effect sizes ranging from 0.31 to 0.70 (Lazorick, Fang,
Hardison, & Crawford, 2015; Lubans, Morgan, Aguiar, &
Callister, 2011). The remaining three studies reported very
small effect sizes on BMI or BMI z-score ranging from
0.07 to 0.04 (Foster et al., 2008; Franckle et al., 2017;
Hollis et al., 2016). However, the two studies with signifi-
cant results had relatively smaller sample sizes than the
remaining three studies (N¼100, 362 vs. 1,150, 1,349,
219,762). Furthermore, one of the two studies, which was
conducted in the United States, did not include randomiza-
tion of the schools to intervention or control conditions and
provided US$20,000 dollars to each school for intervention-
related expenses; the other study, which was conducted out-
side the United States, involved boys only and did not blind
assessors to group assignment.
For the three studies that did not yield significant results,
intervention duration was 12 months in one (Hollis et al.,
2016) and 2 years in the remaining two studies (Foster et al.,
2008; Franckle et al., 2017), and parents were either not
involved or had minimal involvement (e.g., newsletters
about PA sent home; at school meetings, parents encouraged
to assist their children to engage in healthy behaviors). The
12-month intervention was theory based, but focused on PA
only; whereas the other two interventions were not theory
based and involved varied curricular and policy changes to
improve PA and diet quality.
For the two studies that had significant results, the inter-
ventions were theory based, focused on PA and diet quality,
andrangedindurationfrom14weeksto6months.Both
interventions had no parental involvement and included cur-
ricula delivered by teachers during the school day that
involved education, skill development (e.g., self-
monitoring, goal setting), and opportunities for PA. While
both studies demonstrated that school-based interventions
can be successful, altering the curricula during the school day
to promote PA and healthy eating may not be feasible in all
schools due to pressure perceived by administrators and
teachers to improve students’ academic performance (Beets
et al., 2016). Interventions that occur in conjunction with
schools, but take place after school, may be a necessary and
ideal solution for addressing these issues because most ado-
lescents attend school (D. K. Wilson, Van Horn, et al., 2011).
Although participation by adolescents in an after-school
program at their school to increase PA and healthy eating is
convenient and provides an opportunity for acquiring
knowledge and building skills, it may not be sufficient for
assisting them to adequately achieve both behavioral objec-
tives. Although active involvement of parents along with
their adolescents (Bradley et al., 2011) in interventions may
also be important, involving parents has been a challenge
(Smith, Wohlstetter, Kuzin, & De Pedro, 2011), indicating a
need to test novel approaches.
In a systematic review of PA and dietary mobile applica-
tions, Brannon and Cushing (2015) found that apps targeting
health promotion by focusing on improving both adolescent
PA and diet quality are sparse with limited incorporation of
strategies to strengthen theoretical constructs, such as social
support, that have already been identified as important pre-
dictors of positive behavior change. Another limitation is
that technology for promoting healthy behaviors is usually
designed for the individual who needs to change as opposed
to the one who can offer support for the process (Ferrer &
Ellis, 2017). Due to pervasive use among adults, social net-
working platforms, such as Facebook, may have the poten-
tial to address these limitations and bolster parents’ support
for their adolescents to make positive behavioral changes.
Despite the promise of this approach, we found no interven-
tion to empower parents via Facebook to assist their adoles-
cents with increasing PA and diet quality, indicating that the
capability of social networking for achieving this objective
remains basically untapped (Cavallo et al., 2014; Hammers-
ley, Jones, & Okely, 2016).
To address these issues, we conducted a pilot study to test
a 12-week, three-component Guys/Girls Opt for Activities
for Life (GOAL) intervention that involved parents via Face-
book, as an adjunct to a single parent–adolescent dyad meet-
ing and also an after-school club (2 days/week) for urban,
underserved adolescents. To our knowledge, no study
including an intervention combining these three components
has been conducted with parents and adolescents of low
socioeconomic and minority status. Based on this informa-
tion, the primary purpose of this study was 2-fold: (1) to
evaluate the feasibility and acceptability of our school- and
home-based intervention and (2) to examine the preliminary
efficacy of the intervention versus a control condition on
fifth- to seventh-grade adolescents’ accelerometer-
measured moderate-to-vigorous physical activity (MVPA);
diet quality; and psychosocial variables including motiva-
tion, self-efficacy, and perceived social support for PA and
healthy eating. A secondary aim was to explore any effect of
the intervention on adolescents’ percent body fat and BMI.
Theoretical Framework
The intervention was guided by self-determination theory
(SDT; Ryan & Deci, 2000) and the information–motiva-
tion–behavioral skills (IMB) model (Fisher, Fisher, Bryan,
& Misovich, 2002). The SDT identifies the following three
basic needs that promote intrinsic motivation to drive beha-
vior: competence (self-efficacy), autonomy (choice), and
relatedness (social support). The IMB model indicates that
making a positive change in behavior is increased when an
individual has information, motivation, and behavioral skills
for accomplishing the task. Self-efficacy (Fitzgerald, Heary,
Kelly, Nixon, & Shevlin, 2013), social support from others
(e.g., parents, peers, and instructors or teachers; Glozah &
Pevalin, 2015; Lytle et al., 2009), and motivation (Dwyer
et al., 2017; Huffman, Wilson, Van Horn, & Pate, 2017)
are related to MVPA and healthy eating among adolescents.
All three components of GOAL were designed to increase
2The Journal of School Nursing XX(X)