Guided Imagery Intervention for Obese Latino Adolescents

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DESCRIPTION (provided by applicant): Overall Objective: The overall aim of this study is to develop and test a theory-based guided imagery lifestyle intervention to reduce risk factors for type 2 diabetes and cardiovascular disease in overweight Latino adolescents. Overall Hypothesis: Guided imagery lifestyle intervention will be more effective than nutrition education alone in decreasing risk factors for type 2 diabetes and cardiovascular disease, and in increasing health-promoting dietary and physical activity behaviors. Specific Aims and Approach: Specific Aim 1: To develop a guided imagery intervention program based on stress reduction and on the Theory of Meanings of Behavior for use with overweight Latino adolescents. Specific Aim 2: To conduct a randomized and controlled trial to test the direct and mediated effects of adding a guided imagery intervention program to a nutrition education program in overweight Latino adolescents. Major outcomes will include insulin sensitivity, psychosocial measures, and dietary and physical activity behaviors. Rationale: Prevalence of obesity and type 2 diabetes is increasing in overweight youth, especially in ethnic minorities. 28% of overweight Latino adolescents with a family history of type 2 diabetes have impaired glucose tolerance (IGT), and 30% have the metabolic syndrome. There is a critical need to develop innovative and effective lifestyle interventions to reduce insulin resistance and overweight in this population at risk. Research Design & Methods: Using focus group qualitative methods, a 12-week guided imagery intervention program will be developed that is culturally and developmentally appropriate for overweight Latino adolescents. This intervention will then be tested in a randomized, controlled trial. Outcome assessments will include physiologic measures (insulin sensitivity, body composition, cortisol secretion), psychosocial measures (perceived stress, emotional eating, meanings of eating and physical activity), and behavioral measures (dietary intake and physical activity). Health implications: Guided imagery holds particular promise to reduce chronic disease risk factors in overweight adolescents by reducing chronic stress and transforming unhealthful dietary and physical activity behaviors. This could be an effective means of preventing both type 2 diabetes and cardiovascular disease in susceptible youth, thereby reducing both the suffering and costs associated with these diseases.