CAFAP: A multi-disciplinary, family-centred community-based intervention for overweight/obese adolescents

Abstract

Introduction: Around one quarter of Australian adolescents are overweight or obese. This presents a serious individual and community problem due to the related short term and long term physical and mental health issues. Adolescence is seen as a critical period in the development of overweight and obesity. Despite this, there is limited evidence of effective interventions. A number of recent reviews have highlighted the gap in evidence but have also recommended key intervention aspects based on the available evidence; multi-disciplinary, family-centred and community-based targeting sedentary and vigorous activity and diet and cognitive and emotional aspects. Therefore the aim of this study was to develop and evaluate a multi-disciplinary, family-centred, community-based intervention targeting activity, food and attitudes in overweight/obese adolescents.Method: A tertiary hospital based program for adolescent obesity (Princess Margaret Hospital “Fitmatters” program) was adapted for multi-disciplinary community-based delivery. The Curtin University’s Activity, Food and Attitudes Program consisted of twice weekly sessions for adolescents and their parents for an 8 week period. Each session was 2 h in duration with adolescents participating in a gym based exercise program for 1 h and education and support sessions for the second hour. Parents participated in education and support sessions for both hours, some of which were with the adolescents. Sessions were facilitated by physiotherapy, dietetics, psychology and social work professionals and undergraduate/postgraduate students. The program, promoted via the children’s hospital, GP networks, school community health nurses, community newspapers and posters in community centres, was offered during school terms 2, 3 and 4 in 2009. The goal of the program was not weight change but rather to change behaviours to enable sustained improvement in health. Evaluation included qualitative assessment of process and participation along with quantitative assessment of key outcomes. Sedentary and moderate/vigorous activity behaviour was assessed by accelerometer and questionnaire. Diet behaviour was assessed by 3 day food diary.Results: In total 31 obese adolescents were invited to participate, 24 accepted and started the program and 16 completed the program. Qualitative feedback from both adolescent and parent participants found high levels of satisfaction with the program. Attendance rates were high. Clinically useful improvements in activity and diet behaviours were recorded by most, though not all, participants. Conclusion: This initial study demonstrated the acceptability and feasibility of a multi-disciplinary, family-centred, community-based intervention targeting activity, food and attitudes in overweight/obese adolescents. Further research using this approach will evaluate the sustainability of behavioural changes.