title: A primary care-based, multicomponent lifestyle intervention for overweight adolescent females.
abstract: OBJECTIVE
  Most clinic-based weight control treatments for youth have been designed for preadolescent children by using family-based care. However, as adolescents become more autonomous and less motivated by parental influence, this strategy may be less appropriate. This study evaluated a primary care-based, multicomponent lifestyle intervention specifically tailored for overweight adolescent females.
  
  
  METHODS
  Adolescent girls (N = 208) 12 to 17 years of age (mean ± SD: 14.1 ± 1.4 years), with a mean ± SD BMI percentile of 97.09 ± 2.27, were assigned randomly to the intervention or usual care control group. The gender and developmentally tailored intervention included a focus on adoptable healthy lifestyle behaviors and was reinforced by ongoing feedback from the teen's primary care physician. Of those randomized, 195 (94%) completed the 6-month posttreatment assessment, and 173 (83%) completed the 12-month follow-up. The primary outcome was reduction in BMI z score.
  
  
  RESULTS
  The decrease in BMI z score over time was significantly greater for intervention participants compared with usual care participants (-0.15 in BMI z score among intervention participants compared with -0.08 among usual care participants; P = .012). The 2 groups did not differ in secondary metabolic or psychosocial outcomes. Compared with usual care, intervention participants reported less reduction in frequency of family meals and less fast-food intake.
  
  
  CONCLUSIONS
  A 5-month, medium-intensity, primary care-based, multicomponent behavioral intervention was associated with significant and sustained decreases in BMI z scores among obese adolescent girls compared with those receiving usual care.
authors.affiliation: Kaiser Permanente Center for Health Research, Portland, OR 97227, USA. lynn.debar@kpchr.org
authors.forename: Lynn L
authors.initials: LL
authors.lastname: DeBar
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Stevens
authors.forename: Nancy
authors.initials: N
authors.lastname: Perrin
authors.forename: Philip
authors.initials: P
authors.lastname: Wu
authors.forename: John
authors.initials: J
authors.lastname: Pearson
authors.forename: Bobbi Jo
authors.initials: BJ
authors.lastname: Yarborough
authors.forename: John
authors.initials: J
authors.lastname: Dickerson
authors.forename: Frances
authors.initials: F
authors.lastname: Lynch
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001521:Behavior Therapy; D015992:Body Mass Index; D002648:Child; D003131:Combined Modality Therapy; D004032:Diet; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006279:Health Maintenance Organizations; D006801:Humans; D008019:Life Style; D050177:Overweight / Q000175:diagnosis / Q000628:therapy*; D010287:Parent-Child Relations; D010349:Patient Compliance; D018579:Patient Selection; D011320:Primary Health Care / Q000379:methods*; D016896:Treatment Outcome; D015431:Weight Loss