Abstract
BackgroundObesity prevention interventions targeting ‘at-risk’ adolescents are urgently needed. The aim of this study is to evaluate the sustained impact of the ‘Active Teen Leaders Avoiding Screen-time’ (ATLAS) obesity prevention program.MethodsCluster RCT in 14 secondary schools in low-income communities of New South Wales, Australia. Participants were 361 adolescent boys (aged 12–14 years) ‘at risk’ of obesity. The intervention was based on Self-Determination Theory and Social Cognitive Theory and involved: professional development, fitness equipment for schools, teacher-delivered physical activity sessions, lunch-time activity sessions, researcher-led seminars, a smartphone application, and parental strategies. Assessments for the primary (body mass index [BMI], waist circumference) and secondary outcomes were conducted at baseline, 8- (post-intervention) and 18-months (follow-up). Analyses followed the intention-to-treat principle using linear mixed models.ResultsAfter 18-months, there were no intervention effects for BMI or waist circumference. Sustained effects were found for screen-time, resistance training skill competency, and motivational regulations for school sport.ConclusionsThere were no clinically meaningful intervention effects for the adiposity outcomes. However, the intervention resulted in sustained effects for secondary outcomes. Interventions that more intensively target the home environment, as well as other socio-ecological determinants of obesity may be needed to prevent unhealthy weight gain in adolescents from low-income communities.Trial registrationAustralian Clinical Trial Registry ACTRN12612000978864.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-016-0420-8) contains supplementary material, which is available to authorized users.
Highlights
Obesity prevention interventions targeting 'at-risk' adolescents are urgently needed
Sustained effects were found for screen-time, resistance training skill competency, and motivational regulations for school sport
The aim of this paper is to report the sustained impact of the Active Teen Leaders Avoiding Screen-time' (ATLAS) program on primary and secondary outcomes which were assessed 10-months after program completion (i.e., 18-months post baseline)
Summary
Obesity prevention interventions targeting 'at-risk' adolescents are urgently needed. The aim of this study is to evaluate the sustained impact of the 'Active Teen Leaders Avoiding Screen-time' (ATLAS) obesity prevention program. Interventions that more intensively target the home environment, as well as other socio-ecological determinants of obesity may be needed to prevent unhealthy weight gain in adolescents from low-income communities. School-based obesity prevention interventions targeting adolescents are important as physical activity declines [7], dietary behaviors deteriorate [8] and recreational screen-time increases [9] during the teenage years. Little is known regarding the sustainability of intervention effects [10, 11], as few obesity prevention programs have assessed the maintenance of improvements in adiposity and health behaviors beyond immediate posttest assessments [10]
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