Background The excess burden of obesity among black women is well-documented. However, the behavioral weight loss intervention literature often does not report results by ethnic group or gender. Purpose The purpose of this article is to conduct a systematic review of all behavioral weight loss intervention trials published between 1990 and 2010 that included and reported results separately for black women. Methods The criteria for inclusion included: 1) participants age ≥18 years; 2) a behavioral weight loss intervention; 3) weight as an outcome variable; 4) inclusion of black women; and 5) weight loss results reported separately by ethnicity and gender. Results The literature search identified 25 studies that met inclusion criteria. Our findings suggest more intensive randomized behavioral weight loss trials with medically at-risk populations yield better results. Conclusions Well-designed and more intensive multi-site trials with medically at-risk populations currently offer the most promising results for black women. Still, black women lose less weight than other subgroups in behavioral weight loss interventions. It is now critical to expand on individual-level approaches and incorporate the biological, social, and environmental factors that influence obesity. This will help enable the adoption of healthier behaviors for this group of women disproportionately affected by obesity.

IMPORTANCE There is a lack of agreement on what constitutes successful outcomes for the process of health care transition (HCT) among adolescent and young adults with special health care needs. OBJECTIVE To present HCT outcomes identified by a Delphi process with an interdisciplinary group of participants. DESIGN, SETTING, AND PARTICIPANTS A Delphi method involving 3 stages was deployed to refine a list of HCT outcomes. This 18-month study (from January 5, 2013, of stage 1 to July 3, 2014, of stage 3) included an initial literature search, expert interviews, and then 2 waves of a web-based survey. On this survey, 93 participants from outpatient, community-based, and primary care clinics rated the importance of the top HCT outcomes identified by the Delphi process. Analyses were performed from July 5, 2014, to December 5, 2014. EXPOSURES Health care transition outcomes of adolescents and young adults with special health care needs. MAIN OUTCOMES AND MEASURES Importance ratings of identified HCT outcomes rated on a Likert scale from 1 (not important) to 9 (very important). RESULTS The 2 waves of surveys included 117 and 93 participants as the list of outcomes was refined. Transition outcomes were refined by the 3 waves of the Delphi process, with quality of life being the highest-rated outcome with broad agreement. The 10 final outcomes identified included individual outcomes (quality of life, understanding the characteristics of conditions and complications, knowledge of medication, self-management, adherence to medication, and understanding health insurance), health services outcomes (attending medical appointments, having a medical home, and avoidance of unnecessary hospitalization), and a social outcome (having a social network). Participants indicated that different outcomes were likely needed for individuals with cognitive disabilities. CONCLUSIONS AND RELEVANCE Quality of life is an important construct relevant to HCT. Future research should identify valid measures associated with each outcome and further explore the role that quality of life plays in the HCT process. Achieving consensus is a critical step toward the development of reliable and objective comparisons of HCT outcomes across clinical conditions and care delivery locations.

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The SCCRIP cohort will provide a rich resource for the conduct of high impact multidisciplinary research in SCD.

Severely overweight adolescents of both genders and diverse ethnicities face significant stigmatization and manifest poor overall psychosocial functioning, which is negatively associated with QOL. Furthermore, self-esteem appears to partially mediate the negative relationship between teasing and QOL.

The aim of the current descriptive study was to explore factors related to psychosocial wellbeing, weight gain and perceived barriers to exercise and nutrition in 135 obese adolescents enrolled in a multidisciplinary weight management program. Participants completed initial intake interviews, which included information about psychosocial well-being, factors associated with weight gain, and barriers to exercise and nutrition. We examined the associations among psychosocial factors and participants' attendance compliance for the nutrition, exercise, and behavioral support and modification components of the program. Results indicated that familial factors were associated with weight gain, and family, peer, and individual factors were associated with barriers to healthy eating and exercise. Among the psychosocial factors, history of trauma was negatively associated with compliance. Findings emphasize the importance of addressing psychosocial well-being and using a systems approach to weight management for obese adolescents.

Most children with sickle cell disease (SCD) today survive into adulthood. Among emerging adults, there is a marked increase in acute care utilization and a rise in mortality, which can be exacerbated by not establishing or remaining in adult care. Health care transition programs are therefore essential to prepare, transfer, and integrate emerging adults in the adult care setting. The Six Core Elements of Health Care Transition, created by the Center for Health Care Transition Improvement, define the basic components of health care transition support as follows: (1) transition policy, (2) tracking and monitoring progress, (3) assessing transition readiness, (4) planning for adult care, (5) transferring to adult care, and (6) integrating into adult care. Programs that implement the Six Core Elements have experienced significant declines in care abandonment during adolescence and young adulthood and higher early adult care engagement. Most of the core transition activities are not currently reimbursable, however, posing a challenge to sustain transition programs. Ongoing studies are investigating interventions in comparative effectiveness trials to improve health-related quality of life and reduce acute care utilization among emerging adults with SCD. Although these studies will identify best practices for health care transition, it is also important to define how the transition outcomes will be measured, as no consensus definition exists for successful health care transition in SCD. Future research is needed to define best practices for health care transition, systematically assess transition outcomes, and revise payment models to promote sustainability of health care transition programs.

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