The effects of multisystemic therapy on family support for weight loss among obese African-American adolescents: findings from a randomized controlled trial.
OBJECTIVE
To determine whether multisystemic therapy, an intensive, home- and community-based intervention, could increase family support for healthy eating and exercise in obese African-American adolescents. Relationships between changes in family support, weight status, and body fat composition at the end of the trial were also evaluated.


METHODS
A pilot randomized clinical trial was conducted with 49 obese adolescents (body mass index > or = 95th %ile). Participants were randomized to receive multisystemic therapy or Shapedown, a group weight loss intervention. Participants received treatment for 6 months. Data were collected at baseline and 7-month posttest (i.e., treatment termination). Changes in family support for healthy eating and exercise were assessed by self-report questionnaire. Bivariate analyses were used to assess the relationship between change in family support during the trial and youth body mass index, percent overweight, and body fat composition at follow-up.


RESULTS
Participation in multisystemic therapy was associated with significantly greater improvements in family encouragement for healthy eating and family participation in exercise and greater decreases in discouraging behavior from family members than Shapedown participation. Increases in family participation in exercise were significantly related to lower youth body mass index, percent overweight, and body fat composition at follow-up.


CONCLUSIONS
Intensive, home- and community-based treatment increased family support for health behavior changes among obese minority adolescents, and these changes were directly related to weight status. Such health improvements are important for the well-being of a subset of youth who are at high risk for future health complications.
Ellis
Deborah A
DA
Carman and Ann Adams Department of Pediatrics, Wayne State University, Detroit, MI, USA. dellis@med.wayne.edu
Janisse
Heather
H
Naar-King
Sylvie
S
Kolmodin
Karen
K
Jen
K-L Catherine
KL
Cunningham
Phillippe
P
Marshall
Sharon
S
D000293:Adolescent; D001741:Black or African American / Q000523:psychology*; D001823:Body Composition; D050218:Body Fat Distribution; D015992:Body Mass Index; D002648:Child; D004038:Diet, Reducing / Q000208:ethnology / Q000523:psychology; D015444:Exercise / Q000523:psychology; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000208:ethnology* / Q000628:therapy*; D012944:Social Support; D013598:Systems Theory; D015431:Weight Loss / Q000208:ethnology