Preventing and Controlling Obesity and Chronic Disease through Evidence-Based Programming

Principal Investigator: Jessica LaRose, Ph.D.

Funding Source: Virginia Department of Health, Richmond City Health District

The goal of this initiative is to implement environmental and school-based strategies to improve nutrition access, dietary choices and reduce obesity risk among children in Richmond Public Schools. A central goal of this work involves a systematic evaluation of these efforts to determine the impact on key outcomes of interest.

Improving Adolescent Obesity Treatment: Exploring the Role of Parents

Co-Investigator: Jessica LaRose, Ph.D.

Funding Source: National Institutes of Health

There is an urgent need for innovative approaches to obesity prevention and treatment, particularly among African Americans (AA), a population at increased risk of obesity and its associated morbidity and mortality. Research and clinical practice guidelines consistently recommend that parents should be included in their children’s obesity treatment, yet the most effective strategy to engage parents in adolescent obesity treatment is unclear. The adolescent period presents substantial challenges to family-based care, as youth experience increased desire for independence and autonomy, contributing to resistance to authority figures; yet they still rely on parents for many needs. Given these challenges, it is not surprising that research investigating specific clinical paradigms for involving parents in adolescent obesity treatments is inconsistent. To that end, the current application pilots two distinct approaches for involving parents in their adolescents’ obesity treatment. TEENS (Teaching, Encouragement, Exercise, Nutrition, Support) is a family-based, multidisciplinary behavioral treatment program targeting primarily AA, obese adolescents. This investigative team previously demonstrated that participation in the TEENS intervention is associated with significant reductions in body mass index (BMI) at 6 months. In TEENS, parents were included in monthly groups to support their adolescent’s weight management. Although parent weight was not targeted, a significant correlation between parent and adolescent BMI change was found. These findings highlight the importance of parental involvement and suggest that parent weight management might be an important intervention target. Indeed, directly targeting parent weight loss within adolescent treatment might be associated with even greater adolescent BMI reductions, as parents engaged in concurrent weight management might make greater changes to the shared environment and serve as powerful role models, given their common goals. Towards that end and building on our previous work, we developed TEENS+, a family-based adolescent obesity intervention. This application proposes a randomized controlled pilot to determine the feasibility and preliminary efficacy of two parent treatments within TEENS+ among 96 overweight or obese adolescents (BMI>85th percentile) and parent(s) (BMI>25 kg/m2). Families 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, or 2) TEENS+Parent Weight Loss (PWL), engaging parents in their own 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 will be completed at 0, 4, and 7 months. Results of this investigation will inform a subsequent larger trial investigating the role of parents in adolescent obesity treatment, targeting predominately African American families. 

Prevention of Weight Gain in Young Adults

Co-Investigator: Jessica LaRose, Ph.D.

Funding Source: National Institutes of Health / National Heart, Lung, and Blood Institute

This is a multi-site randomized controlled trial testing two innovative interventions to prevent weight gain compared to a control condition over an average 3 years of follow-up in individuals 18 to 35 years of age.

Low Intensity Weight Loss for Young Adults: Autonomous vs. Extrinsic Motivation

Principal Investigator: Jessica LaRose, Ph.D.

Funding Source: National Institutes of Health

Forty percent of 18-25 year olds are overweight or obese, yet this population is markedly underrepresented in behavioral weight loss (BWL) programs, and to date, no programs exist that specifically target this group for weight loss. The proposed study will test the relative efficacy of two novel, low intensity weight loss programs designed to enhance motivation in this age group and a standard web program; all arms will be compared on initial weight loss and maintenance of weight loss following a 6-month no-treatment contact period. If efficacious, the proposed programs have potential for dissemination and could have profound public health impact by decreasing the financial and health costs associated with obesity as this generation ages.