A "novel" intervention: a pilot study of children's literature and healthy lifestyles.
OBJECTIVE
To determine if reading an age-appropriate novel has the potential to improve BMI percentile and exercise- and nutrition-related knowledge and behaviors in girls aged 9 to 13 years who were enrolled in a childhood obesity-treatment program.


METHODS
This preliminary, randomized, controlled trial followed 81 obese girls aged 9 to 13 years who were enrolled in the Duke University Healthy Lifestyles Program, a comprehensive clinical and behavioral lifestyle-modification program for overweight and obese children. Thirty-one girls were randomly assigned to read the intervention novel, which describes an overweight girl who discovers improved health and self-efficacy, and 33 participants were given a control novel to read. Participants were evaluated at the study intake and again at their scheduled follow-up appointments 1 to 2 months later. Intake and follow-up BMI percentiles were evaluated for 17 girls in the program who did not receive either book.


RESULTS
Follow-up data were available for 11 of 31 girls in the intervention-book group, 14 of 33 girls in the control-book group, and 14 of 17 girls who did not receive a book. There was a significantly greater reduction in BMI percentile among those in the intervention-book group (-0.71) versus those in the control-book group (-0.33; P = .03). Girls who read either book had a significantly greater reduction in BMI percentile (-0.49) than girls who were followed in the program but who were not assigned a book (0.05; P = .02).


CONCLUSIONS
Age-appropriate fiction, particularly if it addresses health-oriented behaviors, shows potential for augmenting weight loss in girls who participate in a weight-management program. Future research is needed to determine if the novel is effective for healthy lifestyle promotion among all overweight and obese adolescents.
Nationwide Children's Hospital, Adolescent Medicine, 700 Children's Dr, Columbus, OH 43205, USA. terrill.bravender@nationwidechildrens.org
Terrill
T
Bravender
Alexandra
A
Russell
Richard J
RJ
Chung
Sarah C
SC
Armstrong
D000293:Adolescent; D001638:Bibliotherapy; D002648:Child; D004324:Drama; D005260:Female; D006801:Humans; D008019:Life Style; D009765:Obesity / Q000517:prevention & control / Q000628:therapy*; D010865:Pilot Projects; D011932:Reading