Adding a mental health component to school-based lifestyle programs for teens could be key to lowering obesity, improving grades, alleviating severe depression and reducing substance use, a new study suggests.
As a group, high-school students who participated in COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, Nutrition) Program --- an intervention that emphasized cognitive behavioral skills building in addition to nutrition and physical activity --- had a lower average body mass index, better social behaviors and higher health class grades and drank less alcohol than did teenagers in a class with standard health lessons. Most of the positive outcomes of the COPE program were sustained for six months.
Thirty-two percent of youths in the United States are overweight or obese, and suicide is the third leading cause of death among young people age 14 to 24, according to the Centers for Disease Control and Prevention. Yet most school-based interventions don’t take on both public health problems simultaneously or measure the effects of programs on multiple outcomes.
This is what has been missing from prior healthy lifestyle programs with teens – getting to the thinking piece. We teach the adolescents that how they think directly relates to how they feel and how they behave.
At its core, the COPE program emphasizes the link between thinking patterns, emotions and behavior as well as the ABCs of cognitive behavioral skills building: activator events that trigger negative thoughts, negative beliefs teens may have about themselves based on the triggering event, and the consequences of feeling bad and engaging in negative behavior as a result.
We teach kids how to monitor for activator events and show them that instead of embracing a negative belief, they can turn that around to a positive belief about themselves. Schools are great at teaching math and social studies, but we aren’t giving teens the life skills they need to successfully deal with stress, how to problem-solve, how to set goals, and those are key elements in this healthy lifestyle intervention.
COPE also includes nutrition lessons on such topics as portion sizes and social eating and 20 minutes of movement – dance, dodge ball, taking a walk, anything to keep the students out of their seats.
It’s not possible to tease out exactly which component of the program has the most profound effect on teens, but it is likely to be the combination of all of them together.
I believe it has to be the combination. You’ve got to have a nutrition piece to teach them how to eat healthier and resist unhealthy eating to make themselves feel better. And they’ve got to be more active. But a very key piece is the mental health and cognitive piece.
I invite you to visit the RTIPs website to view the full program summary and scoring for this program and to download related publications and program materials. If you're considering implementing this program and have questions about the program components or how best to adapt, implement, and evaluate it for your specific population and setting, please let me know. Simply post your questions/comments below.