Young, Fit and Happy. A Web-based Intervention to Prevent Obesity in Adolescents.
Condition: Overweight and Obesity
MeSH terms: Obesity; Overweight
Study type: Interventional

Summary: 
      The prevalence of overweight and obesity is increasing throughout the world. Obesity is seen
      as one of the most important public health threats because of the significant impact of
      chronic conditions associated with obesity. Obesity during adolescence is a strong precursor
      of obesity and related morbidity in adulthood.

      Interventions aimed directly at reducing weight or preventing increase in weight shows
      limited results on long term effects and it is shown that increase in activity has more
      impact on health outcome than on weight-loss. Further, weight-loss does not seem to be an
      appropriate measure of therapeutic interventions for growing children. The hypothesis of this
      study is that focusing on increasing meaningful physical activity through individual tailored
      counselling will have positive effects on the adolescents' fitness (health) and quality of
      life. Thus, the overall purpose of the study is to examine the extent to which a web-based
      intervention influences physical activity, fitness and quality of life in over-weight and
      obese adolescents Further, the aim is to explore and describe how adolescents experience
      being over-weight and obese, what they perceive as meaningful physical activity and finally
      how adolescents experience lifestyle changes as demanded in the intervention study.
    

Detailed description: 
      The target group is overweight adolescents, meaning their BMI is over or equal to the 95th
      percentile (BMI>25) and they should not have severe health problems as a result of their
      overweight. For adults, BMI (Body Mass Index; weight in kilograms divided by the square of
      height in meters) values at or above 25 indicate overweight and a BMI at or above 30 defines
      obesity. No such generally accepted definitions exist for children and adolescents. However,
      international standardized cut points have been proposed, among others by Cole et al (2000)
      and experts support the use of BMI cutoff points for children. The cut points proposed by
      Cole et al (2000) are widely used and take age, gender and sex into consideration in the
      estimation. The focus is primarily to prevent a negative development, and the aim is that the
      school health service in the future might implement a modified version of this strategy for
      working with overweight adolescents.

      The design of the study is a complex intervention study with a multi-method design,
      consisting of a quasi-experimental trial and a qualitative study. The sample will be drawn
      from schools in Oslo. Overweight adolescents will be selected and placed in the intervention
      group or control group respectively. The sampling will be based on objective measures of
      weight and height and using Cole's index to define overweight and obesity. Weight and height
      will be measured by the school nurse and will be coordinated with her regular meetings with
      the adolescents in 8th grade.. The study group will receive the web-based intervention and
      the control group will receive standard care. At baseline, 3 months and 1 year both the
      experimental group and the control group will be measured at relevant variables. In the
      qualitative part of the study, in depth interviews with the adolescents in the intervention
      group will be performed and they will write daily unstructured blogs on the web. The sampling
      procedure for the qualitative part of the study will follow the sampling procedure of the
      intervention study. From the intervention group, a strategic or purposive sample of
      adolescents will be asked to participate in the qualitative part (Gerrish and Lacey 2006). A
      sample of maximum variation according to gender and sosio-demographic variables is intended.
      Sampling continues until saturation is reached and the adolescents will be interviewed in
      depth before the intervention starts, further at 3 and 12 months after the intervention is
      ended.
    

Intervention name(s): Young and Active
Intervention type(s): Behavioral
Intervention description(s): The intervention will consist of three meetings between the adolescent, the parents and the researchers, and weekly web-based health-counselling. The adolescents will set goals and make an individual activity plan on the web-page. During the study period all activity will be registered by the adolescents. The researchers will perform weekly counseling based on Selfdetermination Theory and Motivational Interviewing. The webiste also allows for the adolescents to communicate with eacother and with the counsler through a blog.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Obesity prevention; Adolescent; Physical activity; Health counselling