Adolescents Committed to Improvement of Nutrition and Physical Activity (ACTION) was undertaken to determine feasibility of a school-based health center (SBHC) weight management program. Two urban New Mexico SBHCs were randomized to deliver ACTION or standard care. ACTION consisted of eight visits using motivational interviewing to improve eating and physical activity behavior. An educational nutrition and physical activity DVD for students and a clinician toolkit were created for use as menu of options. Standard care consisted of one visit with the SBHC provider who prescribed recommendations for healthy weight. Sixty nondiabetic overweight/obese adolescents were enrolled. Measures included BMI percentile, waist circumference, insulin resistance by homeostasis model assessment (HOMA-IR), blood pressure, triglycerides, and HDL-C levels. Pre- to postchanges for participants were compared between groups. Fifty-one students (mean age 15 years, 62% female, 75% Hispanic) completed pre- and postmeasures. ACTION students ( ) had improvements in BMI percentile ( ) and waist circumference ( ) as compared with students receiving standard care ( ). No differences were found between the two groups in blood pressure, HOMA-IR, triglycerides, and HDL-C. The ACTION SBHC weight management program was feasible and demonstrated improved outcomes in BMI percentile and waist circumference. 1. Introduction The prevalence of childhood obesity in the USA has tripled since 1980 and now affects 12.5 million school-age children and adolescents [1, 2]. Associated with this epidemic is the rising prevalence of metabolic syndrome among adolescents, particularly in obese teens (12.4 to 44.2%) [3]. The components of metabolic syndrome are typically described as a clustering of cardiometabolic risk factors that includes central adiposity, elevated blood pressure, dyslipidemia, and impaired glucose metabolism [4–6]. These derangements increase the risk for cardiovascular disease and type 2 diabetes [7], and weight loss through behavioral modification is the recommended first step in the prevention and treatment of metabolic syndrome [8]. A challenge in delivering behavioral modification interventions is that adolescents seek medical care infrequently [9]. School-based health centers (SBHCs) that provide health care services to students on school campuses offer an opportunity to reach adolescents at a location where they spend a significant portion of their day [10]. SBHCs are designed to focus on the uninsured and underserved, and providers work with a large segment of the adolescent
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