HEALTHY HABITS

OVERVIEW

The Healthy Habits behavioral weight control program is a multi-component program in which adolescents use a computer program to design a behavior modification weight control program and receive counseling by phone and mail over a 4 month period. Results indicate significant decreases in BMI for adolescents in the intervention compared with those in the control group. The differences in BMI between the two groups observed at post-treatment persisted at the three-month follow-up but did not change in magnitude.

DESCRIPTION OF PROGRAM

Target population: Overweight adolescents aged between 12 and 16 years old.

Healthy Habits is a program that uses several delivery methods to help overweight adolescents adopt healthy eating and exercise habits leading to weight loss. The main delivery methods used are computer and telephone-based. The intervention targets behavioral skills and is developmentally tailored.

After an initial clinical assessment, adolescents use a computer program adapted from PACE+ (Patient-Centered Assessment and Counseling for Exercise plus Nutrition) to design an individual health plan to increase physical activity and/or decrease sedentary behavior. A physician tailors this program for the adolescent based on their computer responses. Thereafter, the adolescent continues to receive counseling by telephone on a weekly basis for 14-16 weeks. In addition to telephone counseling, adolescents receive manuals to help them develop behavioral skills for weight loss four times during the course of the intervention. Parents are mailed information sheets to suggest ways parents could support their adolescent.

Adolescents are also required to self-monitor food and beverage intake using a booklet provided for them. Adolescents estimate calorie intake using the The Fat Counter, and their foods are divided into color categories based on calories per serving adopted from Epstein and Squire’s Stoplight Diet. Five weeks into the program, adolescents are encouraged to self-monitor daily physical activity. Adolescents are awarded points/tickets for meeting food intake and physical activity goals each week. Accumulated tickets are entered into a lottery for $50. 

EVALUATION(S) OF PROGRAM

Saelens, B.E., Sallis, J.F., Wilfley, D.E., Patrick, K., Cella, J.A., Buchta, R. (2002). Behavioral weight control for overweight adolescents initiated in primary care. Obesity Research, 10, 22-32.

Evaluated population: Forty-four overweight adolescents were recruited from two pediatric primary care clinics in southern California.  The adolescents were between 12 and 16 years old. These teens were also 20 to 100 percent the median body mass index for teens their age and sex. Fifty nine percent of the adolescents were boys. Seventy-one percent identified as white, 16 percent identified as Hispanic, and 5 percent identified as African American. The median household income ranged from $60,000 to $69,000.

Approach: Adolescents were randomly assigned to either the intervention or the control group. Adolescents in the control group met once with a pediatrician who encouraged them to adopt healthy habits. They talked to the adolescents about the health consequences of being overweight, healthy eating based on the Food Pyramid guide and increasing physical activity. Data were collected at baseline, post-test, and a three-month follow-up on BMI, dietary intake, physical activity, sedentary behavior, problematic eating and weight-related behaviors and beliefs, and behavioral skills use.

Results: At the 4-month post-treatment period, the BMI scores of adolescents in the Healthy Habits program decreased significantly while scores for those in the control group increased significantly. Forty percent of adolescents in the healthy habits program had decreased their BMI compared with 11 percent of the adolescents in the control group. Despite these differences in weight, there were no significant changes in the secondary outcomes of total energy or dietary fat intake, physical activity, sedentary behavior, or problematic eating habits. Changes in BMI remained significant and consistent at the 3-month follow-up after completing the program.

At post-treatment, adolescents in the Healthy Habits program reported significantly higher rates of overall, eating and physical activity behavior skill use than adolescents in the control group. These differences were also significant and consistent at follow-up. Behavior skill use was related to better weight outcomes.

SOURCES FOR MORE INFORMATION

References:

Saelens, B.E., Sallis, J.F., Wilfley, D.E., Patrick, K., Cella, J.A., Buchta, R. (2002). Behavioral Weight Control for Overweight Adolescents Initiated in Primary Care. Obesity Research, 10 (1), 22-32.

KEYWORDS: Adolescents (12-17), Males and Females (Co-ed), Clinic/Provider-based, Computer-based, Obesity, Nutrition

Program information last updated on 6/2/11.

© Child Trends 2003