Please select the eligibility criteria that correspond to the clinical trial below.
Title: Adolescents Committed to Improvement of Nutrition and Physical Activity (ACTION)
Brief Summary: Community based participatory research principles will be used to create, implement and evaluate a culturally relevant and age-appropriate obesity intervention for adolescents who are overweight or obese. The intervention will be implemented through school-based health centers (SBHC) and will include clinical encounters with SBHC providers, use of Motivational Enhancement Therapy to help overweight/obese adolescents adopt healthier behaviors, and use of a community advisory council to develop obesity risk reduction strategies that will be delivered by print and digital video disc (DVD) media. To test efficacy of the ACTION intervention, overweight/obese adolescents will be recruited to either the intervention condition or the usual care condition. Students will have pre- and post- intervention measurements to assess if adolescents in the intervention condition will have improved risk factor profile for metabolic syndrome, improved nutrition and increased physical activity when compared with students in the usual care condition.


Options:
A: Inclusion Criteria:

Criteria for participation in the study include:

* Being overweight (BMI \> 85th percentile for age and sex, weight for height \>85th percentile, or weight \>120% of ideal for height). In addition, at least half of the study participants will have a BMI \> 95th percentile for age and sex. Study participants will have a maximum body weight of 285 pounds.
* Adolescent subjects must also have at least two of the following risk factors:

  * family history of type 2 diabetes in a first-or second-degree relative,
  * race/ethnicity of American Indian, African-American, Hispanic, Asian/Pacific Islander, or
  * signs of insulin resistance (acanthosis nigricans, hypertension, dyslipidemia, or polycystic ovarian syndrome).
* In addition, adolescent subjects must be able to read and speak English or Spanish, have access to the Internet at home, school, or work, be reachable at a telephone number, be willing to participate in monthly 90-minute group meetings, have plans to stay in the San Diego area for the one-year study period, and have an English or Spanish speaking parent/guardian also willing to participate in the study.
* Parental consent (obtained in parents primary language) and subject assent is also required.
* Participants must have a parent or guardian agree to enroll who is able to speak and read in English or Spanish, has ongoing access and uses the internet, and plans to reside in San Diego for the length of the study.

Exclusion Criteria:

Subjects will be excluded from participation if they have any of the following conditions:

* Diabetes
* Pregnancy
* Cardiovascular problem, musculoskeletal problem or any medical condition that would limit their ability to comply with physical activity or dietary recommendations.
* Patients in foster care will be ineligible due to difficulty in obtaining follow-up measures.
B: Inclusion Criteria:

* greater than or equal to the 85th percentile in BMI
* in 9th through 11th grades at participating schools

Exclusion Criteria:

* BMI greater than or equal to 40
* previously diagnosed type 1 or type 2 diabetes
* blood pressure in the range of stage 2 hypertension
* medications that significantly interfere with weight
C: Inclusion Criteria:

* patients from POC/HSM
* aged between 12 and 18 years
* BMI percentile ≥ 95th
* internet access at least once a week

Exclusion Criteria:

* presence of severe psychopathology
* inability to communicate in writing
* pregnancy
* having been proposed for bariatric surgery
D: Inclusion Criteria:

* age 6-17 years;
* overweight or obesity based on the WHO (World Health Organization) growth charts/references (\>+1 standard deviation \[SD\] or \>+2 SD, respectively)

Exclusion Criteria:

* drug therapy for a chronic disease (including drugs that influence appetite or body weight);
* type 1 or 2 diabetes;
* history of surgical treatment of obesity;
* participation in another program for treating obesity during the project and/or 3 months prior to recruitment;
* secondary causes of obesity;
* pregnancy.

Answer: B