Peer Enhanced Intervention to Support Teen Weight Loss

描述（由申请人提供）：超重儿童和青少年的患病率在过去二十年中显著增加。虽然有经验支持对学龄儿童进行体重管理干预，但对超重青少年的治疗结果并不一致。青少年体重控制干预措施的一个潜在限制是，作为治疗的一个积极组成部分，对同伴群体的关注很少。我们从一项试点研究中获得了令人鼓舞的发现，该研究将创新的同伴干预（同伴技能训练；PBST）添加到青少年的认知行为体重管理治疗中。拟议研究的目的是通过以下方式扩大试点：1)增加样本量，2)评估更长时间内的体重减轻情况，以及3)评估心理社会变量以及身体活动和饮食在调节治疗结果中的作用。假设超重青少年随机接受同伴增强认知行为治疗比随机接受运动认知行为治疗的青少年在长期随访中表现出更大的体重减轻。

DESCRIPTION (provided by applicant): The prevalence of overweight children and adolescents has increased significantly during the last two decades. While there are empirically supported weight management interventions for school age children, treatment findings with overweight adolescents are not as consistent. A potential limitation of weight control interventions for adolescents is the minimal attention given to the peer group as an active component of treatment. We have promising findings from a pilot study that involves adding an innovative peer-based intervention (peer-based skills training; PBST) to cognitive behavioral weight management treatment for adolescents. The purpose of the proposed study is to expand the pilot by: 1) increasing our sample size, 2) assessing weight loss over a longer time period, and 3) evaluating the role of psychosocial variables, as well as physical activity and diet, in mediating treatment outcome. It is hypothesized that overweight adolescents randomized to cognitive-behavioral treatment with peer enhancement will demonstrate greater weight loss at long term follow-up than adolescents randomized to cognitive-behavioral treatment with exercise. One hundred and fifty adolescents between the ages of 13 and 16 years and 20% and 80% overweight will be randomized to one of two treatment conditions: 1) Cognitive-Behavioral Weight Loss Treatment with Peer-Based Skills Training (CBT + PBST) or 2) Cognitive-Behavioral Weight Loss Treatment with Exercise (CBT+EXER). Measures of height, weight, physical activity, diet, and psychosocial functioning will be obtained at baseline, end of treatment, 12 months, and 24 months after randomization. A between-groups t-test will be conducted to evaluate group differences in change in percent overweight between baseline and 24 month follow-up . Hierarchical linear modeling will be used to assess the pattern of weight loss for the two treatment groups across four time points: baseline, end of treatment, 12 month, and 24 month follow-up. Effects of treatment of psychosocial measures will be analyzed using mixed analysis of variance with treatment condition as the between subjects factor and a within subject factor of time. Finally, a series of regression analyses will be conducted to evaluate the role of psychosocial variables, physical activity, and diet, as mediators of treatment outcome.