LONGITUDINAL QUALITY OF LIFE IMPROVEMENT AFTER A FAMILY BASED LIFESTYLE INTERVENTION IN YOUTH WITH OBESITY
Authors: Engebretsen Steven R. , Early Kathaleen Briggs , Sorrells Robert , Yi‐Frazier Joyce P. , Sanchez Martin , Gottlieb Kate , Gonzalez Bertha Lily , Lopez Bertha 
Published: November 2023

Background

ACT (Actively Changing Together) is an evidence‐based intervention aimed at youth with overweight or obesity and their families – developed by Seattle Children's Hospital. Yakima WA is an agricultural community with high rates of youth obesity, associated comorbidities, and other risk factors related to the social determinants of health. One objective of ACT was to improve quality of life (QOL) in youth participants. Previous analyses have found an initial improvement in anthropometric outcomes and eating behaviors after participation in the ACT program. However, initial and sustaining psychosocial factors contribute to the health of youth and may impact future success maintaining a healthy body weight.

Objective

To establish the impact of immediate and longitudinal QOL after the 12‐week ACT intervention.

Methods

Youth (n=78) aged 8–14 years were referred by a primary care provider upon meeting inclusion criteria (BMI‐for‐age ≥85th percentile); youth were also required to have a parent co‐enroll in ACT. Twelve, 90‐minute classes were held weekly at the YMCA in English and Spanish. The PedsQLTM 4.0 Generic Core Scale was used to assess QOL at baseline (1 week prior to start of the intervention) and 3 follow‐up periods: initial follow‐up upon completion of the intervention (n = 64); 6‐months after the intervention concluded (n = 37); and 12‐months after the intervention concluded (n = 27). Psychosocial and physical health scores were calculated at each time point according to PedsQLTM scoring guidelines with a score of 100 representing the highest QOL rating. Scores were analyzed with paired dependent t‐test correlations and paired differences between baseline and each follow‐up period. Analyses were performed using SPSS v22 with a p‐value set to < 0.05.

Results

Psychosocial health summary scores significantly improved at all 3 time‐points: from baseline (mean = 74.8) to initial follow‐up (mean = 81.2; p < 0.001); baseline (mean = 72.0) to 6‐month follow‐up (mean = 83.1; p < 0.001), and baseline (mean = 76.8) to 12‐month follow‐up (mean = 87.1; p = 0.010). Physical health summary scores significantly improved from baseline (mean = 76.4) to initial follow‐up (mean = 84.3; p < 0.001) and baseline (mean = 76.6) to 6‐month follow‐up (mean = 85.1; p < 0.001); however, baseline (mean = 78.7) to 12‐month follow (mean = 85.8) was not significantly changed (p = 0.088). Paired differences analyses showed significant changes in both psychosocial and physical health at each time point (Table 1). There were no significant differences between gender or session (English vs. Spanish) in psychosocial or physical health at baseline or any follow‐up period.

Conclusions

This study found significant improvements in QOL following a 12‐week community and family based lifestyle intervention. The novel finding of this study was the longitudinal impact of this brief intervention. Significant positive improvements in psychosocial health QOL measurements were continuous up to 12‐months following the conclusion of the intervention, while significant physical health QOL measurements were demonstrated up to 6‐months following the conclusion of the intervention – with non‐significant trends in the 12‐month follow‐up group.

Support or Funding Information

The Safeway Foundation; Yakima Valley Memorial Hospital; Sage Fruit

Results of paired differences analyses displaying average change in scores between baseline and each follow‐up period.

Absolute Mean Difference (95% Cl; p‐value)

Baseline and initial
Baseline and 6‐month
Baseline and 12‐month

Psychosocial Health
6.4 (3.2–9.5;<0.001)
11.0 (7.2–14.9;<0.001)
10.3 (5.7–14.8;<0.001)

Physical Health
7.8 (3.9–11.7;<0.001)
8.5 (4.8–12.1;<0.001)
7.1 (1.5–12.6;< 0.014)