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The Military Teenagers’ Environments, Exercise, and Nutrition Study (M-TEENS) is a joint initiative between the University of Southern California (USC) and RAND Corporation. The project examines how the food and physical activity environments in military children’s schools and neighborhoods influence their diet, physical activity, sedentary behaviors, and body weight. This study will help us learn more about what factors influence the health and well-being of military children.
M-TEENS is unique because it follows military children and their families over multiple years as they transition across installations. By collecting data over time and geographic locations, we can learn more about the changing environments faced by military children and their families and how those environments affect children’s health behaviors and outcomes. This is a critical first step in developing policies and programs designed to help military families stay healthy.
We will be sending out online surveys starting in November. Once your family completes the online surveys, we will be setting up appointments for self-body composition measurements through videoconference using Skype. Payments will be made in the form of e-gift cards for the surveys and body composition measurements and will be sent to your email.
About M-TEENS
During 2013 and 2014 M-TEENS recruited U.S. Army families living within the Continental United States with at least one child born between April 1, 1999 and March 31, 2001 who attended a public or DoD-run (DoDEA) school. Army personnel received an email inviting them to participate and providing instructions for how to begin the enrollment process. Within each family, one parent/guardian and one child independently completed an online survey. If preferred, parents and children could fill out a paper copy and mail the completed survey back using a self-addressed stamped envelope provided by the study.
Over the past four years, M-TEENS has surveyed over 1,500 military families. This Fall 2017, we will be reaching out to these families and will be asking them to complete follow-up surveys. Additionally, M-TEENS will be conducting videoconferences through Skype to measure the height, weight, and waist circumference of participating parents and teens. Following these families over a three year period will help us understand how military children’s diet and physical activity can change over time.
USC and RAND will analyze survey information and measurements to describe the food and physical activity environments in the children’s schools and neighborhoods and evaluate how the characteristics of those environments influence their diet, physical activity, sedentary behaviors, and body weight. Outcomes of particular interest include:
- Participation in physical activity and the location of those activities
- Participation in sedentary behaviors
- Eating behaviors including frequency of intake of selected foods and beverages
- Body composition measures such as BMI, waist circumference, and body fat.
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Many characteristics set M-TEENS apart from other studies:
- This study uses a large sample of Army enlisted families across multiple installations within the Continental United States.
- Data are collected from multiple informants within each participating family (one parent/guardian and one teen).
- Collecting data from the same respondents over multiple years allows us to describe the changes in environments that result from Permanent Change of Station (PCS) moves and their impact on children’s body weight and related behaviors.
- We select families of enlisted Army personnel based on their having a child in the appropriate age group and based on the likelihood of a PCS move
- The study will examine environments related to food and physical activity in a variety of contexts including the child’s school, home, and neighborhood.
M-TEENS uses standard and validated measures (where available) that will enable comparison with other study samples. This study assesses a wide range of outcomes including:
- Participation in physical activity as well as the intensity and location of those activities,
- Participation in sedentary behaviors,
- Eating behaviors including frequency of intake for specific food and beverage items, and
- Body composition measures such as body mass index (BMI) and percent fat.
M-TEENS is funded by the National Institutes of Health, U.S. Department of Health and Human Services and conducted by the University of Southern California (USC) and RAND Corporation, an independent research organization. The study is led by Ashlesha Datar and Nancy Nicosia.
For more information, read the Frequently Asked Questions (FAQ).
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For General Information
Email: mteenshelp@usc.edu
Phone: 1-213-740-4429Mailing Address
University of Southern California
635 Downey Way, Suite 305
Los Angeles, CA 90089-3332 -
Between 2013-2015, M-TEENS surveyed more than 1500 Army families. If your family completed a M-TEENS parent or child survey between 2013-2015, you are eligible to participate in the M-TEENS 2019-2020 follow-up. Please visit our Frequently Asked Questions (FAQ) to learn more about your participation this year.
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What is M-TEENS?
M-TEENS, which stands for the Military Teenagers’ Environments, Exercise, and Nutrition Study, is a joint initiative between USC and RAND Corporation that examines how the food and physical activity environments in military children’s schools and neighborhoods influence their diet, physical activity, sedentary behaviors, and body weight. While there is a considerable research examining relationships among civilians, very little is known about these relationships among military children. M-TEENS will help policymakers understand how food and physical activity environments can be modified to promote healthy behaviors and reduce childhood obesity in military families. M-TEENS is funded by the National Institutes of Health.
Who can participate in M-TEENS?
In 2013 and 2014, a sample of Army families with at least one child who was born between April 1, 1999 and March 31, 2001 were selected to participate. These families were asked to complete an online parent and child survey, as well as the child body composition measurements. This year we will be following-up with families that previously participated in 2013-2015. Therefore, if your family has completed a M-TEENS parent or child survey during that time, you can participate in M-TEENS 2019-2020.
How do I know if my family has been selected to participate?
If your family was selected in 2013/2014, the Army enlisted parent received an email in their AKO email with details about how to confirm your family’s eligibility. This year, emails will be sent to the enlisted parent’s AKO email as well as the preferred email address each family provided.
Can my child still participate if they no longer live at home?
Yes. As long as the child participating is the same child that was initially involved in 2013-2015, they will still be eligible to participate regardless of where they currently live (e.g. if they moved away for college).
Why is this study being conducted?
The study is being conducted in order to better understand how the food and physical activity environments where children spend their time influence their activity, diet and body composition. The goal of the study is to help policymakers understand how food and physical activity environments can be modified to promote healthy behaviors and reduce childhood obesity in military families.
Who is funding the study?
The study is being funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, which is part of the National Institutes of Health. This study is also being funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), grant number 1R01DK111169-01A1.
Does the Army support the study?
Yes, the study has the full support of the Army. Senior Army officials have approved and endorsed this study.
What does participation involve?
Participation is simple. There are two short web-based surveys: one for you as the parent/guardian and one for your child. Please ensure that the child completing this year’s survey is the same child that previously participated in 2013-2015. Each survey will take about 30-40 minutes to complete.
In addition, you and your child will be asked to participate in self-body composition measurements through videoconference with one of our staff members as they guide you through the process of measuring you and your child’s height, weight, percent body fat, and waist circumference. The videoconference measurement will take about 30 minutes. If your child no longer lives at home, you will each need to have another person (peer, spouse, neighbor, etc.) take each of your body composition measurements. This individual will also be compensated with a single e-gift card for their time and participation.
What kind of information will you be collecting?
We will ask one parent/guardian and one child from each family questions about themselves, their families, diet, and activities. We are particularly interested in how families respond to the various aspects of their food and physical activity environments. Remember, your participation in this study is completely confidential and entirely voluntary; you can refuse any question at any time, for any reason.
How can I be sure that my answers will remain confidential?
Your privacy and confidentiality are important to us, and we take a number of steps to make sure your answers remain confidential:
- Outside your family, only a select number of people working on this study will know whether you agree or refuse to participate. USC and RAND will use the information you provide for research purposes only and will not disclose your identity or information that identifies you to anyone outside of the project team. While the study has the support of the Army, the research team does not include any Army or DoD staff.
- We do need your name and contact information so we can reach you for the next interview, but your name and contact information are always kept separate from your survey responses.
- In our report, we will only show group responses and will not report information from any individual alone.
- After the study (about a year after the final interview), your name and other personal data will be destroyed, so there will be no chance of anyone linking you to your answers or to the study.
How long will the survey and assessments take?
Both the parent/guardian survey and the child survey should take 30 minutes to complete. You and your child may complete the survey online or you may complete it on a paper copy and mail it back using a self-addressed stamped envelope provided by the study. The body composition measurements will take 30 minutes.
Are there any benefits to participating in M-TEENS?
There are many reasons to participate in M-TEENS:
- In recognition of your family’s time and participation, your family will receive between $170 and $200 in e-gift cards. Parents will receive $50 for completing the parent survey. Teens will receive $40 for completing the child survey. Depending on choices made in the survey, both parent and teen have the chance to earn an additional $10-$25 each. Both the parent and teen will receive an additional $30 for completing the body composition measurements.
- Every family has a unique experience and faces unique challenges. This is an opportunity to have your thoughts and opinions added to the collective voice. No one knows better than you about how environments to which military families are exposed as a result of Permanent Change of Station moves influence your family’s health and well-being.
- This study represents an important opportunity to improve our understanding of how food and physical activity environments influence children’s health and well-being, particularly among military children. Our study will help policymakers understand how food and physical activity environments can be modified to promote healthy behaviors and reduce childhood overweight and obesity in military families.
We don’t have a computer; can we still be in the study?
It isn’t necessary to have your own computer in order to be in M-TEENS. Participants will be able to log in using any computer that has Internet access, like one at your public library, using the PIN we assign to you. If you aren’t comfortable using a computer, you may complete a hard copy version of the survey and mail it back to us.
What if you ask me questions that I just don’t want to answer?
You are free to refuse or skip any questions you don’t want to answer. You can do this at any time, for any reason, and without any penalty.
Why is it important to collect all three measurements?
The three measurements (height, weight, and waist circumference) capture different aspects of body composition. Height and weight will be used to calculate each child’s BMI. While very commonly used, body mass index is not always the most reliable indicator of healthy weight. For example, it makes no allowance for the relative proportions of bone, muscle and fat in the body. Because each measurement has its own strengths and weaknesses, the combination of BMI and waist circumference provides a more comprehensive assessment of body composition.
What should my child wear to be measured?
Ideally, children should wear lightweight, loose fitting clothing for the measurements. We suggest that children empty their pockets and remove hats, belts and heavy jewelry for the weight measurement. We also suggest that shoes be removed for the weight and height measurements. Hair accessories and coverings should also be removed if they interfere with measurements. These guidelines ensure standardized measurements, however, children may opt to keep these items on during measurement.
What if I am not comfortable with a particular body measurement?
If you are not comfortable with a particular measurement, you have the right to refuse the measurement at any time. If you have any questions about a specific measurement or procedure, we encourage you to ask us by sending us an email at mteenshelp@usc.edu. Refusing a particular measurement will not affect your participation in the study or eligibility for incentives.
What does my child’s BMI mean?
BMI is not interpreted the same way for children and teens as it is for adults. BMI age- and sex-specific percentiles are used for children and teens because the amount of body fat changes with age and the amount of body fat differs between girls and boys. Therefore, the interpretation of BMI for children and teens is both age- and sex-specific. The CDC BMI-for-age growth charts take into account these differences and translate a BMI number into a percentile for a child’s sex and age.
If I decide to quit the study, is someone going to start calling me all the time to get me to re-enroll?
If we are unable to reach you for the follow-up survey, we will try to contact you by phone, email, or letter to give you the opportunity to continue in the study if you wish to do so. We will respect whatever decision you make about participating, and you can change your mind at any time.
What is USC?
The University of Southern California (USC) is a private research university located in Los Angeles, California. Since the institution was founded in 1880 it has become a renowned center for academics and interdisciplinary research with over 50 research centers specializing in subjects which include health and medicine, social sciences, engineering, and technology.
What is RAND?
The RAND Corporation is a nonprofit institution that helps improve policy and decision-making through research and analysis. RAND began in 1946 as a research project (Project Rand) backed by a single client, the U.S. Army Air Forces. The project was developed at Douglas Aircraft in Santa Monica, California. In 1948, with Ford Foundation support, RAND became an independent, nonprofit research institution committed to exploring the most complex and consequential problems facing our society.
Who can I contact with questions about the study?
If you have any questions about the study, please see above for our Contact information.
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Ashlesha Datar, Ph.D. (Senior Economist, USC) – Principal Investigator
Nancy Nicosia, Ph.D. (Senior Economist, RAND)Bonnie Ghosh Dastidar, Ph.D. (Senior Statistician, RAND)Ann Haas, M.S. (Statistical Analyst, RAND)Lisa Kraus, M.S. (GIS Programmer, RAND)Andrea Richardson, Ph.D. (Nutritional Epidemiologist, RAND)Anya Samek, Ph.D. (Behavioral/Experimental Economist, USC)Project Manager
Leah McConnell
Benefits
There are many reasons for families to participate in M-TEENS.
In recognition of your family’s time and participation, your family will receive between $170 and $200 in e-gift cards. Parents will receive $50 for completing the parent survey. Teens will receive $40 for completing the child survey. Depending on choices made in the survey, both parent and teen have the chance to earn an additional $10-$25 each. Both the parent and teen will receive an additional $30 for completing the body composition measurements.
Every family has a unique experience and faces unique challenges. This is an opportunity to have your thoughts and opinions added to the collective voice. No one knows better than you about how environments to which military families are exposed as a result of Permanent Change of Station moves influence your family’s health and well-being.
This study represents an important opportunity to improve our understanding of how food and physical activity environments influence children’s health and well-being, particularly among military children. Our study will help policymakers understand how food and physical activity environments can be modified to promote healthy behaviors and reduce childhood overweight and obesity in military families.
Letters of Support
Senior military officials have approved and endorsed M-TEENS. View the following letters from military leadership expressing their support for this study:
Publications
Samek, A., Gray, A., Datar, A., & Nicosia, N. Adolescent time and risk preferences: Measurement, determinants and field consequences. Journal of Economic Behavior & Organization, 2021-02-27, Volume 184, Pages 460-488.
Summary: The literature on economic preferences in adolescents is relatively new and limited. This study aims to fill that gap by exploring economic time and risk preferences in a group of 16-19 year old adolescents. This study explores not only the overall association between surveyed time/risk preferences and real monetary rewards, but also heterogeneities across gender, race/ethnicity, and within child-parent relationships. Some findings of this study show that girls are overall less risk seeking and more patient than boys, while black adolescents are less risk seeking and more impatient than white or Hispanic adolescents. Furthermore, this study found that parents preferences are strongly predictive of those in their children, and that having more patience is significantly associated with lower BMI as well as other positive health behaviors (lower sedentary activities, more physical activity, etc.).
Nicosia, N., & Datar, A. The impact of state policies for school-based BMI/fitness assessments on children’s BMI outcomes in rural versus urban schools: Evidence from a natural experiment. Preventive Medicine, 2020-10-06, Volume 141. Article 106257
Summary: Childhood obesity continues to be one of the most prevalent and concerning public health issues. As children typically spend most of their time and eat the majority of their meals at school, state-led school policies to combat obesity (such as measuring BMI and fitness) have become more common. To evaluate the effects of these policies on childhood obesity, this study leveraged the natural experiment of military family assignments to look at children’s BMI and obesogenic behaviors in rural and urban locations. This study found that school policies were associated with lower odds of both overweight and being at-risk of overweight in rural, but not urban, schools. This study also found that children in rural schools with obesity-prevention policies had greater activity levels and lower intake of unhealthy foods. Overall, school policies to combat obesity were found to be effective for children attending rural, but not urban schools.
Ghosh-Dastidar, M., Nicosia, N., Datar A. A novel approach to anthropometric assessment for geographically dispersed samples: A pilot study. Preventive Medicine, 2020-09-01, Volume 19, Article 101125.
Summary: While collecting in-person measurements is typically thought to be best practice for assessing body mass index (BMI) and obesity, the cost and practicality of this approach creates significant barriers. In this pilot study of a geographically dispersed sample, the validity of videoconference-assisted measurements (VCAM) was tested against a sample of individuals who were measured in-person. Results from this in-person and staff-assisted VCAM comparison showed a small magnitude of difference and high agreement, suggesting that the two measurement approaches produce similar values. These findings, therefore, suggest that body composition measurements can be valid when collected using a VCAM approach, and that this approach may be more cost-effective for geographically dispersed samples.
Datar A., Mahler A., Nicosia N. Association of Exposure to Communities With High Obesity With Body Type Norms and Obesity Risk Among Teenagers. JAMA Netw Open. 2020-03-16;3(3):e200846. doi:10.1001/jamanetworkopen.2020.0846.
Summary: Previous research has clearly shown that obesity clusters within geographic and social networks. The main cause of this clustering – whether it be shared environments, homophily, or social contagion – remains undefined. Because military families are often assigned to specific installations, their exposure to communities creates a unique opportunity for a natural experiment. To add to existing literature on obesity, therefore, we analyzed and compared data collected from military families to county-level obesity rates. Results from this analysis show that teenagers’ who are exposed to higher obesity rates were associated with selecting an ‘Ideal Body Type’ that was more overweight or at-risk of overweight. This suggests that exposure to obesity may normalize higher weight status among children and teenagers.
Nicosia, N., Datar A. Neighborhood Environments and Physical Activity: A Longitudinal Study of Adolescents in a Natural Experiment. American Journal of Preventive Medicine. 2018; 54(5):671-678.
Summary: Existing literature on the relationship between physical activity and environment is limited, as most studies rely on methods easily confounded by selection bias. This study, therefore, adds an important piece to the existing literature by using natural experimental evidence to explore how physical activity in adolescents is impacted by physical activity environments. Adolescent physical activity data was collected from the Military Teenagers’ Environment Exercise and Nutrition Study, which includes multiple measures of self-reported exercise, while the neighborhood environment was constructed using GIS methods. Results found a significant and positive association between opportunities for physical activity in the neighborhood environment and levels of vigorous physical activity among adolescents. These findings not only suggest that age is a crucial consideration for addressing obesity, but also provide strong evidence to support increasing physical activity opportunities in neighborhood environments to increase physical activity in adolescents.
Datar A, Nicosia N. Assessing Social Contagion in Body Mass Index, Overweight, and Obesity Using a Natural Experiement. JAMA Pediatrics. 2018; 172(3):239-246.
Summary: This study aims to determine whether exposure to communities with higher rates of obesity increases the body mass index (BMI) of individuals and their risk of being overweight or obese. Also, whether social contagion, shared environments, or self-selection can account for these identified differences. Using data collected by the Military Teenagers’ Environments, Exercise, and Nutrition Study, families from 38 military installations around the United States were examined to determine if individuals had higher BMI and greater odds of overweight and obesity when assigned to installations in counties with higher rates of obesity. Study participants included 1 parent and 1 child aged 12 or 13 years from 1519 families of Army-enlisted personnel. We conclude that exposure to counties with higher rates of obesity was associated with higher BMI and higher odds of overweight and/or obesity in both parents and children, and this may suggest the presence of social contagion.
Nicosia N, Datar A. The Effect of State Competitive Food and Beverage Regulations on Childhood Overweight and Obesity. Journal of Adolescent Health. May 2017; 60(5):520-527.
Summary: Policy efforts for combating childhood obesity have sought stronger state policies for regulating competitive foods and beverages (CF&Bs) available in schools. However, the evidence linking state policies to children’s overall diet and body weight outcomes is limited and mixed, and experts have called for more rigorous studies that are able to address concerns about selection bias. The present study leverages a rare natural experiment where children in military families are “assigned” to different state policies, due to their military parent’s periodic relocation, to examine whether state CF&B policies were associated with children’s body mass index (BMI) and overweight or obesity. We analyzed data from 894 12- and 13- year old children in army families and found that, compared to no policy, having strong or weak state policies was significantly associated with lower BMI, lower odds of overweight or obesity, and better dietary outcomes. Therefore, we conclude that multiple strong CF&B policies is likely needed to observe any meaningful changes in BMI and obesity.
Ghosh-Dastidar B, Haas A, Nicosia N, Datar A. Accuracy of BMI Correction Using Multiple Reports in Children. BMC Obesity. 2016; 3(37).
Summary: Body mass index (BMI) has become the most common indicator to assess obesity, and while objective measurements are more accurate than self- or proxy-reports of BMI, they are sometimes infeasible. This study examines the accuracy of using multiple reports of BMI using reported height and weight from children’s self-reports and their parents’ reports. We conclude that using multiple reports of height and weight and BMI correction models maybe a cost-effective and practical solution to the bias of self-reported BMI measurements.
Nicosia N, Wong E, Shier V, Massachi S, Datar A. Parent Deployment, Adolescents’ Academic and Social-Behavioral Adjustment, and Parent’s Psychological Well-Being in Military Families. Public Health Reports. 2015.
Summary: Increases in the frequency and length of military deployments have raised concerns about the well-being of military families. We examined the relationship between a military parent’s deployment and (1) adolescent academic and social behavioral maladjustment and (2) parental psychological well-being. Using data from April 2013 to January 2014 and 1021 US Army families with children aged 12 or 13, we found that long deployments (>180 days in the past 3 years) were associated with adolescents’ academic and social-behavioral maladjustments and diminished parental well-being, especially among boys and military fathers.
Shier V, Nicosia N, Datar A. Neighborhood and home food environment and children’s diet and obesity: Evidence from military personnel’s installation assignment. Soc Sci Med. 2015.
Summary: Research and policy initiatives are increasingly focused on the role of neighborhood food environment in children’s diet and obesity. However, existing evidence relies on observational data that is limited by neighborhood selection bias. The Military Teenagers’ Environments, Exercise, and Nutrition Study (M- TEENS) leverages the quasi-random variation in neighborhood environment generated by military personnel’s assignment to installations to examine whether neighborhood food environments are associated with children’s dietary behaviors and BMI. Our results suggest that neither the actual nor the perceived availability of particular food outlets in the neighborhood is associated with children’s diet or BMI. However, the healthiness of food available at home was associated with healthy dietary behaviors while eating at fast food outlets and restaurants were associated with unhealthy dietary behaviors in children. Further, parental supervision, including limits on snack foods and meals eaten as a family, was associated with dietary behaviors. These findings suggest that focusing only on the neighborhood food environment may ignore important factors that influence children’s outcomes.
Datar A, Nicosia N, Wong E, Shier V. Neighborhood Environment and Children’s Physical Activity and Body Mass Index: Evidence from Military Personnel Installation Assignments. Childhood Obesity. April 2015; 11(2):130-138.
Summary: Obesity has become an epidemic in the United States, and this study aims to examine how a neighborhood environment influences an individual’s level of physical activity and subsequently their BMI. The natural experiment utilizes military families’ periodic relocation as a way to examine how different neighborhood environments could affect physical activity and BMI. Using data collected from 903 12- and 13-year old children in military families, we found that different features of the neighborhood environment were significant for off- versus on-post families, and conclude that efforts to increase children’s physical activity in military families should take into account the different neighborhood environment aspects that matter for children living on- versus off-post.