A Scalable Weight Control Intervention for Adolescents

In 2010, the U.S. Preventive Services Task Force (USPSTF) provided a Grade recommendation B
(i.e. the service is recommended with moderate/high certainty of benefit) for clinicians to
screen children ages 6-17 years for obesity and refer identified youth to comprehensive
behavioral programs. The challenge in meeting this objective is the lack of community-based
obesity treatments to which to refer, particularly for adolescents. The JOIN program,
developed as a collaboration between United HealthGroup and Y-USA is a pediatric weight
control intervention targeted toward a broad age range of youth from 6-17 years that is: 1)
based on well established and evidence based principles; 2) delivered by YMCA facilitators
within a community setting: and 3) potentially scalable nationally. Findings from a 6-month
pilot study examining the effectiveness of JOIN demonstrated impressive changes in weight
status for school age children, but more modest results for adolescents. The primary aim of
this study is to modify the JOIN program to increase its effectiveness with adolescents
while retaining its potential for scalability.

A total of 120 adolescents (ages 13-17) with BMI > 85th% and < 50 will be randomly assigned
to a 16-week targeted program (TEEN JOIN), or the traditional JOIN intervention, followed by
biweekly and monthly maintenance sessions. Evaluation of adolescent height, weight,
objective physical activity and psychosocial outcomes will be obtained at baseline, 4
months, and 10 months. Additional outcomes will include treatment feasibility, including
attendance, completion of diet and physical activity monitoring logs, and exit interviews
with adolescents and parents regarding the intervention. The investigators will also obtain
preliminary indicators of cost effectiveness. It is hypothesized that adolescents who are
randomized to TEEN JOIN will demonstrate greater decrease in BMI at 4 and 10 months than
those randomized to JOIN. It is further hypothesized that adolescents randomized to TEEN
JOIN will demonstrate greater increases in participation in moderate-vigorous physical
activity and greater improvements in self-concept, self-efficacy related to physical
activity, and group cohesion than adolescents who receive the standard JOIN condition.

Inclusion Criteria:

- 13 to 17 years

- BMI > 85th percentile and absolute BMI < 50

- have at least one parent available to provide consent and participate in sessions

- speak English

- agree to study participation and random assignment

Exclusion Criteria:

- currently involved in another weight loss program

- have a medical condition that would interfere with the prescribed dietary plan or
participation in physical activity

- developmentally delayed such that the intervention materials will not be appropriate

- in treatment for a major psychiatric disorder, including an eating disorder, or are
diagnosed with a major psychiatric disorder at the time of screening.