The Impact of Curtin University's Activity, Food and Attitudes Program on Physical Activity, Sedentary Time and Fruit, Vegetable and Junk Food Consumption among Overweight and Obese Adolescents: A Waitlist Controlled Trial

Abstract

BackgroundTo determine the effects of participation in Curtin University's Activity, Food and Attitudes Program (CAFAP), a community-based, family-centered behavioural intervention, on the physical activity, sedentary time, and healthy eating behaviours of overweight and obese adolescents.MethodsIn this waitlist controlled clinical trial in Western Australia, adolescents (n = 69, 71% female, mean age 14.1 (SD 1.6) years) and parents completed an 8-week intervention followed by 12 months of telephone and text message support. Assessments were completed at baseline, before beginning the intervention, immediately following the intervention, and at 3-, 6-, and 12- months follow-up. The primary outcomes were physical activity and sedentary time assessed by accelerometers and servings of fruit, vegetables and junk food assessed by 3-day food records.ResultsDuring the intensive 8-week intervention sedentary time decreased by −5.1 min/day/month (95% CI: −11.0, 0.8) which was significantly greater than the rate of change during the waitlist period (p = .014). Moderate physical activity increased by 1.8 min/day/month (95% CI: −0.04, 3.6) during the intervention period, which was significantly greater than the rate of change during the waitlist period (p = .041). Fruit consumption increased during the intervention period (monthly incidence rate ratio (IRR) 1.3, 95% CI: 1.10, 1.56) and junk food consumption decreased (monthly IRR 0.8, 95% CI: 0.74, 0.94) and these changes were different to those seen during the waitlist period (p = .004 and p = .020 respectively).ConclusionsParticipating in CAFAP appeared to have a positive influence on the physical activity, sedentary and healthy eating behaviours of overweight and obese adolescents and many of these changes were maintained for one year following the intensive intervention.Trial RegistrationAustralia and New Zealand Clinical Trials Registry ACTRN12611001187932

It’s A-bout Time: Detailed Patterns of Physical Activity in Obese Adolescents Participating in a Lifestyle Intervention

“…This study provides a detailed analysis of physical activity and sedentary time as part of a larger waitlist controlled clinical trial with details previously published. 5,6 Participants completed an 8-week intervention with 12 months of follow-up maintenance intervention. Six assessments were completed: baseline, 3 months following baseline and immediately prior to beginning the intervention (waitlist period for within subject comparison), immediately completing the 8-week intervention (intervention period), and at 3 months, 6 months, and 12 months following the intensive intervention (maintenance periods).…”

“…A total of 69 participants (age range 11.3-16.9 years; n=55 with BMI percentile >95) enrolled in the study and a detailed participant flow diagram has been previously published. 6 CAFAP was developed based on Self-Determination Theory and Goal Setting Theory through formative assessment with stakeholders. 25,26 The program was delivered in the community by a multidisciplinary team of a dietitian, physiotherapist/exercise scientist, and psychologist.…”

“…Each session included a behavior change lesson (both separately and with parents and adolescents together) and an exercise component for adolescents. 6 Exercises were designed to be fun and included team games, circuits, and other activities that they could continue after CAFAP. Behavioral sessions focused on goal setting, overcoming barriers and finding community resources.…”

“…Behavioral sessions focused on goal setting, overcoming barriers and finding community resources. 6 Parents were guided to provide need-supportive environments for their child to make behavior changes. Following the initial 8-week intervention, participants received maintenance phone calls and text messages at a decreasing frequency for 12 months following the intervention.…”

“…In a waitlist controlled clinical trial, participants in CAFAP had limited positive changes in objectively measured physical activity and sedentary behavior. 6 However, these overall changes in physical activity and sedentary behavior may overlook specific changes in activity patterns of overweight and obese adolescents. Detailed information about patterns in these behaviors may be useful for multiple purposes.…”