title: A Multimodal Counseling-Based Adolescent Physical Activity Intervention.
abstract: National guidelines recommend adolescents achieve 60 minutes of moderate-to-vigorous physical activity (MVPA)/day, yet few adolescents meet these guidelines.
  
  
  
  We piloted a novel quasi-randomized physical activity intervention to promote adolescent's use of their surrounding built environment among 30 intervention and 30 control overweight/obese adolescents aged 10-16 years living in greater Boston from 2013 to 2015. Location-specific MPVA was measured by accelerometry and global positioning system for three one-week periods (Time 1 [T1], Time 2 [T2], and Time 3 [T3]). One month after T1, intervention participants received individualized counseling on how to use their surrounding built environment to increase MVPA, and control participants received standard-of-care lifestyle modification counseling; both groups received their T1 physical activity data. T2 assessment occurred the week after the counseling visit and T3 assessment 3-4 months later. The main outcome was change in average daily minutes of MVPA; the secondary outcome was meeting national MVPA guidelines. Multivariable modeling accounted for covariates (baseline MVPA, body mass index, age, sex, race/ethnicity) and clustering by study group and town.
  
  
  
  Among the 60 adolescents recruited, 55 (92%) completed data collection. Short-term (T2) intervention effects included increased average MVPA of +13.9 minutes intervention versus -.6 minutes control (p < .0001). Differential increase in mean daily MVPA was sustained at T3 (9.3 minutes more in intervention group; p = .0006). The proportion of adolescents in the intervention group who achieved 60 minutes/day of MVPA increased from 11% (T1) to 21% (T2), whereas declining (7%-0%) among controls.
  
  
  
  Individualized counseling about the built environment can help increase MVPA among overweight and obese adolescents.
authors.affiliation: Department of Pediatrics, Division of General Academic Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts; Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; Department of Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Electronic address: noreskovic@mgh.harvard.edu.
authors.forename: Nicolas M
authors.initials: NM
authors.lastname: Oreskovic
authors.affiliation: Department of Pediatrics, Division of General Academic Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts; Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Winickoff
authors.affiliation: Department of Pediatrics, Division of General Academic Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts; Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: James M
authors.initials: JM
authors.lastname: Perrin
authors.affiliation: Department of Pediatrics, Division of General Academic Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts.
authors.forename: Alyssa I
authors.initials: AI
authors.lastname: Robinson
authors.affiliation: Department of Pediatrics, Division of General Academic Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts; Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Goodman
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D003376:Counseling / Q000379:methods*; D015444:Exercise; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000628:therapy*; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D013997:Time Factors
keywords: Adolescents; Built environment; Counseling; Intervention; Obesity; Overweight; Physical activity