Long-term obesity prevention and the Motivating Adolescents with Technology to CHOOSE Health™ program

Abstract

Background: The Motivating Adolescents with Technology to CHOOSE Health™ (MATCH) intervention integrates lifestyle behavior change curriculum within academic subjects taught in seventh grade. This study assesses obesity prevention in participants into high school.

Methods: The study compares four- to five-year longitudinal data from a single-site cohort (N=106, 54% retained from 195 participants at baseline; 82% of those still at the school) pre- and postintervention in a rural middle school with high obesity rates with data from the 2006 Child Survey and 2010 Child and Young Adult Surveys from the National Longitudinal Survey of Youth 1979 (N=600), which serves as a nationally representative comparison group. Outcome measures include pre- and postchanges in weight category, BMI, BMI z-score, BMI percentile for age and gender, and rates of change per month in BMI measures.

Results: At follow-up, change in percent overweight was significantly different between groups, with the MATCH group decreasing (20-12%) and the comparison group increasing (17-19%). Overall, the MATCH group had significantly higher decrease rates in BMI z-scores (p=0.002) and BMI percentile (p=0.01) than the comparison group. Of all adolescents at healthy weight at baseline, 2% from MATCH became overweight after five years, whereas 13% of the comparison group increased to overweight or obese (p=0.02) after four years.

Conclusions: Despite a small sample size and a high-risk setting, at long-term follow-up, a greater proportion of MATCH participants than in the comparison group decreased from overweight to healthy weight or remained at healthy weight. The MATCH results suggest that some proportion of high-risk adolescents can have their growth trajectory follow a healthier path than expected.