Program

Apr 13, 2011

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
>85th 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:
A total of 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 (98th 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: A total of 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 Psychology13,
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.

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.

KEYWORDS:
Computer-Based, African American or Black, Children, Adolescence (12-17), Therapy/Counseling, Nutrition,
Obesity, Female Only, Parent or Family Component

Program
information last updated on 4/13/11.

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