Promoting Social Nurturance and Positive Social Environments to Reduce Obesity in High-Risk Youth

  • Dawn K. Wilson
  • Allison M. Sweeney
  • Heather Kitzman-Ulrich
  • Haylee Gause
  • Sara M. St. George


Nurturing environments within the context of families, schools, and communities all play an important role in enhancing youth’s behavioral choices and health outcomes. The increasing prevalence rates of obesity among youth, especially among low income and ethnic minorities, highlight the need to develop effective and innovative intervention approaches that promote positive supportive environments across different contexts for at-risk youth. We propose that the integration of Social Cognitive Theory, Family Systems Theory, and Self-Determination Theory offers a useful framework for understanding how individual, family, and social-environmental-level factors contribute to the development of nurturing environments. In this paper, we summarize evidence-based randomized controlled trials that integrate positive parenting, motivational, and behavioral skills strategies in different contexts, including primary care, home, community, and school-based settings. Taken together, these studies suggest that youth and parents are most likely to benefit when youth receive individual-level behavioral skills, family-level support and communication, and autonomous motivational support from the broader social environment. Future investigators and healthcare providers should consider integrating these evidence-based approaches that support the effects of positive social climate-based interventions on promoting healthy eating, physical activity, and weight management in youth.


Nurturance Positive parenting Obesity prevention Diet Physical activity Ethnic minorities Youth 



This research was supported in part by the National Institute of Child Health and Human Development (R01HD072153) to Dawn K. Wilson, Ph.D..

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflicts of interest.


  1. An, R., & Sturm, R. (2012). School and residential neighborhood food environment and diet among California youth. American Journal of Preventive Medicine, 42, 129–135. doi: 10.1016/j.amepre.2011.10.012.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall Inc.Google Scholar
  3. Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31, 143–164. doi: 10.1177/1090198104263660.CrossRefGoogle Scholar
  4. Barr-Anderson, D. J., Adams-Wynn, A. W., DiSantis, K. I., & Kumanyika, S. (2013). Family-focused physical activity, diet and obesity interventions in African-American girls: A systematic review. Obesity Review, 14, 29–51. doi: 10.1111/j.1467-789X.2012.01043.x.CrossRefGoogle Scholar
  5. Bauer, U. E., Briss, P. A., Goodman, R. A., & Bowman, B. A. (2014). Prevention of chronic disease in the 21st century: Elimination of the leading preventable causes of premature death and disability in the USA. The Lancet, 38, 45–52. doi: 10.1016/s0140-6736(14)60648-6.CrossRefGoogle Scholar
  6. Baumrind, D. (1966). Effects of authoritative control on child behavior. Child Development, 37, 887–907.CrossRefGoogle Scholar
  7. Beavers, W. R., & Hampson, R. B. (2000). Succesful families: Assessment and intervention. New York, NY: W.W. Norton & Co.Google Scholar
  8. Biglan, A., & Embry, D. D. (2013). A framework for intentional cultural change. Journal of Contextual Behavioral Science, 2, 95–104. doi: 10.1016/j.jcbs.2013.06.001.CrossRefGoogle Scholar
  9. Biglan, A., Flay, B. R., Embry, D. D., & Sandler, I. N. (2012). The critical role of nurturing environments for promoting human well-being. American Psychologist, 67, 257–271. doi: 10.1037/a0026796.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Braveman, P., Egerter, S., & Williams, D. R. (2011). The social determinants of health: Coming of age. Annual Review of Public Health, 32, 381–398. doi: 10.1146/annurev-publhealth-031210-101218.CrossRefPubMedGoogle Scholar
  11. Broderick, C. (1993). Understanding family process: Basics of family systems theory. Thousand Oaks, CA: Sage Publications.Google Scholar
  12. Brownson, R. C., Fielding, J. E., & Maylahn, C. M. (2009). Evidence-based public health: A fundamental concept for public health practice. Annual Review of Public Health, 30, 175–201. doi: 10.1146/annurev.publhealth.031308.10013410.1146/annurev.pu.30.031709.100001.CrossRefPubMedGoogle Scholar
  13. Center for Disease Control. (2016). Chronic Disease Prevention and Health Promotion. Retrieved from
  14. Colquhoun, H., Leeman, J., Michie, S., Lokker, C., Bragge, P., Hempel, S., et al. (2014). Towards a common terminology: A simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. Implementation Science, 9, 781. doi: 10.1186/1748-5908-9-51.CrossRefGoogle Scholar
  15. Davoli, A. M., Broccoli, S., Bonvicini, L., Fabbri, A., Ferrari, E., D’Angelo, S., et al. (2013). Pediatrician-led motivational interviewing to treat overweight children: An RCT. Pediatrics, 132, e1236–e1246. doi: 10.1542/peds.2013-1738.CrossRefPubMedGoogle Scholar
  16. Di Cesare, M., Khang, Y. H., Asaria, P., Blakely, T., Cowan, M. J., Farzadfar, F., et al. (2013). Inequalities in non-communicable diseases and effective responses. Lancet, 381, 585–597. doi: 10.1016/s0140-6736(12)61851-0.CrossRefPubMedGoogle Scholar
  17. Doak, C. M., Visscher, T. L. S., Renders, C. M., & Seidell, J. C. (2006). The prevention of overweight and obesity in children and adolescents: A review of interventions and programmes. Obesity Reviews, 7, 111–136. doi: 10.1111/j.1467-789X.2006.00234.x.CrossRefPubMedGoogle Scholar
  18. Epstein, L. H., Paluch, R. A., Roemmich, J. N., & Beecher, M. D. (2007). Family-based obesity treatment, then and now: Twenty-five years of pediatric obesity treatment. Health Psychology, 26, 381–391. doi: 10.1037/0278-6133.26.4.381.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Epstein, L. H., Wing, R. R., Koeske, R., & Valoski, A. (1987). Long-term effects of family-based treatment of childhood obesity. Journal of Consulting and Clinical Psychology, 55, 91–95. doi: 10.1037/0022-006X.55.1.91.CrossRefPubMedGoogle Scholar
  20. Expert Panel on Integrated Guidelines for Cardiovascular, Risk Reduction in, Adolescents, National Heart, and Blood. (2011). Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Summary report. Pediatrics, 128(Suppl 5), S213–S256. doi: 10.1542/peds.2009-2107C.Google Scholar
  21. Ferrer-Caja, E., & Weiss, M. R. (2000). Predictors of intrinsic motivation among adolescent students in physical education. Research Quarterly for Exercise and Sport, 71, 267–279. doi: 10.1080/02701367.2000.10608907.CrossRefPubMedGoogle Scholar
  22. Flodmark, C. E., Marcus, C., & Britton, M. (2006). Interventions to prevent obesity in children and adolescents: A systematic literature review. International Journal of Obesity, 30, 579–589. doi: 10.1038/sj.ijo.0803290.CrossRefPubMedGoogle Scholar
  23. Flynn, M. A. T., McNeil, D. A., Maloff, B., Mutasingwa, D., Wu, M., Ford, C., et al. (2006). Reducing obesity and related chronic disease risk in children and youth: A synthesis of evidence with ‘best practice’recommendations. Obesity Reviews, 7, 7–66. doi: 10.1111/j.1467-789X.2006.00242.x.CrossRefPubMedGoogle Scholar
  24. Gortmaker, S. L., Peterson, K., Wiecha, J., Sobol, A. M., Dixit, S., Fox, M. K., et al. (1999). Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Archives of Pediatrics & Adolescent Medicine, 153, 409–418. doi: 10.1001/archpedi.153.4.409.CrossRefGoogle Scholar
  25. Hagger, M., Chatzisarantis, N. L., Hein, V., Soos, I., Karsai, I., Lintunen, T., et al. (2009). Teacher, peer and parent autonomy support in physical education and leisure-time physical activity: A trans-contextual model of motivation in four nations. Psychology and Health, 24, 689–711. doi: 10.1080/08870440801956192.CrossRefPubMedGoogle Scholar
  26. Jones, S. A., Moore, L. V., Moore, K., Zagorski, M., Brines, S. J., Diez Roux, A. V., et al. (2015). Disparities in physical activity resource availability in six US regions. Prevative Medicine, 78, 17–22. doi: 10.1016/j.ypmed.2015.05.028.CrossRefGoogle Scholar
  27. Kindig, D. A. (2007). Understanding population health terminology. Milbank Quarterly, 85, 139–161. doi: 10.1111/j.1468-0009.2007.00479.x.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Kindig, D., & Stoddart, G. (2003). What is population health? American Journal of Public Health, 93, 380–383. doi: 10.2105/AJPH.93.3.380.CrossRefPubMedPubMedCentralGoogle Scholar
  29. Kitzmann, K. M., Dalton, W. T., 3rd, Stanley, C. M., Beech, B. M., Reeves, T. P., Buscemi, J., et al. (2010). Lifestyle interventions for youth who are overweight: A meta-analytic review. Health Psychology, 29, 91–101. doi: 10.1037/a0017437.CrossRefPubMedGoogle Scholar
  30. Kitzman-Ulrich, H., Wilson, D. K., St. George, S. M., Lawman, H., Segal, M., & Fairchild, A. (2010). The integration of a family systems approach for understanding youth obesity, physical activity, and dietary programs. Clincal Child and Family Psychology Review, 13, 231–253. doi: 10.1007/s10567-010-0073-0.CrossRefGoogle Scholar
  31. Kitzman-Ulrich, H., Wilson, D. K., St. George, S. M., Segal, M., Schneider, E., & Kugler, K. (2011). A preliminary test of a motivational and parenting weight loss program targeting low-income and minority adolescents. Child Obesity, 7, 379–384. doi: 10.1089/chi.2011.0030.CrossRefGoogle Scholar
  32. Koplan, J., Liverman, C. T., Kraak, V. I., & Wisham, S. L. (2006). Progress in preventing childhood obesity, how do we measure up?. Washington, DC: The National Academies Press.Google Scholar
  33. Kremers, S. P., Brug, J., de Vries, H., & Engels, R. C. (2003). Parenting style and adolescent fruit consumption. Appetite, 41, 43–50. doi: 10.1016/S0195-6663(03)00038-2.CrossRefPubMedGoogle Scholar
  34. Kumanyika, S. K., Obarzanek, E., Stettler, N., Bell, R., Field, A. E., Fortmann, S. P., et al. (2008). Population-based prevention of obesity. Circulation, 118, 428–464. doi: 10.1161/CIRCULATIONAHA.108.189702.CrossRefPubMedGoogle Scholar
  35. Larson, N. I., Story, M. T., & Nelson, M. C. (2009). Neighborhood environments: Disparities in access to healthy foods in the U.S. American Journal of Prevative Medicine, 36, 74–81. doi: 10.1016/j.amepre.2008.09.025.CrossRefGoogle Scholar
  36. LaVeist, T. A., Gaskin, D., & Richard, P. (2011). Estimating the economic burden of racial health inequalities in the United States. International Journal of Health Services, 41, 231–238. doi: 10.2190/HS.41.2.c.CrossRefPubMedGoogle Scholar
  37. Lee, H. (2012). The role of local food availability in explaining obesity risk among young school-aged children. Social Science and Medicine, 74, 1193–1203. doi: 10.1016/j.socscimed.2011.12.036.CrossRefPubMedGoogle Scholar
  38. Lubans, D. R., Smith, J. J., Plotnikoff, R. C., Dally, K. A., Okely, A. D., Salmon, J., et al. (2016). Assessing the sustained impact of a school-based obesity prevention program for adolescent boys: The ATLAS cluster randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity, 13, 92. doi: 10.1186/s12966-016-0420-8.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Luepker, R. V., Perry, C. L., McKinlay, S. M., Nader, P. R., Parcel, G. S., Stone, E. J., et al. (1996). Outcomes of a field trial to improve children’s dietary patterns and physical activity. The Child and Adolescent Trial for Cardiovascular Health. CATCH collaborative group. JAMA, 275, 768–776. doi: 10.1001/jama.1996.03530340032026.CrossRefPubMedGoogle Scholar
  40. Lushniak, B. D., Alley, D. E., Ulin, B., & Graffunder, C. (2015). The National Prevention Strategy: Leveraging multiple sectors to improve population health. American Journal of Public Health, 105, 229–231. doi: 10.2105/AJPH.2014.302257.CrossRefPubMedPubMedCentralGoogle Scholar
  41. Macartney, S., Bishaw, A., & Fontenot, K. (2013). Poverty rates for selected detailed race and Hispanic groups by state and place: 2007–2011. American Community Survey Briefs. Retrieved from
  42. McNiece, K. L., Poffenbarger, T. S., Turner, J. L., Franco, K. D., Sorof, J. M., & Portman, R. J. (2007). Prevalence of hypertension and pre-hypertension among adolescents. Journal of Pediatrics, 150, 640–644. doi: 10.1016/j.jpeds.2007.01.052.CrossRefPubMedGoogle Scholar
  43. Miller, W. R., Brown, J. M., Simpson, T. L., et al. (1995). What works? A methodological analysis of the alcohol treatment outcome literature. In R. K. Hester & W. R. Miller (Eds.), Handbook of Alcoholism treatment approaches: Effective alternatives (2nd ed., pp. 12–44). Needham Heights, MA: Allyn & Bacon.Google Scholar
  44. Miller, G. E., Chen, E., & Parker, K. J. (2011a). Psychological stress in childhood and susceptibility to the chronic diseases of aging: Moving toward a model of behavioral and biological mechanisms. Psychological Bulletin, 137, 959–997. doi: 10.1037/a0024768.CrossRefPubMedPubMedCentralGoogle Scholar
  45. Miller, G. E., Lachman, M. E., Chen, E., Gruenewald, T. L., Karlamangla, A. S., & Seeman, T. E. (2011b). Pathways to resilience maternal nurturance as a buffer against the effects of childhood poverty on metabolic syndrome at midlife. Psychological Science, 22, 1591–1599. doi: 10.1177/0956797611419170.CrossRefPubMedPubMedCentralGoogle Scholar
  46. Ng, J. Y., Ntoumanis, N., Thogersen-Ntoumani, C., Deci, E. L., Ryan, R. M., Duda, J. L., et al. (2012). Self-determination theory applied to health contexts: A meta-analysis. Perspectives in Psychological Science, 7, 325–340. doi: 10.1177/1745691612447309.CrossRefGoogle Scholar
  47. Niemeier, B. S., Hektner, J. M., & Enger, K. B. (2012). Parent participation in weight-related health interventions for children and adolescents: A systematic review and meta-analysis. Prevative Medicine, 55, 3–13. doi: 10.1016/j.ypmed.2012.04.021.CrossRefGoogle Scholar
  48. Ntoumanis, N., & Standage, M. (2009). Motivation in physical education classes: A self-determination theory perspective. School Field, 7, 194–202. doi: 10.1177/1477878509104324.Google Scholar
  49. Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA, 311, 806–814. doi: 10.1001/jama.2014.732.CrossRefPubMedPubMedCentralGoogle Scholar
  50. Østbye, T., Krause, K. M., Stroo, M., Lovelady, C. A., Evenson, K. R., Peterson, B. L., et al. (2012). Parent-focused change to prevent obesity in preschoolers: Results from the KAN-DO study. Preventive Medicine, 55, 188–195. doi: 10.1016/j.ypmed.2012.06.005.CrossRefPubMedPubMedCentralGoogle Scholar
  51. Plumb, J., Weinstein, L. C., Brawer, R., & Scott, K. (2012). Community-based partnerships for improving chronic disease management. Primary Care, 39, 433–447. doi: 10.1016/j.pop.2012.03.011.CrossRefPubMedGoogle Scholar
  52. Radziszewska, B., Richardson, J. L., Dent, C. W., & Flay, B. R. (1996). Parenting style and adolescent depressive symptoms, smoking, and academic achievement: Ethnic, gender, and SES differences. Journal of Behavioral Medicine, 19, 289–305. doi: 10.1007/BF01857770.CrossRefPubMedGoogle Scholar
  53. Rehm, C. D., Penalvo, J. L., Afshin, A., & Mozaffarian, D. (2016). Dietary Intake Among US Adults, 1999–2012. JAMA, 315, 2542–2553. doi: 10.1001/jama.2016.7491.CrossRefPubMedGoogle Scholar
  54. Resnicow, K., McMaster, F., Bocian, A., Harris, D., Zhou, Y., Snetselaar, L., et al. (2015). Motivational interviewing and dietary counseling for obesity in primary care: An RCT. Pediatrics, 135, 649–657. doi: 10.1542/peds.2014-1880.CrossRefPubMedPubMedCentralGoogle Scholar
  55. Rhee, K. (2008). Childhood overweight and the relationship between parent behaviors, parenting style, and family functioning. Annals of the American Academy of Political and Social Science, 615, 12–37. doi: 10.1177/0002716207308400.CrossRefGoogle Scholar
  56. Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55, 68–78. doi: 10.1037/0003-066X.55.1.68.CrossRefPubMedGoogle Scholar
  57. Sallis, J., & Glanz, K. (2006). The role of built environments in physical activity, eating, adn obesity in childhood. Child Obesity, 16, 89–108. Retrieved from
  58. Sheeran, P., Klein, W. M., & Rothman, A. J. (2017). Health behavior change: Moving from observation to intervention. Annual Review of Psychology, 68, 573–600. doi: 10.1146/annurev-psych-010416-044007.CrossRefPubMedGoogle Scholar
  59. Singh, G. K., Siahpush, M., & Kogan, M. D. (2010). Neighborhood socioeconomic conditions, built environments, and childhood obesity. Health Affairs, 29, 503–512. doi: 10.1377/hlthaff.2009.0730.CrossRefPubMedGoogle Scholar
  60. Sleddens, E. F., Gerards, S. M., Thijs, C., de Vries, N. K., & Kremers, S. P. (2011). General parenting, childhood overweight and obesity-inducing behaviors: A review. International Journal of Pediatric Obesity, 6, e12–e27. doi: 10.3109/17477166.2011.566339.CrossRefPubMedGoogle Scholar
  61. St. George, S. M., Wilson, D. K., Schneider, E. M., & Alia, K. A. (2013). Project SHINE: Effects of parent-adolescent communication on sedentary behavior in African American adolescents. Journal of Pediatric Psychology, 38, 997–1009. doi: 10.1093/jpepsy/jst027.CrossRefPubMedPubMedCentralGoogle Scholar
  62. Standage, M., Gillison, F. B., Ntoumanis, N., & Treasure, D. C. (2012). Predicting students’ physical activity and health-related well-being: A prospective cross-domain investigation of motivation across school physical education and exercise settings. Journal of Sport and Exercise Psychology, 34, 37–60. doi: 10.1123/jsep.34.1.37.CrossRefPubMedGoogle Scholar
  63. Sung-Chan, P., Sung, Y. W., Zhao, X., & Brownson, R. C. (2013). Family-based models for childhood-obesity intervention: A systematic review of randomized controlled trials. Obesity Reviews, 14, 265–278. doi: 10.1111/obr.12000.CrossRefPubMedGoogle Scholar
  64. Taveras, E. M., Gortmaker, S. L., Hohman, K. H., Horan, C. M., Kleinman, K. P., Mitchell, K., et al. (2011). Randomized controlled trial to improve primary care to prevent and manage childhood obesity: The High Five for Kids study. Archives of Pediatric and Adolescescent Medicine, 165, 714–722. doi: 10.1001/archpediatrics.2011.44.CrossRefGoogle Scholar
  65. Thompson, C., & Wankel, L. (1980). The effects of perceived activity choice upon frequency of exercise behavior. Journal of Applied Social Psychology, 10, 436–443. doi: 10.1111/j.1559-1816.1980.tb00722.x.CrossRefGoogle Scholar
  66. van der Horst, K., Kremers, S., Ferreira, I., Singh, A., Oenema, A., & Brug, J. (2007). Perceived parenting style and practices and the consumption of sugar-sweetened beverages by adolescents. Health Education Ressearch, 22, 295–304. doi: 10.1093/her/cyl080.CrossRefGoogle Scholar
  67. Viner, R. M., Ozer, E. M., Denny, S., Marmot, M., Resnick, M., Fatusi, A., et al. (2012). Adolescence and the social determinants of health. The Lancet, 379, 1641–1652. doi: 10.1016/S0140-6736(12)60531-5.CrossRefGoogle Scholar
  68. Wandersman, A., Chien, V. H., & Katz, J. (2012). Toward an evidence-based system for innovation support for implementing innovations with quality: Tools, training, technical assistance, and quality assurance/quality improvement. American Journal of Community Psychology, 50, 445–459. doi: 10.1007/s10464-012-9509-7.CrossRefPubMedGoogle Scholar
  69. West, F., Sanders, M. R., Cleghorn, G. J., & Davies, P. S. (2010). Randomised clinical trial of a family-based lifestyle intervention for childhood obesity involving parents as the exclusive agents of change. Behaviour Research and Therapy, 48, 1170–1179. doi: 10.1016/j.brat.2010.08.008.CrossRefPubMedGoogle Scholar
  70. Whitlock, E. P., Williams, S. B., Gold, R., Smith, P. R., & Shipman, S. A. (2005). Screening and interventions for childhood overweight: A summary of evidence for the US Preventive Services Task Force. Pediatrics, 116, e125–e144. doi: 10.1542/peds.2005-0242.CrossRefPubMedGoogle Scholar
  71. Wilson, D. K. (2009). New perspectives on health disparities and obesity interventions in youth. Journal of Pediatric Psychology, 34, 231–244. doi: 10.1093/jpepsy/jsn137.CrossRefPubMedPubMedCentralGoogle Scholar
  72. Wilson, D. K., Evans, A. E., Williams, J., Mixon, G., Sirard, J. R., & Pate, R. (2005). A preliminary test of a student-centered intervention on increasing physical activity in underserved adolescents. Annals of Behavioral Medicine, 30, 119–124. doi: 10.1207/s15324796abm3002_4.CrossRefPubMedPubMedCentralGoogle Scholar
  73. Wilson, D. K., Griffin, S., Saunders, R. P., Kitzman-Ulrich, H., Meyers, D. C., & Mansard, L. (2009). Using process evaluation for program improvement in dose, fidelity and reach: The ACT trial experience. International Journal of Behavioral Nutrition and Physical Activity, 6, 79. doi: 10.1186/1479-5868-6-79.CrossRefPubMedPubMedCentralGoogle Scholar
  74. Wilson, D. K., Kitzman-Ulrich, H., Resnicow, K., Van Horn, M. L., George, S. M., Siceloff, E. R., et al. (2015). An overview of the Families Improving Together (FIT) for weight loss randomized controlled trial in African American families. Contemporary Clinical Trials, 42, 145–157. doi: 10.1016/j.cct.2015.03.009.CrossRefPubMedPubMedCentralGoogle Scholar
  75. Wilson, D. K., Kitzman-Ulrich, H., Williams, J. E., Saunders, R., Griffin, S., Pate, R., et al. (2008). An overview of “The Active by Choice Today” (ACT) trial for increasing physical activity. Contemporary Clinical Trials, 29, 21–31. doi: 10.1016/j.cct.2007.07.001.CrossRefPubMedGoogle Scholar
  76. Wilson, D. K., Van Horn, M. L., Kitzman-Ulrich, H., Saunders, R., Pate, R., Lawman, H. G., et al. (2011). Results of the “Active by Choice Today” (ACT) randomized trial for increasing physical activity in low-income and minority adolescents. Health Psychology, 30, 463–471. doi: 10.1037/a0023390.CrossRefPubMedPubMedCentralGoogle Scholar
  77. Woolf, S. H., & Aron, L. Y. (2013). The US health disadvantage relative to other high-income countries: Findings from a National Research Council/Institute of Medicine report. JAMA, 309, 771–772. doi: 10.1001/jama.2013.91.CrossRefPubMedGoogle Scholar
  78. Zarrett, N., Skiles, B., Wilson, D. K., & McClintock, L. (2012). A qualitative study of staff’s perspectives on implementing an after school program promoting youth physical activity. Evaluation and Program Planning, 35, 417–426. doi: 10.1016/j.evalprogplan.2011.12.003.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of Psychology, Barnwell CollegeUniversity of South CarolinaColumbiaUSA
  2. 2.Diabetes Health and Wellness InstituteBaylor Scott and White HealthDallasUSA
  3. 3.Department of Public Health SciencesUniversity of Miami Miller School of MedicineMiamiUSA

Personalised recommendations