The Effect of a Prospective Lifestyle Intervention on Obesity Related Quality of Life in Youth

Abstract

BackgroundIn childhood obesity interventions, tools that measure obesity related quality of life are as important as physical health markers like BMI and waist circumference. Seattle Children's Hospital developed an evidence‐based intervention, ACT (Actively Changing Together), aimed at youth with overweight or obesity and their families living in an agricultural community with high rates of obesity, associated comorbidities, food insecurity, and low health literacy. In previous analyses of the ACT program, improvements were found in anthropometric measures, selected eating behaviors and general pediatric quality of life (QOL). In an attempt to provide convergent validity, an understudied obesity‐specific quality of life instrument was used in addition to the general quality of life tool. Measurement of psychosocial health was emphasized because it contributes to the health of youth and may impact future success maintaining healthy lifestyle habits.ObjectiveTo measure immediate and prospective QOL after the 12‐week ACT intervention using an obesity‐specific instrument.MethodsParticipants were 8–14‐year‐old youth with overweight or obesity who were referred to the program by a healthcare provider (inclusion criteria BMI≥85th percentile). Twelve, 90‐min classes in English and Spanish were held weekly at the YMCA for both the participants and their parents. In addition to anthropometrics, QOL was measured with the obesity‐specific instrument, Sizing Me Up. Complete data were collected for 68 participants at baseline and at three follow‐up points after the intervention: initial follow‐up (n = 68), 6 months (n = 44), and 12 months (n = 24). Analyses were done using SPSS v22 and included omnibus ANOVA and subsequent paired dependent t‐tests between the four time points for anthropometrics and QOL.ResultsTotal obesity related QOL improved across all three time points: baseline (mean = 73.54) to initial follow up (mean = 81.49), baseline (mean = 69.27) to 6‐months (mean = 77.966), and baseline (mean = 74.974) to 1‐year (mean = 79.544). Tests of simple effects revealed significant improvements in both physical and obesity‐specific quality of life in each group: baseline to follow‐up, baseline to 6‐month, baseline to 1 year (Table 1). ANOVA for waist circumference revealed significant differences F(3,60)=12.395, p<0.001. Waist circumference decreased between baseline and follow up t(67)=2.83, p=.006. Additionally, BMI was lower t(67)=2.707, p=.009.ConclusionsFor up to 1 year after the conclusion of the 12‐week community and family based intervention, the Sizing Me Up instrument detected significant and positive changes in this study population. This tool provides convergent validity for the generic PedsQLTM tool. Because it emphasizes psychosocial dimensions including teasing, positive attributes, and emotion, changes in these obesity related quality of life markers provide clinically meaningful success of the intervention.Support or Funding InformationThe Safeway Foundation Results of paired differences analysis between baseline and each follow‐up period with p‐values. Paired Differences (t value; p‐value) Baseline to initial Baseline to 6 month Baseline to 1 year Total Obesity Related QOL t(20)=2.76, p=.012 t(15)=2.915, p=.011 t(22)=2.360, p=.028 Physical NS t(15)=2.708, p=.016 t(22)=2.536, p=.019 Emotion t(20)=2.713, p=.013 t(15)=2.82, p=.013 t(22)=2.986, p=.007 Teasing NS t(15)=2.782. p=.014 NS