Guided Imagery Lifestyle Intervention to Promote Health and Prevent Diabetes in Youth
Condition: Obesity; Insulin Resistance; Stress
MeSH terms: Insulin Resistance
Study type: Interventional

Summary: 
      The childhood obesity epidemic, which falls disproportionately on Latino adolescents,
      represents a major public health threat to the current generation of youth, and therefore to
      the health of the nation overall. This project directly addresses the role of psychosocial
      stress in promoting obesity and metabolic disease risk, and investigates the role of the
      mind-body CAM intervention of guided imagery in both reducing stress and promoting healthy
      lifestyle behaviors that could dramatically improve the metabolic health of today's youth.
    

Detailed description: 
      The childhood obesity epidemic represents a major health threat to the current generation of
      youth, and falls disproportionately on urban, Latino adolescents. Data suggests modern
      inner-city minority youth suffer from high levels of psychosocial stress, and that such
      chronic stress contributes to obesity and insulin resistance, increasing risk of type 2
      diabetes, cardiovascular disease, fatty liver disease, and other obesity-related disorders.
      Guided imagery is a mind-body complementary/alternative medicine (CAM) modality that offers
      promise as a therapeutic intervention to reduce psychosocial stress, and also to promote
      healthy lifestyle behaviors. In a pilot 12-week lifestyle intervention, Interactive Guided
      ImagerySM significantly reduced salivary cortisol, reduced sedentary behavior, and increased
      moderate physical activity in overweight Latino adolescents. The overall aim of this proposal
      is to determine the separate contributions of stress reduction guided imagery and health
      behavior guided imagery, when delivered in the context of a health-promoting, lifestyle
      intervention, on short-term and long-term stress-reduction and behavioral outcomes in
      predominantly Latino high school students. The study consists of a high school-based, 12-week
      lifestyle intervention delivered in an after school program to urban, predominantly Latino
      adolescents. The intervention features a health-promoting, lifestyle education class,
      combined with a group guided imagery intervention that is theoretically grounded in
      Self-Determination Theory (SDT). High school students are randomized to one of 4 intervention
      arms 1) Non-intervention control; 2) lifestyle education alone (LS); 3) LS + Stress Reduction
      guided imagery alone; 4) LS + Physical Activity/Healthy Eating guided imagery. Outcomes will
      be measured upon completion of the 12-wk intervention, after an additional 6-month
      maintenance program, and after a further 6-month period of no program contact. Primary
      outcomes will be change in salivary cortisol patterns and changes in physical activity and
      dietary intake. Secondary outcomes are insulin resistance, body fat, carotid intima media
      thickness, metabolic syndrome, perceived stress, well-being (self-esteem, health related
      quality of life), and measures of mediation by SDT constructs. Results will demonstrate the
      isolated effects of the lifestyle education and the two different forms of guided imagery,
      and could shift the paradigm of obesity prevention and treatment in urban minority youth to
      include attention to social stress and promotion of well-being.
    

Intervention name(s): Lifestyle Education (LS); LS + Stress Reduction Guided Imagery; LS + Activity/Eating Guided Imagery
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): See arm description; See Arm Description; See arm description
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: obesity; stress; intuitive eating; guided imagery; adolescents; insulin resistance; latinos; minorities