Background:
Determinants of obesity are multidimensional and influenced in part by early-life environments. Lifestyle intervention programs for adolescents with obesity are challenging and frequently report disappointing results with lack of published insights to guide development for effective practice-based models. We provide practical insights from lessons learnt in delivering the Danny’s Place™ integrated health model for the management of adolescent (10-18yrs) obesity.
Methods:
We delivered a 24-week family-centred adolescent weight-management program and examined the characteristics of the population including standard demographics (age, gender and weight), family dynamics and program retention. Perceived program benefits, based on feedback provided by families will also be thematically represented.
Results:
From March 2016 to March 2017, 20 adolescents aged 11-17.5yrs were recruited into the program (11yrsF,9yrsM). Baseline mean overall weight was 110.9kg (105.2kgF, 131.8kgM) with an overall change in weight of -1.8kg at 24 weeks (range: +8.5kg to – 30.6kg). The wide range in weight change over time is indicative of the challenges faced in keeping adolescents motivated to sustain change. Although there was 100% retention to week 24, frequency of contact with the team ranged between 2-4 weekly visits.
The family dynamic included 4 single-parent families and 2 ward of the state. Of the adolescents 4 were first child, 9 second children, 3 middle children and 2 were only child and 2 unknown (ward-of-the-state). Sibling comparisons and preferential treatments within families were identified.
Key themes emerging from family feedback surrounded the benefits of mobile messaging with program-coordinator support, health-provider access and interactive and practical education sessions. Challenges included referrals and continuity of counselling care for ward cases.
Conclusion:
The Danny's Place 24-week program demonstrated, that with support for parents and adolescents with practical and real-life education sessions, adherence to the program is promising and that adolescents with obesity were able achieve positive lifestyle changes. These preliminary findings provide insights to future program development.