Program

Jun 02, 2011

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), Youth, Males and Females (Co-ed), Clinic/Provider-based,
Computer-based, Obesity, Nutrition

Program
information last updated on 6/2/11.

Subscribe to Child Trends

Short weekly updates of recent research on children and youth.