Obesity and mental health disorders are interconnected problems affecting children and teens across the country, although they disproportionately affect racial and ethnic minorities and those with lower socioeconomic status. In an attempt to address the problem, researchers compared a structured education program called Creating Opportunities for Personal Empowerment (COPE) Healthy Lifestyles Thinking, Emotions, Exercise, Nutrition (TEEN) (hereafter just COPE) with a control intervention, Healthy Teens, in an ethnically diverse group of adolescents 14 to 16 years old at 11 high schools in the American Southwest. The schools-rather than the students-were randomly assigned to one of the two programs: 342 teens to COPE and 421 to Healthy Teens.

Both programs were integrated into the freshman and sophomore health education classes (a requirement for graduation). COPE consisted of 15 weekly educational sessions that included building cognitive-behavioral skills and 15 to 20 minutes of physical activity. COPE students received pedometers and kept weekly records of their step count, which they were encouraged to increase as the study progressed. Healthy Teens focused on safety and common teen-specific topics and was structured in the same 15-session format, although there was no content overlap. These teens received pedometers for one week at the beginning and end of the program to assess physical activity.

Immediately after program completion, COPE students had logged significantly more steps, and their mean body mass index (BMI) was lower. They also scored higher on the cooperation, assertion, and academic competence subscales of the Social Skills Rating System. Alcohol use was significantly lower among COPE students (13%) than Healthy Teens (20%). There were no differences between groups in Healthy Lifestyles Behavior Scale scores or scores on the Beck Youth Inventories for anxiety or depression.

Six months after program completion, BMI was still significantly lower in the COPE group, and the proportion of students who were overweight before the program had decreased in the COPE group but increased in the control group. Marijuana use was similar between the groups at six months, but alcohol use remained lower among COPE students (12%) than in the control group (17%).

The authors conclude that the COPE program had a positive effect in a variety of areas and point out that COPE can be integrated into existing health education curricula without a need for extra staff, making it more cost-effective.

Melnyk BM, et al. Am J Prev Med 2013;45(4):407-15.