title: National Adolescent Treatment Trial for Obesity in Kuwait (NATTO): project design and results of a randomised controlled trial of a good practice approach to treatment of adolescent obesity in Kuwait.
abstract: BACKGROUND
  Few randomised controlled trials (RCTs) of interventions for the treatment of adolescent obesity have taken place outside the western world. This RCT tested whether a simple 'good practice' intervention for the treatment of adolescent obesity would have a greater impact on weight status and other outcomes than a referral to primary care (control) in adolescents in Kuwait City.
  
  
  METHODS
  We report on an assessor-blinded RCT of a treatment intervention in 82 obese 10- to 14-year-olds (mean age 12.4, SD 1.2 years), randomised to a good practice treatment or primary care control group over 6 months. The good practice intervention was intended as relatively low intensity (6 hours contact over 24 weeks, group-based), aiming to change sedentary behaviour, physical activity, and diet. The primary outcome was a change in body mass index (BMI) Z score; other outcomes were changes in waist circumference and blood pressure.
  
  
  RESULTS
  The retention of subjects to follow up was acceptable (n = 31 from the intervention group, and n = 32 from the control group), but engagement with both the intervention and control treatment was poor. Treatment had no significant effect on BMI Z score relative to control, and no other significant benefits to intervention were observed.
  
  
  CONCLUSIONS
  The trial was feasible, but highlights the need to engage obese adolescents and their families in the interventions being trialled. The trial should inform the development of future adolescent obesity treatment trials in the Gulf States with the incorporation of qualitative assessment in future intervention trials.
  
  
  BACKGROUND
  RCT Registered as National Adolescent Treatment Trial for Obesity in Kuwait (NATTO): http://www.controlled-trials.com/ISRCTN37457227, 1 December 2009.
authors.affiliation: University of Glasgow School of Medicine, Level 3 New Lister Building, GRI, 10 Alexander Parade, Glasgow, Scotland. s.boodai.1@research.gla.ac.uk.
authors.forename: Shurooq A
authors.initials: SA
authors.lastname: Boodai
authors.forename: John H
authors.initials: JH
authors.lastname: McColl
authors.forename: John J
authors.initials: JJ
authors.lastname: Reilly
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D004038:Diet, Reducing; D005500:Follow-Up Studies; D006801:Humans; D007730:Kuwait; D009043:Motor Activity; D063766:Pediatric Obesity / Q000628:therapy*; D011320:Primary Health Care / Q000379:methods*; D012107:Research Design; D057185:Sedentary Behavior; D055105:Waist Circumference