PT  - JOURNAL ARTICLE
AU  - DeBar, Lynn L.
AU  - Stevens, Victor J.
AU  - Perrin, Nancy
AU  - Wu, Philip
AU  - Pearson, John
AU  - Yarborough, Bobbi Jo
AU  - Dickerson, John
AU  - Lynch, Frances
TI  - A Primary Care–Based, Multicomponent Lifestyle Intervention for Overweight Adolescent Females
AID  - 10.1542/peds.2011-0863
DP  - 2012 Feb 01
TA  - Pediatrics
PG  - peds.2011-0863
4099  - http://pediatrics.aappublications.org/content/early/2012/02/08/peds.2011-0863.short
4100  - http://pediatrics.aappublications.org/content/early/2012/02/08/peds.2011-0863.full
AB  - 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.Abbreviations:HMO — health maintenance organizationPCP — primary care providerPedsQL — Pediatric Quality of Life Inventory–Child ReportPHQ-A — Patient Health Questionnaire for AdolescentsQEWP-A — Questionnaire of Eating and Weight Patterns–Adolescent Version