xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT05977959</url>
    </required_header>
    <id_info>
      <org_study_id>AHA HSRC</org_study_id>
      <nct_id>NCT05977959</nct_id>
    </id_info>
    <brief_title>Optimizing the Impact of the Healthy School Recognized Campus Program on Youth's CVD Risk Factors</brief_title>
    <acronym>HSRC</acronym>
    <official_title>Optimizing the Impact of the Healthy School Recognized Campus Program on Youth's CVD Risk Factors</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>Texas A&amp;M University</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
      <collaborator>
        <agency>American Heart Association</agency>
        <agency_class>Other</agency_class>
      </collaborator>
    </sponsors>
    <source>Texas A&amp;M University</source>
    <oversight_info>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
    </oversight_info>
    <brief_summary>
      <textblock>
        Healthy School Recognized Campus is a Texas A&amp;M AgriLife Extension initiative that supports&#xD;
        the delivery of school-based physical activity and nutrition programs for diverse youth&#xD;
        across Texas. The purpose of this study is to improve the delivery of these programs and&#xD;
        optimize the effect they have on youth's cardiovascular risk factors.&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        The investigators will conduct a group randomized factorial trial using the Multiphase&#xD;
        Optimization STrategy (MOST) framework to evaluate the impact (i.e., implementation and&#xD;
        effectiveness) of three implementation strategies on program implementation and youth's&#xD;
        cardiovascular disease risk. HSRC is a Texas A&amp;M AgriLife Extension initiative that supports&#xD;
        the delivery of school-based physical activity and nutrition programs.&#xD;
  &#xD;
        Elementary schools in North and East Texas (n=16) of similar socio-economic status will be&#xD;
        randomized at baseline to receive either 3, 2, 1, or no strategies to support HSRC program&#xD;
        implementation. All schools will participate in HSRC during the full school year.&#xD;
  &#xD;
        The investigators hypothesize that one strategy will result in significantly greater HSRC&#xD;
        implementation and effectiveness than the other strategies tested.&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Not yet recruiting</overall_status>
    <start_date type="Anticipated">August 1, 2023</start_date>
    <completion_date type="Anticipated">June 30, 2025</completion_date>
    <primary_completion_date type="Anticipated">June 30, 2025</primary_completion_date>
    <phase>N/A</phase>
    <study_type>Interventional</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <allocation>Randomized</allocation>
      <intervention_model>Factorial Assignment</intervention_model>
      <primary_purpose>Prevention</primary_purpose>
      <masking>None (Open Label)</masking>
    </study_design_info>
    <primary_outcome>
      <measure>Presence or absence of metabolic syndrome (MetS)</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
      <description>MetS is present after identifying abdominal obesity plus at least two of the four other MetS Risk factors: high blood pressure, high blood sugar, low HDL cholesterol, and high triglyceride levels.&#xD;
  MetS = (abdominal obesity) + (2 of 4 other MetS Risk factors)&#xD;
  Measures to determine MetS risk factors:&#xD;
  Abdominal obesity: waist circumference &gt;90th percentile for child's sex and age&#xD;
  High blood pressure: systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥90 mmHg)&#xD;
  High blood glucose: blood glucose ≥5.6 mmol/L or known diabetes&#xD;
  Low HDL cholesterol: HDL cholesterol &lt;1.03 mmol/L&#xD;
  High triglyceride level: Triglyceride level ≥ 1.7mmol/L</description>
    </primary_outcome>
    <primary_outcome>
      <measure>Change in the number of MetS risk factors</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
      <description>Change in the number of MetS risk factors = (new # of MetS risk factors) - (original # of MetS risk factors)&#xD;
  Measures to determine MetS risk factors:&#xD;
  Abdominal obesity: waist circumference &gt;90th percentile for child's sex and age&#xD;
  High blood pressure: systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥90 mmHg)&#xD;
  High blood glucose: blood glucose ≥5.6 mmol/L or known diabetes&#xD;
  Low HDL cholesterol: HDL cholesterol &lt;1.03 mmol/L&#xD;
  High triglyceride level: Triglyceride level ≥ 1.7mmol/L</description>
    </primary_outcome>
    <primary_outcome>
      <measure>Number of programs schools delivered (in addition to Walk Across Texas)</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
    </primary_outcome>
    <primary_outcome>
      <measure>Number of sessions delivered for each program</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
    </primary_outcome>
    <primary_outcome>
      <measure>Length of the sessions delivered</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
    </primary_outcome>
    <primary_outcome>
      <measure>Individual-level attendance data for programs delivered</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
    </primary_outcome>
    <primary_outcome>
      <measure>Body mass index (BMI)</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
      <description>Weight will be measured with a scale (in pounds), and height will be measured using a stadiometer (in inches). Weight and height will be combined to report BMI as follows, BMI = (weight (lb)/height (inches)2) x 703.</description>
    </primary_outcome>
    <primary_outcome>
      <measure>Concentration of subdermal carotenoids</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
      <description>The concentration of subdermal carotenoids will assess the changes in fruit and vegetable consumption using the Veggie Meter: A non-invasive, portable machine that measures subdermal carotenoid levels using resonance Raman spectroscopy.</description>
    </primary_outcome>
    <primary_outcome>
      <measure>Physical fitness capacity estimation</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
      <description>Physical fitness will be measured using the FitnessGram PACER multistage aerobic capacity test: Children will run back and forth 20 meters, with an initial running speed of 8.5 km/hour and a progressive 0.5-km/hour increase in running speed every minute. As the test continues it becomes progressively harder. The number of laps completed is used to estimate children's physical fitness physical fitness.</description>
    </primary_outcome>
    <secondary_outcome>
      <measure>Blood pressure level</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
      <description>Blood pressure (systolic and diastolic) will be measured with two numbers using an automated Omron sphygmomanometer.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Concentration of blood glucose</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
      <description>Glucose will be measured using a portable CardioChek Plus analyzer to assess a single capillary blood sample following an overnight fast.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Waist circumference</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
      <description>Waist circumference will be measured at the midpoint between the floating rib and iliac crest using a tape measure.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Concentration of HDL cholesterol</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
      <description>HDL-C will be measured using a portable CardioChek Plus analyzer to assess a single capillary blood sample following an overnight fast.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Concentration of serum triglycerides</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
      <description>Triglycerides will be measured using a portable CardioChek Plus analyzer to assess a single capillary blood sample following an overnight fast.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Height</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
      <description>Height will be measured using a stadiometer in inches.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Weight</measure>
      <time_frame>Baseline, 9 months (immediate post intervention)</time_frame>
      <description>Weight will be measured with a scale in pounds.</description>
    </secondary_outcome>
    <number_of_arms>8</number_of_arms>
    <enrollment type="Anticipated">800</enrollment>
    <condition>Cardiovascular Diseases</condition>
    <condition>Physical Activity</condition>
    <condition>Nutrition</condition>
    <arm_group>
      <arm_group_label>Mentoring Program</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Participants in this group will receive the Mentoring Program strategy in addition to Healthy School Recognized Campus.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Enhanced Resources</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Participants in this group will receive the Enhanced Resources strategy in addition to Healthy School Recognized Campus.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Enhanced Engagement</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Participants in this group will receive the Enhanced Engagement strategy in addition to Healthy School Recognized Campus.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>No Intervention</arm_group_label>
      <arm_group_type>No Intervention</arm_group_type>
      <description>All schools will participate in the HSRC initiative. The requirements for the initiative are to complete a school-wide walking program, 1 youth, and 1 adult program from a list of available programs that make up the initiative.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Mentoring + Enhanced Resources</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Participants in this group will receive the Mentoring Program and Enhanced Resources strategies in addition to Healthy School Recognized Campus.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Mentoring + Enhanced Engagement</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Participants in this group will receive the Mentoring Program and Enhanced Engagement strategies in addition to Healthy School Recognized Campus.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Enhanced Resources + Enhanced Engagement</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Participants in this group will receive the Enhanced Resources and Enhanced Engagement strategies in addition to Healthy School Recognized Campus.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Mentoring + Enhanced Resources + Enhanced Engagement</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Participants in this group will receive the Mentoring Program, Enhanced Resources, and Enhanced Engagement strategies in addition to Healthy School Recognized Campus.</description>
    </arm_group>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>Mentoring Program</intervention_name>
      <description>Schools in this group will participate in meetings and discussion boards and receive newsletters to help with program implementation.</description>
      <arm_group_label>Mentoring Program</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>Enhanced Resources</intervention_name>
      <description>Schools in this group will receive extra resources such as program incentives to aid in program implementation.</description>
      <arm_group_label>Enhanced Resources</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>Enhanced Engagement</intervention_name>
      <description>Schools in this group will participate in program contests to aid program implementation.</description>
      <arm_group_label>Enhanced Engagement</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>Mentoring + Enhanced Resources</intervention_name>
      <description>Schools in this group will participate in meetings and discussion boards and receive newsletters to help with program implementation. They will also receive extra resources such as program incentives to aid in program implementation.</description>
      <arm_group_label>Mentoring + Enhanced Resources</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>Mentoring + Enhanced Engagement</intervention_name>
      <description>Schools in this group will participate in meetings and discussion boards and receive newsletters to help with program implementation. They will also participate in program contests to aid program implementation.</description>
      <arm_group_label>Mentoring + Enhanced Engagement</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>Enhanced Resources + Enhanced Engagement</intervention_name>
      <description>Schools in this group will receive extra resources such as program incentives to aid in program implementation. They will also participate in program contests to aid program implementation.</description>
      <arm_group_label>Enhanced Resources + Enhanced Engagement</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>Mentoring + Enhanced Resources + Enhanced Engagement</intervention_name>
      <description>Schools in this group will participate in meetings and discussion boards and receive newsletters to help with program implementation. They will also receive extra resources such as program incentives to aid in program implementation. They will also participate in program contests to aid program implementation.</description>
      <arm_group_label>Mentoring + Enhanced Resources + Enhanced Engagement</arm_group_label>
    </intervention>
    <eligibility>
      <criteria>
        <textblock>
          School Inclusion Criteria:&#xD;
  &#xD;
            -  located in North and East Texas&#xD;
  &#xD;
            -  Public elementary school&#xD;
  &#xD;
          Student Inclusion Criteria&quot;&#xD;
  &#xD;
            -  at least 10 years old by September 1, 2023 (2024 for the 2024-2025 school year)&#xD;
  &#xD;
            -  enrolled in the 5th or 6th grade&#xD;
  &#xD;
            -  able to read, speak, and write in English&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            -  any motor or cognitive impairments or other health conditions that would prevent them&#xD;
               from completing a physical assessment&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>10 Years</minimum_age>
      <maximum_age>14 Years</maximum_age>
      <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
    </eligibility>
    <overall_official>
      <last_name>Jacob Szeszulski, PhD</last_name>
      <role>Principal Investigator</role>
      <affiliation>Texas A&amp;M AgriLife</affiliation>
    </overall_official>
    <overall_contact>
      <last_name>Jacob Szeszulski, PhD</last_name>
      <phone>972-952-9202</phone>
      <email>jacob.szeszulski@ag.tamu.edu</email>
    </overall_contact>
    <verification_date>June 2023</verification_date>
    <study_first_submitted>July 24, 2023</study_first_submitted>
    <study_first_submitted_qc>August 2, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">August 7, 2023</study_first_posted>
    <last_update_submitted>August 2, 2023</last_update_submitted>
    <last_update_submitted_qc>August 2, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">August 7, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Sponsor</responsible_party_type>
    </responsible_party>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Cardiovascular Diseases</mesh_term>
    </condition_browse>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT05977959
  org study id: AHA HSRC
  nct id: NCT05977959
  lead sponsor: 
  collaborator: 
  is fda regulated drug: No
  is fda regulated device: No
  Healthy School Recognized Campus is a Texas A&M AgriLife Extension initiative that supports
        the delivery of school-based physical activity and nutrition programs for diverse youth
        across Texas. The purpose of this study is to improve the delivery of these programs and
        optimize the effect they have on youth's cardiovascular risk factors.
  The investigators will conduct a group randomized factorial trial using the Multiphase
        Optimization STrategy (MOST) framework to evaluate the impact (i.e., implementation and
        effectiveness) of three implementation strategies on program implementation and youth's
        cardiovascular disease risk. HSRC is a Texas A&M AgriLife Extension initiative that supports
        the delivery of school-based physical activity and nutrition programs.
  
        Elementary schools in North and East Texas (n=16) of similar socio-economic status will be
        randomized at baseline to receive either 3, 2, 1, or no strategies to support HSRC program
        implementation. All schools will participate in HSRC during the full school year.
  
        The investigators hypothesize that one strategy will result in significantly greater HSRC
        implementation and effectiveness than the other strategies tested.
  allocation: Randomized
  intervention model: Factorial Assignment
  primary purpose: Prevention
  masking: None (Open Label)
  measure: Presence or absence of metabolic syndrome (MetS)
  time frame: Baseline, 9 months (immediate post intervention)
  description: MetS is present after identifying abdominal obesity plus at least two of the four other MetS Risk factors: high blood pressure, high blood sugar, low HDL cholesterol, and high triglyceride levels.
  MetS = (abdominal obesity) + (2 of 4 other MetS Risk factors)
  Measures to determine MetS risk factors:
  Abdominal obesity: waist circumference >90th percentile for child's sex and age
  High blood pressure: systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥90 mmHg)
  High blood glucose: blood glucose ≥5.6 mmol/L or known diabetes
  Low HDL cholesterol: HDL cholesterol <1.03 mmol/L
  High triglyceride level: Triglyceride level ≥ 1.7mmol/L
  measure: Change in the number of MetS risk factors
  time frame: Baseline, 9 months (immediate post intervention)
  description: Change in the number of MetS risk factors = (new # of MetS risk factors) - (original # of MetS risk factors)
  Measures to determine MetS risk factors:
  Abdominal obesity: waist circumference >90th percentile for child's sex and age
  High blood pressure: systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥90 mmHg)
  High blood glucose: blood glucose ≥5.6 mmol/L or known diabetes
  Low HDL cholesterol: HDL cholesterol <1.03 mmol/L
  High triglyceride level: Triglyceride level ≥ 1.7mmol/L
  measure: Number of programs schools delivered (in addition to Walk Across Texas)
  time frame: Baseline, 9 months (immediate post intervention)
  measure: Number of sessions delivered for each program
  time frame: Baseline, 9 months (immediate post intervention)
  measure: Length of the sessions delivered
  time frame: Baseline, 9 months (immediate post intervention)
  measure: Individual-level attendance data for programs delivered
  time frame: Baseline, 9 months (immediate post intervention)
  measure: Body mass index (BMI)
  time frame: Baseline, 9 months (immediate post intervention)
  description: Weight will be measured with a scale (in pounds), and height will be measured using a stadiometer (in inches). Weight and height will be combined to report BMI as follows, BMI = (weight (lb)/height (inches)2) x 703.
  measure: Concentration of subdermal carotenoids
  time frame: Baseline, 9 months (immediate post intervention)
  description: The concentration of subdermal carotenoids will assess the changes in fruit and vegetable consumption using the Veggie Meter: A non-invasive, portable machine that measures subdermal carotenoid levels using resonance Raman spectroscopy.
  measure: Physical fitness capacity estimation
  time frame: Baseline, 9 months (immediate post intervention)
  description: Physical fitness will be measured using the FitnessGram PACER multistage aerobic capacity test: Children will run back and forth 20 meters, with an initial running speed of 8.5 km/hour and a progressive 0.5-km/hour increase in running speed every minute. As the test continues it becomes progressively harder. The number of laps completed is used to estimate children's physical fitness physical fitness.
  measure: Blood pressure level
  time frame: Baseline, 9 months (immediate post intervention)
  description: Blood pressure (systolic and diastolic) will be measured with two numbers using an automated Omron sphygmomanometer.
  measure: Concentration of blood glucose
  time frame: Baseline, 9 months (immediate post intervention)
  description: Glucose will be measured using a portable CardioChek Plus analyzer to assess a single capillary blood sample following an overnight fast.
  measure: Waist circumference
  time frame: Baseline, 9 months (immediate post intervention)
  description: Waist circumference will be measured at the midpoint between the floating rib and iliac crest using a tape measure.
  measure: Concentration of HDL cholesterol
  time frame: Baseline, 9 months (immediate post intervention)
  description: HDL-C will be measured using a portable CardioChek Plus analyzer to assess a single capillary blood sample following an overnight fast.
  measure: Concentration of serum triglycerides
  time frame: Baseline, 9 months (immediate post intervention)
  description: Triglycerides will be measured using a portable CardioChek Plus analyzer to assess a single capillary blood sample following an overnight fast.
  measure: Height
  time frame: Baseline, 9 months (immediate post intervention)
  description: Height will be measured using a stadiometer in inches.
  measure: Weight
  time frame: Baseline, 9 months (immediate post intervention)
  description: Weight will be measured with a scale in pounds.
  arm group label: Mentoring Program
  arm group type: Experimental
  description: Participants in this group will receive the Mentoring Program strategy in addition to Healthy School Recognized Campus.
  arm group label: Enhanced Resources
  arm group type: Experimental
  description: Participants in this group will receive the Enhanced Resources strategy in addition to Healthy School Recognized Campus.
  arm group label: Enhanced Engagement
  arm group type: Experimental
  description: Participants in this group will receive the Enhanced Engagement strategy in addition to Healthy School Recognized Campus.
  arm group label: No Intervention
  arm group type: No Intervention
  description: All schools will participate in the HSRC initiative. The requirements for the initiative are to complete a school-wide walking program, 1 youth, and 1 adult program from a list of available programs that make up the initiative.
  arm group label: Mentoring + Enhanced Resources
  arm group type: Experimental
  description: Participants in this group will receive the Mentoring Program and Enhanced Resources strategies in addition to Healthy School Recognized Campus.
  arm group label: Mentoring + Enhanced Engagement
  arm group type: Experimental
  description: Participants in this group will receive the Mentoring Program and Enhanced Engagement strategies in addition to Healthy School Recognized Campus.
  arm group label: Enhanced Resources + Enhanced Engagement
  arm group type: Experimental
  description: Participants in this group will receive the Enhanced Resources and Enhanced Engagement strategies in addition to Healthy School Recognized Campus.
  arm group label: Mentoring + Enhanced Resources + Enhanced Engagement
  arm group type: Experimental
  description: Participants in this group will receive the Mentoring Program, Enhanced Resources, and Enhanced Engagement strategies in addition to Healthy School Recognized Campus.
  intervention type: Behavioral
  intervention name: Mentoring Program
  description: Schools in this group will participate in meetings and discussion boards and receive newsletters to help with program implementation.
  arm group label: Mentoring Program
  intervention type: Behavioral
  intervention name: Enhanced Resources
  description: Schools in this group will receive extra resources such as program incentives to aid in program implementation.
  arm group label: Enhanced Resources
  intervention type: Behavioral
  intervention name: Enhanced Engagement
  description: Schools in this group will participate in program contests to aid program implementation.
  arm group label: Enhanced Engagement
  intervention type: Behavioral
  intervention name: Mentoring + Enhanced Resources
  description: Schools in this group will participate in meetings and discussion boards and receive newsletters to help with program implementation. They will also receive extra resources such as program incentives to aid in program implementation.
  arm group label: Mentoring + Enhanced Resources
  intervention type: Behavioral
  intervention name: Mentoring + Enhanced Engagement
  description: Schools in this group will participate in meetings and discussion boards and receive newsletters to help with program implementation. They will also participate in program contests to aid program implementation.
  arm group label: Mentoring + Enhanced Engagement
  intervention type: Behavioral
  intervention name: Enhanced Resources + Enhanced Engagement
  description: Schools in this group will receive extra resources such as program incentives to aid in program implementation. They will also participate in program contests to aid program implementation.
  arm group label: Enhanced Resources + Enhanced Engagement
  intervention type: Behavioral
  intervention name: Mentoring + Enhanced Resources + Enhanced Engagement
  description: Schools in this group will participate in meetings and discussion boards and receive newsletters to help with program implementation. They will also receive extra resources such as program incentives to aid in program implementation. They will also participate in program contests to aid program implementation.
  arm group label: Mentoring + Enhanced Resources + Enhanced Engagement
  criteria: 
  gender: All
  minimum age: 10 Years
  maximum age: 14 Years
  healthy volunteers: Accepts Healthy Volunteers
  last name: Jacob Szeszulski, PhD
  role: Principal Investigator
  affiliation: Texas A&M AgriLife
  last name: Jacob Szeszulski, PhD
  phone: 972-952-9202
  email: jacob.szeszulski@ag.tamu.edu
  responsible party type: Sponsor
  mesh term: Cardiovascular Diseases