Resilience and Obesity Prevention in Adolescents

Study Overview
=================
Brief Summary
-----------------
This is a cross-sectional observational study where investigators are trying to see the associations between factors contributing to obesity (dietary behavior and physical activity), resilience (self-efficacy, self-esteem, and optimism), and HRQoL in Indian adolescents. The key research question and sub-questions are as follows: Main research question: Is there a relationship between resilience (measured as self-efficacy) and obesity in children? What is the level of other resilience factors (measured as self-esteem and optimism) among overweight, obese, and normal-weight adolescents? Are there differences between the groups? Are there differences between ages? Are there differences between genders? Is there a relationship between resilience factors (measured as self-esteem and optimism) and HRQoL among overweight, obese, and normal-weight adolescents? Are there differences between the groups? Are there differences between ages? Are there differences between genders? Is low resilience (measured as self-esteem, self-efficacy, and optimism) associated with overweight or obesity among adolescents and a lower HRQoL? Are there differences between ages? Are there differences between genders? What is the level of association between resilience (identified as self-esteem, self-efficacy, and optimism) and factors contributing to obesity (dietary habits - measured in terms of more frequent unhealthy eating, such as eating fast food, sugary beverages, more calories, and less frequent healthy habits, such as more junk foods for meals, less physical activity, higher BMI, or higher weight-for-age Z scores, more body fat percentage and psychosocial factors related to obesity: socio-economic status

Detailed Description
-----------------
Childhood obesity is associated with increased health risks in adulthood, affecting capacity for physical activity and occupational performance, as well as psychological and social deficits. These are significant contributors to direct and indirect costs. The prevalence of obesity and related factors in young children emphasizes the importance of understanding periods of vulnerability in early development and the interaction between physical activity, resilience, and HRQoL. Factors for preventing obesity are social support and a person's willingness to lifestyle changes (Gilchrist & Zametkin, 2006). With many adverse effects of adolescent obesity, one's resilience (self-esteem, self-efficacy, and optimism) may contribute to being protective, ultimately influencing the individual's overall health-related quality of life. However, to the investigator's knowledge, resilience (self-esteem, self-efficacy, and optimism) has not been explored from the perspective of factors that contribute to obesity (dietary habits, physical activity, perceived stress, and psychosocial factors) in Indian adolescents. The study aims to identify the relationship between resilience to obesity factors in Indian adolescents. The main aim of this study is to see the correlation of resilience, identified as self-esteem, self-efficacy, and optimism, with factors influencing the development of obesity (dietary habits, physical activity, perceived stress, and psychosocial factors) in Indian children/adolescents. In this cross-sectional study, samples will be recruited from sites where other influencing factors can be controlled, like either from a school (where investigators can control for socioeconomic background, education, etc.) or from an obesity clinic in the city, after ensuring the case is a newly refereed one, who has not been given any intervention that might interfere with their resilience. The current study findings may lead to a holistic understanding of obesity-contributing factors, such as dietary habits, physical activity, perceived stress, and psychosocial factors, and their relationship with resilience and HRQoL. Increased knowledge of these factors may lead to more comprehensive studies involving resilience and obesity and also study if the early resilience-building intervention can potentially lower the chances of developing obesity in adolescents. Results from the study can also help build more effective programs for health professionals and nutritionists striving to reduce or prevent obesity among adolescents. Investigator/s also aim to use their data further to develop an intervention to strengthen resilience among these children. Investigator/s further aim to compare their findings to a small group of age-sex-matched Dutch children. All participants will be given the information sheets and consent forms that require both participant's permission and parental consent that will be collected before the beginning of data collection. In addition, the primary researcher will clarify any questions/doubts by the participant and/or the parents. Participant recruitment process in India: The primary researcher (Ph.D. student) is currently working towards obtaining permission from two local bodies here in Kolkata, India. The first permission is to be obtained from the District Inspector (DI) of Schools (for both government and private schools), Kolkata, West Bengal (India), and the second one is from the local member of the Legislative Assembly (MLA) (Member of Lok Sabha for Kolkata Dakshin/South) office. This permission is required based on the control of the MLA on the local school clusters (mainly government schools). Kolkata Municipal Corporation (abbreviated KMC; also Calcutta Municipal Corporation) is the local government of the Indian city of Kolkata, the state capital of West Bengal. This civic administrative body administers an area of 206.08 square kilometers (79.57 sq mi). The city is divided into 144 administrative wards that are grouped into 16 boroughs. Each of these wards elects a councilor to the Kolkata Municipal Corporation. Each borough has a committee consisting of the councilors elected from the respective wards of the boroughs. Through the borough committees, the corporation maintains government-aided schools, hospitals, and municipal markets and partakes in urban planning and road maintenance. As the apex body, the corporation discharges its function through the Mayor-in-Council, consisting of a mayor, assisted by a deputy mayor, and ten other elected members of the KMC. The mayor is responsible for the overall functioning of the KMC and has a tenure of five years. The All India Trinamool Congress currently holds power in the KMC. Schools across cities in India are divided into clusters. For example, Kolkata Municipality is a block in the Kolkata district of West Bengal with about 94 clusters (approximately, an exact list can be obtained from the DI office in due course). All the government and private schools of the Kolkata Municipality block are divided into different clusters of schools. Ward No. 88, Kolkata Municipal Corporation is an administrative division of Kolkata Municipal Corporation in Borough No. 9, covering parts of the Kalighat (Sahanagar-Lalpara) neighborhood in South Kolkata, in the Indian state of West Bengal. For the current study, the local MLA (Ms. Mala Roy), who controls ward number 88, permission will be taken. Every city resident belongs to an individual ward based on the location of their residence and voting eligibility. In this case, based on the primary researcher's area of residence, it is Ward No. 88, Kolkata Municipal Corporation. Once the local permission is obtained, a complete list of schools covered under Ward No. 88, Kolkata Municipal Corporation, will be provided by the local MLA/DI office. Schools from this list will then be selected through randomization. The number of schools chosen will depend on the total sample size for the study. Both private and government schools will be selected. After completing the school selection, the researcher will visit each school and meet the school principal to brief about the research study. If any school refuses to participate, the investigator/s will move on to the next randomized school on the list.

Official Title
-----------------
Associations Between Factors Contributing to Obesity (Dietary Habits and Physical Activity), Resilience (Self-Efficacy, Self-Esteem, and Optimism), and HRQoL in Indian Adolescents

Conditions
-----------------
Obesity, Childhood, Self Efficacy, Self Esteem, Optimism, Resilience, Psychological, Quality of Life

Intervention / Treatment
-----------------
* Behavioral: Behaviour intervention targeted for Lifestyle modification


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Children who are overweight, children with obesity, and children with normal body weight based on IOTF cut-offs otherwise healthy, without any confirmed diagnosed clinical/mental illness age between 14-16 years agreed to participate Exclusion Criteria: confirmed diagnosed clinical/mental illness underweight more than 16 years, less than 14 years of age

Ages Eligible for Study
-----------------
Minimum Age: 14 Years
Maximum Age: 16 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Overweight<br>BMI Cut-Off Points (kg/m²) by International Obesity Task Force; IOTF Overweight (including obesity) ≥25.00 | Behavioral: Behaviour intervention targeted for Lifestyle modification<br>* An intervention to strengthen resilience that controls self-efficacy, self-esteem and optimism.<br>|
| Obese<br>BMI Cut-Off Points (kg/m²) by International Obesity Task Force; IOTF Obese ≥30.00 | Behavioral: Behaviour intervention targeted for Lifestyle modification<br>* An intervention to strengthen resilience that controls self-efficacy, self-esteem and optimism.<br>|
| Normal-weight<br>BMI Cut-Off Points (kg/m²) by International Obesity Task Force; IOTF Healthy Weight - 18.5-24.99 | Behavioral: Behaviour intervention targeted for Lifestyle modification<br>* An intervention to strengthen resilience that controls self-efficacy, self-esteem and optimism.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Obesity prevalence in children | Weight measured as change in BMI z-score | At 1 year | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
psychosocial resilience, obesity prevention, adolescents, quality of life, weight resilience