title: Contingency management adapted for African-American adolescents with obesity enhances youth weight loss with caregiver participation: a multiple baseline pilot study.
abstract: BACKGROUND
  Contingency management (CM) interventions, which use operant conditioning principles to encourage completion of target behavioral goals, may be useful for improving adherence to behavioral skills training (BST). Research-to-date has yet to explore CM for weight loss in minority adolescents.
  
  
  OBJECTIVE
  To examine the effects of CM in improving adolescent weight loss when added to BST.
  
  
  METHODS
  The study utilized an innovative experimental design that builds upon multiple baseline approaches as recommended by the National Institutes of Health.
  
  
  METHODS
  Six obese African-American youth and their primary caregivers living in Detroit, Michigan, USA.
  
  
  METHODS
  Adolescents received between 4 and 12 weeks of BST during a baseline period and subsequently received CM targeting weight loss.
  
  
  METHODS
  Youth weight.
  
  
  METHODS
  Linear mixed effects modeling was used in the analysis.
  
  
  RESULTS
  CM did not directly affect adolescent weight loss above that of BST (p=0.053). However, when caregivers were involved in CM session treatment, contingency management had a positive effect on adolescent weight loss. The estimated weight loss due to CM when caregivers also attended was 0.66 kg/week (p<0.001, [95% CI; -1.96, -0.97]) relative to the baseline trajectory.
  
  
  CONCLUSIONS
  This study demonstrates application of a novel experimental approach to intervention development and demonstrated the importance of parent involvement when delivering contingency management for minority youth weight loss. Lessons learned from contingency management program implementation are also discussed in order to inform practice.
authors.forename: Kathryn Brogan
authors.initials: KB
authors.lastname: Hartlieb
authors.forename: Sylvie
authors.initials: S
authors.lastname: Naar
authors.forename: David M
authors.initials: DM
authors.lastname: Ledgerwood
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Templin
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Ellis
authors.forename: Bradley
authors.initials: B
authors.lastname: Donohue
authors.forename: Phillippe B
authors.initials: PB
authors.lastname: Cunningham
keywords: contingency management; minority adolescents; obesity