title: The COPE Healthy Lifestyles TEEN program: feasibility, preliminary efficacy, & lessons learned from an after school group intervention with overweight adolescents.
abstract: BACKGROUND
  There has been a paucity of theory-based interventions to improve health outcomes in overweight adolescents. Therefore, two intervention studies were conducted to: (a) determine the feasibility of implementing the Creating Opportunities for Personal Empowerment (COPE) Healthy Lifestyles Thinking, Emotions, Exercise, and Nutrition (TEEN) program with overweight adolescents; (b) obtain feedback that could be used to refine the program; and (c) examine the preliminary efficacy of the COPE program on the adolescents' weight and body mass index (BMI).
  
  
  METHODS
  Phase I and Phase II clinical trials were conducted with 23 overweight teens. The Phase 1 trial used a pre-experimental design with one group of 11 urban adolescents. The Phase 2 trial was conducted with 12 suburban teens using a randomized controlled pilot study. COPE teens received a 15-session cognitive-behavioral skills building program that included physical activity, while the control group received an attention control program. Weight change and BMI were the key outcomes.
  
  
  RESULTS
  COPE teens experienced a significantly greater reduction in weight and BMI than did teens in the control group, who gained weight over time. Although the COPE program was well received by all of the teens, retention of subjects across time and parent involvement in the program were challenges in the urban high school.
  
  
  CONCLUSIONS
  These studies provide preliminary data to indicate that the implementation of COPE is feasible and may lead to a reduction in weight and BMI in overweight teens. Implementing COPE within the context of the school day may be more successful in sustaining adolescent involvement in the program versus using an after-school format.
authors.affiliation: Arizona State University College of Nursing & Healthcare Innovation, 500 N 3rd St, Phoenix, AZ 85004, USA. Bernadette.Melnyk@asu.edu
authors.forename: Bernadette Mazurek
authors.initials: BM
authors.lastname: Melnyk
authors.forename: Leigh
authors.initials: L
authors.lastname: Small
authors.forename: Dianne
authors.initials: D
authors.lastname: Morrison-Beedy
authors.forename: Anne
authors.initials: A
authors.lastname: Strasser
authors.forename: Lisa
authors.initials: L
authors.lastname: Spath
authors.forename: Richard
authors.initials: R
authors.lastname: Kreipe
authors.forename: Hugh
authors.initials: H
authors.lastname: Crean
authors.forename: Diana
authors.initials: D
authors.lastname: Jacobson
authors.forename: Stephanie
authors.initials: S
authors.lastname: Kelly
authors.forename: Judith
authors.initials: J
authors.lastname: O'Haver
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D001294:Attitude to Health; D053198:Child Nutrition Sciences / Q000193:education; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D015928:Cognitive Behavioral Therapy / Q000458:organization & administration; D015444:Exercise; D005240:Feasibility Studies; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D020380:Needs Assessment; D009518:New York; D015404:Nursing Methodology Research; D009765:Obesity / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology*; D010353:Patient Education as Topic / Q000458:organization & administration*; D011209:Power, Psychological; D015397:Program Evaluation; D000297:Psychology, Adolescent; D016032:Randomized Controlled Trials as Topic; D012572:School Health Services / Q000458:organization & administration*; D012648:Self Care