | 7.31 (1.39) | 7.55 (1.14) | 0.08 (1.40) | −0.35 (1.39) | 0.28 (−0.04, 0.60) | d=0.23 | −0.08 (0.84) | −0.15 (0.77) | −0.00 (−0.38, 0.37) | d=0.00 | −0.03 (0.59) | −0.09 (0.45) | 0.02 (−0.36, 0.39) | d=0.01 |
| Depressive Symptoms (0 low – 20 high) | 2.68 (2.33) | 3.24 (3.29) | −0.53 (2.57) | −1.03 (3.01) | 0.06 (−0.46, 0.57) | d=0.03 | −0.45 (1.56) | −0.64 (1.72) | −0.08 (−0.71, 0.56) | d=0.03 | −0.36 (1.24) | −0.57 (1.31) | 0.10 (−0.63, 0.83) | d=0.03 |
| Total Child Implicit Theories (1 fixed – 6 growth) | 3.72 (1.17) | 3.78 (1.07) | 0.53 (1.12) | 0.48 (1.04) | −0.00 (−0.25, 0.25) | d=0.00 | 0.46 (0.74) | 0.46 (0.60) | −0.08 (−0.34, 0.19) | d=0.07 | 0.41 (0.49) | 0.37 (0.39) | 0.06 (−0.19, 0.32) | d=0.06 |
a
Baseline data from all participants, N = 120 for MMM and N= 121 for Health Education for all variables at baseline
b
Unadjusted slopes calculated from all participants with follow-up data, N= 120 for MMM and N = 117 for Health Education for blood pressures and resting heart rate, N= 114 for MMM and N = 116 for Health Education for all blood measures, N= 117 for MMM and N = 116 for Health Education for accelerometer measures, N = 119 for MMM and N = 116 – 117 for Health Education for all survey measures.
c
Adjusted MMM minus Health Education differences from linear trajectories (slopes) for each individual regressed on intervention group assignment (centered), with the baseline value (centered at its mean) and the Intervention x baseline interaction as covariates, using standard maximum likelihood linear regression techniques. Consistent with intent-to-treat principles, trajectories for children with only a baseline measure were imputed using a joint modeling multiple imputation approach as implemented in SAS using PROC MI (version 9.4). Thus, N= 120 for MMM and 121 for Health Education, for all outcomes.
d
For outcome analyses, glucose values trimmed to 126 mg/dL and Hemoglobin A1c values trimmed to 6.5% for three participants diagnosed with diabetes (1 child at years 2 and 3, and 2 children at year 3).
e
Daily accelerometer estimates between 5:00 AM and 11:59pm for all days, weighted 5:2 weekdays to weekend days.