Active, Nourished, and Empowered Teens (ANET): Co-Development of a Modular Nutrition and Fitness Intervention for Community Youth

PROJECT SUMMARY/ABSTRACT Cardiovascular diseases (CVDs) are the leading cause of global mortality, with adolescents facing increasing risks due to poor diet and lack of physical activity. Although interventions to improve nutrition and activity have had modest success, they often fail to align with adolescents' developmental needs and community contexts. This project will engage a Youth Advisory Panel to co-design an intervention aimed at empowering youth in their nutrition and physical activity choices, fostering advocacy for nutritional and environmental justice. Utilizing the Transcreation Framework, the Active, Nourished, and Empowered Teens (ANET) Program will be developed and evaluated to enhance community capacity for effective delivery. Specific Aim 1a will focus on defining and adapting behavior change techniques (BCTs) from formative evaluation data to create intervention modules, with the research team and Youth Advisory Panel co-designing protocols and training materials that address cultural and accessibility issues. Specific Aim 1b will involve gathering qualitative feedback on the intervention's acceptability and feasibility through four focus groups of 5-7 adolescents each (N=20-28) to refine the intervention and identify implementation barriers. Specific Aim 2a will evaluate the feasibility of the intervention through 1-arm trial and obtain critical information (e.g., feasibility of procedures, recruitment, retention) to inform a future pilot randomized control trial (RCT). Adolescents will complete questionnaires, 7 days of actigraphy, and 2 24-hour diet recalls at Pre- and Post-Intervention data collection time points. YAP members will be trained as co-facilitators of the intervention program using a structured training protocol developed for the study. We will administer four provisional, 6-session, group interventions with 10-12 high school students per group (total of 40 adolescents). Participants will complete individual interviews evaluating feasibility, acceptability, and implementation barriers post-intervention. Specific Aim 2b will utilize community youth input to create a preliminary implementation blueprint for the Active, Nourished, and Empowered Teens (ANET) Program, synthesizing barriers and facilitators to tailor implementation strategies using the CFIR-ERIC matching tool. This project will lead to an R01 to test the efficacy of the intervention and the implementation strategies in a RCT to improve adolescent health through evidence-based methods to improve nutrition and increase physical activity, community engagement, and nutrition advocacy.