Parental Involvement as a Strategy to Enhance Adolescent Weight Control

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DESCRIPTION (provided by applicant): The prevalence of overweight among children and adolescents continues to increase. Data from the most recent National Health and Nutrition Examination Survey (NHANES) indicate that approximately 37 percent of children and 34 percent of adolescents are either overweight or obese (BMI greater than 85th percent). Interventions to treat currently overweight children and adolescents are critical for prevention of overweight into adulthood. While considerable attention has been given to comprehensive behavioral interventions to address obesity in children, there is less empirical evidence demonstrating efficacy of such interventions with adolescents. The purpose of the proposed study is to test a novel model of parental involvement for enhancing weight control among overweight adolescents. The intervention combines standardized cognitive behavioral adolescent weight management treatment with increased parental involvement through two mechanisms: parental modeling of healthy weight control strategies and enhanced parent-adolescent communication related to diet, physical activity, and weight. Study objectives are to: 1) evaluate the feasibility of the intervention; 2) compare the enhanced intervention to standard adolescent weight control treatment with regard to changes in adolescent-parent communication and parent healthy weight practices, and 3) obtain preliminary data to test the hypothesis of whether participation in the enhanced intervention results in greater decrease in BMI. A total of 48 adolescents between the ages of 13 and 17 years and 30 percent and 90 percent overweight will be randomized to one of two group-based treatment conditions: adolescent weight control that includes standard cognitive-behavioral intervention combined with minimal parent involvement (CBT+MPC) or an enhanced parental support condition focused on healthy parent weight control practices and improved communication (CBT+ EPS). Measures of weight, height, healthy parent weight control strategies, and adolescent-parent communication will be obtained at baseline and at the end of the 16-week intervention. We will evaluate feasibility of the enhanced intervention by collecting measures of weekly attendance, adolescent and parent completion of diet and physical activity monitoring logs, and adolescent and parent ratings of treatment acceptability. Adolescent-parent communication will be evaluated through questionnaire measures as well as coding of adolescent-parent videotaped interactions related to diet, weight, and physical activity. Separate multivariate analysis of variance (MANOVA) will be used to evaluate parent healthy weight strategies and combined questionnaire and videotaped data of parent-adolescent communication. Analysis of variance (ANOVA) will be conducted on the change scores from baseline to end of treatment to evaluate the effects of treatment condition on adolescent BMI and z-BMI. Given that this is an exploratory pilot study, we expect to obtain estimates of effect size for BMI. The next objective in this line of research is to conduct a full-scale clinical trial to evaluate the efficacy of enhanced parent involvement for adolescent weight control. PUBLIC HEALTH RELEVANCE: The prevalence of overweight in children and adolescents in the United States continues to increase, with approximately 37 percent of children and 34 percent of adolescents defined as either overweight (BMI greater than 85th percent and < 94th percent) or obese (BMI greater than 95th percent). Interventions to decrease overweight during adolescence are critical for prevention of overweight into adulthood. The proposed study will test the feasibility of a novel approach for parental involvement, including focus on healthy parent weight practices and improved communication, in enhancing adolescent weight control.