A Primary Care–Based, Multicomponent Lifestyle Intervention for Overweight Adolescent Females
BACKGROUND AND OBJECTIVE: Most clinic-based weight control treatments for youth have been designed for preadolescent children by using family-based care. However, as adolescents become more autonomous and less motivated by parental influence, this strategy may be less appropriate. This study evaluated a primary care–based, multicomponent lifestyle intervention specifically tailored for overweight adolescent females.
METHODS: Adolescent girls (N = 208) 12 to 17 years of age (mean ± SD: 14.1 ± 1.4 years), with a mean ± SD BMI percentile of 97.09 ± 2.27, were assigned randomly to the intervention or usual care control group. The gender and developmentally tailored intervention included a focus on adoptable healthy lifestyle behaviors and was reinforced by ongoing feedback from the teen’s primary care physician. Of those randomized, 195 (94%) completed the 6-month posttreatment assessment, and 173 (83%) completed the 12-month follow-up. The primary outcome was reduction in BMI z score.
RESULTS: The decrease in BMI z score over time was significantly greater for intervention participants compared with usual care participants (−0.15 in BMI z score among intervention participants compared with −0.08 among usual care participants; P = .012). The 2 groups did not differ in secondary metabolic or psychosocial outcomes. Compared with usual care, intervention participants reported less reduction in frequency of family meals and less fast-food intake.
CONCLUSIONS: A 5-month, medium-intensity, primary care–based, multicomponent behavioral intervention was associated with significant and sustained decreases in BMI z scores among obese adolescent girls compared with those receiving usual care.
- HMO —
- health maintenance organization
- PCP —
- primary care provider
- PedsQL —
- Pediatric Quality of Life Inventory–Child Report
- PHQ-A —
- Patient Health Questionnaire for Adolescents
- QEWP-A —
- Questionnaire of Eating and Weight Patterns–Adolescent Version
- Accepted November 9, 2011.
- Copyright © 2012 by the American Academy of Pediatrics