HIPTeens

Guide to Effective Programs
for Children and Youth

HIPTeens

OVERVIEW

HIPTeens is an interactive behavioral internet-based weight loss program aimed at African-American adolescent girls aged between 11-15 years old and one obese parent. Fifty seven adolescent girls were randomly assigned to enter into the interactive internet based program or a passive internet-based health program. In addition to behavioral counseling via email, the interactive program included self-monitoring of physical activity, diet, and weight. Participation in the interactive program for adolescent girls and parents resulted in weight loss during the first 6 months but did not yield long-term loss.

DESCRIPTION OF PROGRAM

Target population: African-American girls between 11-15 years of age who are at risk for chronic obesity. Risk for chronic obesity is defined as having a BMI >85^th percentile for girls aged 11-15 years old and with at least one obese biological parent (BMI >30).

The intervention is an internet-based interactive behavior therapy aimed at helping adolescents and their parent achieve reductions in body fat. The intervention provides nutrition education as well as behavior modification of lifestyle, eating, and physical activity habits of participants via a website specifically designed for the intervention. The intervention also includes face-to-face counseling sessions at Weeks 1, 3, 6, and 12 aimed at encouraging adherence to behavioral principles and providing additional training on use of computers to take advantage of numerous interactive components on the website.

Interactive nutritional education available from the website includes graphical tools for self-monitoring of weight and physical activity. Self-monitoring of food intake is also available on the website and is modeled on the ‘traffic light diet’ (Epstein, 1994). The website also provides 52 weekly lesson plans on healthy eating and exercise.

The internet-based behavioral component of the intervention is based on family treatment methods developed by Epstein et al. (Epstein, 1994) that encourages mutual problem-solving and behavior contracting involving all members of the family. Counseling for behavior modification involves weekly email exchanges.

EVALUATION(S) OF PROGRAM

Williamson, D.A., Walden, H.M., White, M.A., York-Crowe, E., Newton Jr., R. L.N., Alfonso, A., et al. (2006). Two-year Internet-based randomized controlled trial for weight loss in African-American girls. Obesity 14(7), 1231-1243.

Williamson, D. A., Martin, P. D., White, M. A., Newton, R. L., Walden, H. M., York-Crowe, E. E., et al. (2005). Efficacy of an Internet-based behavioral weight loss program for overweight adolescent African-American girls. Eating and Weight Disorders 10(3), 193-203.

White, M. A., Martin, P. D., Newton, R. L., Walden, H. M., York-Crowe, E. E., Gordon, S. T., et al. (2004). Mediators of weight loss in a family-based intervention presented over the internet. Obesity Research 12(7), 1050-1059.

Evaluated population: 57 African-American adolescent girls aged 11 to 15 years old with at least one obese biological parent willing to participate in the study were enrolled for the study sample. On average, the adolescents were 13 years old with a BMI of 36.4 (98^th percentile for their age and gender) and approximately 46 percent body fat. Out of the 57 adolescents who enrolled, 40 completed the program.

Parents participating in the study were an average of 43 years old with an average BMI of 38.4. All but one of the parents was female. Additionally, each adolescent’s family was willing and able to pay $300 toward the purchase of a $1000 computer used in the study.

Approach: 57 African-American adolescent girls aged 11-15 years old with a risk for chronic obesity along with one obese parent were enrolled for the study. The adolescents were randomly assigned to an interactive behavior therapy group or passive health education control group using a stratified randomization strategy based on BMI percentile and age.

Both groups received their intervention via the internet, using two separate websites, as well as four face-to-face counseling sessions over a 24-month period. The interactive behavior therapy intervention included interactive nutrition education modules as well as an internet counseling behavior modification program. The control group received non-interactive health education between the face-to-face sessions. They did not receive explicit prescriptions for behavior modifications or opportunities for self-monitoring on the website.

Results: During the first six months, adolescents in the behavioral program lost more mean body fat relative to those in the control group, -1.12% vs. 0.43%, p<0.05. Parents in the behavioral program also lost more mean body weight than parents in the control group, -2.43kg vs. -0.35kg, p<0.05. These significant reductions in body fat and body weight were regained over the next 18 months. At 2 years, differences in body fat for adolescents and body weight for parents in both groups were not statistically different. Significant differences in use of the intervention medium (the respective websites) between the intervention and control group were also eliminated after 24 months. Treatment group use of the web site declined substantially between year one and year two.

SOURCES FOR MORE INFORMATION

References:

Epstein, L. H., Valoski, A., Wing, R. R., McCurley, J., (1994). Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychology 13, 373-383.

Williamson, D.A., Walden, H.M., White, M.A., York-Crowe, E., Newton Jr., R. L., Alfonso, A., et al. (2006). Two-Year Internet-Based Randomized Controlled Trial for Weight Loss in African-American Girls. Obesity 14(7), 1231-1243.

Program categorized in this guide according to the following:

KEYWORDS: Computer-based, African American or Black, Adolescence (12-17), Nutrition, Obesity, Female only, Parent or Family Component

Program information last updated on 4/13/11.