The role of parents in behavioral treatment for adolescent obesity: design and rationale for the TEENS+ randomized clinical trial

Melanie K Bean; Jessica Gokee LaRose; Edmond P Wickham 3rd; Hollie A Raynor; Laura Caccavale; Ronald K Evans; Laura M Thornton; Sarah Farthing; Ashley Mendoza; Suzanne E Mazzeo

doi:10.1186/s12889-023-16421-0

The role of parents in behavioral treatment for adolescent obesity: design and rationale for the TEENS+ randomized clinical trial

BMC Public Health. 2023 Aug 4;23(1):1484. doi: 10.1186/s12889-023-16421-0.

Authors

Melanie K Bean^{1

2}, Jessica Gokee LaRose³, Edmond P Wickham 3rd^{4

5}, Hollie A Raynor⁶, Laura Caccavale⁴, Ronald K Evans⁷, Laura M Thornton⁸, Sarah Farthing⁴, Ashley Mendoza⁴, Suzanne E Mazzeo^{4

9}

Affiliations

¹ Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Box 980140, Richmond, VA, 23298, USA. melanie.bean@vcuhealth.org.
² Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Box 980308, Richmond, VA, 23298, USA. melanie.bean@vcuhealth.org.
³ Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Box 980430, Richmond, VA, 23298, USA.
⁴ Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Box 980140, Richmond, VA, 23298, USA.
⁵ Department of Internal Medicine, School of Medicine, Virginia Commonwealth University, Box 980111, Richmond, VA, 23298, USA.
⁶ Department of Nutrition, University of Tennessee, Knoxville, 1215 W. Cumberland Ave., Knoxville, TN, 37996, USA.
⁷ Department of Kinesiology and Health Sciences, College of Humanities and Sciences, Virginia Commonwealth University, Box 843021, Richmond, VA, 23284, USA.
⁸ Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, CB#7160 101 Manning Drive, Chapel Hill, NC, 27599-7160, USA.
⁹ Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, Box 842018, Richmond, VA, 23284, USA.

Abstract

Background: There is an urgent need for innovative approaches to adolescent obesity treatment, particularly among individuals from racially and ethnically marginalized backgrounds, who face increased risk of obesity and its associated morbidity and mortality. There is a particular dearth of research on the long-term efficacy of adolescent obesity treatments. Further, research and clinical practice guidelines consistently recommend parents' inclusion in their adolescents' obesity treatment, yet the most effective strategy to engage parents in adolescent obesity treatment remains unclear. Towards that end, this investigation will conduct a fully-powered, randomized clinical trial to examine the efficacy of two distinct approaches to involving parents in their adolescents' obesity treatment.

Methods: Participants will be 210 12-16 year old adolescents (body mass index [BMI]≥85^th percentile) and parents (BMI≥25 kg/m²) with overweight or obesity. Dyads will be randomized to one of two 4-month treatments: 1) TEENS+Parents as Coaches (PAC), engaging parents as helpers in their child's weight management via parent skills training based on authoritative parenting, or 2) TEENS+Parent Weight Loss (PWL), engaging parents in their own behavioral weight management. All adolescents will participate in the TEENS+ protocol, which includes nutrition education with dietary goals, supervised physical activity, and behavioral support, and integrates motivational interviewing to enhance treatment engagement. Assessments of anthropometrics, dietary intake, physical activity, parenting and home environment variables will be completed at 0, 2, 4, 8, and 12 months with the primary endpoint at 12-month follow-up.

Discussion: Results of this investigation have the potential to significantly advance science in this area and ultimately inform clinical practice guidelines related to the role of parents in adolescent obesity treatment.

Trial registration: Clinicaltrials.gov NCT03851796. Registered: February 22, 2019.

Keywords: Adolescent; Obesity; Parent; Randomized clinical trial.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Behavior Therapy
Body Mass Index
Child
Humans
Overweight / therapy
Parents / education
Pediatric Obesity* / prevention & control

Associated data

ClinicalTrials.gov/NCT03851796

Abstract

Publication types

MeSH terms

Associated data

Grants and funding