title: Evaluation of a community-based weight management program for predominantly severely obese, difficult-to-reach, inner-city minority adolescents.
abstract: BACKGROUND
  Few interventions targeting severely obese minority youth have been implemented in community-based settings. We evaluate a 9-month multicomponent, community-based program for obese, inner-city adolescents.
  
  
  METHODS
  Of 5250 estimated eligible adolescents, 349 were recruited; they had a mean age of 15 ± 2 years, mean BMI %ile 98.9 ± 1.5, and comprised 52% African American and 44% Hispanic. Longitudinal trends of anthropometric measures were compared 1 year before enrollment (T-12), at baseline (T0) and after program completion (T9). Dietary and physical activity behaviors were compared at T0 and T9. Anthropometric changes were compared at T9 and 18 months (T18) in completers and noncompleters.
  
  
  RESULTS
  A majority of participants were severely obese (67%) and expressed low readiness to change behaviors (82%). For intervals T-12 to T0 versus T0 to T9, there were significant decreases in rates of gain in BMI (0.13 vs. 0.04, p < 0.01), BMI percentile (0.0002 vs. -0.0001, p < 0.01), percent overweight (0.001 vs. -0.001, p < 0.01), and BMI z-score (0.003 vs. -0.003, p < 0.01). Significant increases in vegetable and fruit consumption and in vigorous physical activity participation were observed. From T9 to T18, except for a significant increase in BMI (38.3 ± 7.4 vs. 39.0 ± 7.5, p < 0.01) in completers, all other anthropometric measures remained unchanged in completers and noncompleters.
  
  
  CONCLUSIONS
  We demonstrate modest clinical improvements and increased healthy lifestyle behaviors in predominantly severely obese, difficult-to-reach, ethnic minority adolescents attending a community-based weight management program. The loss of clinical improvements 9 months after program completion implies that extending the duration of such a program may prevent long-term weight regain in severely obese adolescents.
authors.affiliation: Children's Hospital at Montefiore, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Rieder
authors.forename: Unab I
authors.initials: UI
authors.lastname: Khan
authors.forename: Moonseong
authors.initials: M
authors.lastname: Heo
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Mossavar-Rahmani
authors.forename: Arthur E
authors.initials: AE
authors.lastname: Blank
authors.forename: Temima
authors.initials: T
authors.lastname: Strauss
authors.forename: Nisha
authors.initials: N
authors.lastname: Viswanathan
authors.forename: Judith
authors.initials: J
authors.lastname: Wylie-Rosett
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology; D015992:Body Mass Index; D004032:Diet; D005260:Female; D005638:Fruit; D015438:Health Behavior; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008297:Male; D008913:Minority Groups; D009767:Obesity, Morbid / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*; D015397:Program Evaluation; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D014675:Vegetables; D015431:Weight Loss; D061217:Weight Reduction Programs