Abstract
Objective: Social influences play an important role in shaping adolescents’ dietary and physical activity behaviors. We examined the role of perceived modeling and perceived social support from family and friends on diet and physical activity behaviors among overweight and obese adolescents participating in a weight management trial. Methods: Six high schools were randomized to a school-nurse delivered behavioral weight management intervention or an information attention-control. Data on perceived support and modeling of healthy eating and physical activity from family and friends and dietary and physical activity behaviors were obtained from participants (N=82) at baseline and 2- and 6-months follow-up. Results: Linear mixed models were used to examine associations between social factors at baseline and diet and physical behaviors at 6 months. Friend support was correlated with increased fruit and vegetable consumption (0.4 servings/day) and decreased added sugar intake (-14.2 grams/day) (p’s<0.05). Family support for physical activity, friend support for physical activity, and family modeling of physical activity were associated with increased number of days/week active for ≥ 60 minutes/day (0.7 days/week; 0.6 days/week; and 0.4 days/week, respectively, p’s<0.05). Conclusions: Among overweight and obese high school adolescents, support from family and friends was associated with a greater number of improvements in diet and physical activity at follow-up than modeling. Strategies to solicit support may maximize efficacy of adolescent obesity intervention efforts.
Highlights
Adolescence is a critical period for addressing overweight and obesity, with 15.2% of U.S adolescents in grades 9-12 overweight and 13.0% obese in 2011 [1]
Among overweight and obese high school adolescents, support from family and friends was associated with a greater number of improvements in diet and physical activity at follow-up than modeling
This study aimed to examine modeling and social support from family and friends associated with changes in diet and physical activity over time among overweight and obese high school adolescents participating in a pilot school-based weight management trial
Summary
Adolescence is a critical period for addressing overweight and obesity, with 15.2% of U.S adolescents in grades 9-12 overweight and 13.0% obese in 2011 [1]. Healthy weight management among adolescents is critical, as they establish independence and make more choices outside of the home environment [4], with respect to diet and physical activity behaviors. Schools serve as a valuable intervention setting for obesity intervention, yet less than 14% of school-based interventions targeting body mass index (BMI) took place in high schools (approximate student population age range of 14-18 years) [5,6]. Findings from a pilot cluster-randomized trial of a school-based weight management intervention targeting high school youth indicated that the intervention was associated with improvements in dietary behaviors, but not BMI or physical activity, among overweight and obese adolescents [7]. Understanding the interplay of other factors related to weight management, such as social norms and influences, is essential for advancing obesity intervention efforts among this population and preventing obesity-related complications and conditions later on in the life course
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