title: School-based health center-based treatment for obese adolescents: feasibility and body mass index effects.
abstract: BACKGROUND
  School-based health centers (SBHCs) may be an ideal setting to address obesity in adolescents because they provide increased access to a traditionally difficult-to-reach population. The study evaluated the feasibility of adding a health educator (HE) to SBHC teams to provide support and increase the delivery of preventive services for overweight or obese adolescents.
  
  
  METHODS
  Adolescents with BMI ≥85% recruited from two SBHCs were randomized to a control group (CG) or an intervention group (IG). Both groups received preventive services, including physical examinations and laboratory screening in the SBHC. The educator met with the IG during the academic year, utilizing motivational interviewing techniques to set lifestyle goals. Text messaging was used to reinforce goals between visits.
  
  
  RESULTS
  Eighty-two students (15.7±1.5 years of age; BMI, 31.9±6.2 kg/m(2)) were enrolled in the IG and 83 in the control group (16.0±1.5 years of age; BMI, 31.6±6.5 kg/m(2)). Retention was 94% in the IG and 87% in the CG. A total of 54.5% of the IG and 72.2% of the CG decreased or maintained BMI z-score (less than 0.05 increase; p=0.025). Sports participation was higher in the CG (47% vs. 28% in the IG; p=0.02). Mean BMI z-score change was -0.05±0.2 for students participating in sports vs. 0.01±0.2 for those not (p=0.09).
  
  
  CONCLUSIONS
  This SBHC intervention showed successful recruitment and retention of participants and delivery of preventive services in both groups. Meeting with an HE did not improve BMI outcomes in the IG. Confounding factors, including sports participation and SBHC utilization, likely contributed to BMI outcomes.
authors.affiliation: 1 Department of Pediatrics, Denver Health and Hospitals Authority , Denver, CO.
authors.forename: Kathy
authors.initials: K
authors.lastname: Love-Osborne
authors.forename: Rachel
authors.initials: R
authors.lastname: Fortune
authors.forename: Jeanelle
authors.initials: J
authors.lastname: Sheeder
authors.forename: Steven
authors.initials: S
authors.lastname: Federico
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Haemer
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D016497:Adolescent Health Services; D017195:Adolescent Nutritional Physiological Phenomena; D015992:Body Mass Index; D004032:Diet; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D062405:Motivational Interviewing; D009765:Obesity / Q000517:prevention & control / Q000523:psychology*; D040242:Risk Reduction Behavior; D012572:School Health Services; D013334:Students; D060145:Text Messaging; D016896:Treatment Outcome