Program

Sep 26, 2012

OVERVIEW

Bright Bodies is a family-based weight management program designed for children and adolescents whose body mass index (BMI) is above the 95th percentile. Participants in this intensive lifestyle intervention attend sessions on exercise and nutrition. An experimental evaluation found impacts on weight, body fat, BMI, total cholesterol, fasting insulin, and insulin resistance at assessments 6- and 12-months into the study.

DESCRIPTION OF PROGRAM

Target population: Children and adolescents (8- to 16- years-old) with a BMI above the 95th percentile

Bright Bodies is a family-based weight management program designed for children and adolescents whose BMI is above the 95th percentile. This intensive lifestyle intervention takes place over the course of 12 months, with participants attending sessions twice a week for the first six months and then every other week for the remaining six months. As part of the first six months, the program comprises 50-minute exercise routines twice a week and 40-minute nutrition sessions, and behavior modification sessions once a week. Participants and caregivers attend all classes together except behavior modification classes. The behavior modification classes occur separately for participants and caregivers. Participants are weighed every one to two weeks during the first six months and every two weeks for the remaining six months.

A registered nurse or social worker delivers the behavior modification component of the Bright Bodies program. Using the Smart Moves workbook manual, sample topics include “Ready, Set, Goal!,” “Bullies, Teasers, and Other Annoying People,” and “Oops I Slipped–Understanding a Relapse.” Concepts covered in these topics include self-awareness, goal setting, stimulus control, coping skills training, cognitive behavior strategies, and contingency management. For the caregivers, behavior modification sessions stress the important role caregivers can play in establishing healthy behavior change in the home.

Exercise physiologists deliver the exercise component of the program. Sessions include a warm-up period, followed by high intensity aerobic exercise and concluding with a cool-down period. During the high-intensity aerobic exercises, participants engage in games such as Swim Fish Swim, obstacle courses, basketball, flag football, sprinting games, basic sport drills, and Dance Dance Revolution, in which participants follow dance patterns and compete with one another. Additionally, participants are encouraged to exercise at home three days a week and to decrease sedentary behaviors.

Using the Smart Moves workbook, a registered dietician delivers the nutrition education component of the program to participants. These sessions rely on a non-diet approach to food consumption to emphasize low-fat, nutrient-dense foods, and portion control. Topics addressed in these sessions include: “Determining Portion Sizes,” “Making Sense of a Food Label,” and “Bag It!–The Pros to Bringing Lunch to School.”

EVALUATION OF PROGRAM

Savoye, M., Shaw, M., Dziura, J., Tamborlane, W. V., Rose, P., Buandalini, C., Goldberg-Gell, R., Burgert, T. S., Cali, A. M. G., Weiss, R., & Caprio, S. (2007). Effects of a weight management program on body composition and metabolic parameters in overweight children: A randomized controlled trial. Journal of the American Medical Association, 24, 2697-2704.

Evaluated population: A total of 174 participants between 8- and 16-years-old from New Haven, CT were enrolled in this program study, with an average age of 12 years. Among those in the intervention group, 38 percent were white, 38 percent were black, 24 percent were Latino, and 56 percent were female.

Approach: Participants were recruited from the Yale Pediatric Obesity Clinic. Individuals were randomized to either the intervention group (n=105) or the control group (n=69). Control group participants received diet, exercise, and psychosocial counseling every six months at the clinic, and, after the conclusion of the intervention, they went on to receive the Bright Bodies intervention.

The following clinical measures were collected: weight and height to calculate BMI; blood pressure; and blood samples to assess glucose, insulin, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. Outcome measures were collected 6 months and 12 months into the study.

Originally, a total of 209 participants were enrolled in this study, as there were three arms to the evaluation: One group received a structured meal plan only. A second group received the full intervention described above. The third group was the control group. Due to a large dropout rate of the structured meal plan only group (83%), this study arm was discontinued. The analysis focuses on the 174 participants randomized into the second and third groups.

Results: At the 6-month assessment period, the intervention had significant positive impacts on weight, body fat, BMI, total cholesterol, fasting insulin, and insulin resistance; these findings were sustained at the 12-month post-test. There were no impacts on blood pressure, either systolic and diastolic, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and fasting glucose.

SOURCES FOR MORE INFORMATION

References

Savoye, M., Shaw, M., Dziura, J., Tamborlane, W. V., Rose, P., Buandalini, C., Goldberg-Gell, R., Burgert, T. S., Cali, A. M. G., Weiss, R., & Caprio, S. (2007). Effects of a weight management program on body composition and metabolic parameters in overweight children: A randomized controlled trial. Journal of the American Medical Association, 24, 2697-2704.

Website:For more information about the Bright Bodies program, please visit:

www.brightbodies.org.

For more information, including purchasing information, about the Smart Moves Workbook used throughout the Bright Bodies program, please visit:

http://www.smartmovesforkids.com/products.html.

Contact Information

Mary Savoye

(203)785-6459

mary.savoye@yale.edu

KEYWORDS: Children (3-11), Adolescents (12-17), Youth (16+), Males and Females (Co-ed), Clinic-/Provider-based, Parent or Family Component, Parent Training/Education, Skills Training, Health status/Conditions, Nutrition, Obesity, Other Physical Health, Manual Available

Program information last updated 9/26/12.

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