Weight-Dependent Disparities in Adolescent Girls: The Impact of a Brief Pilot Intervention on Exercise and Healthy Eater Identity

Abstract

Adolescent girls report low participation in healthy behaviors (e.g., nutritious eating and exercise), and are disproportionately affected by obesity. Short-term interventions, such as behavioral summer camps, may positively influence psychological underpinnings of healthy behavior, particularly exercise identity (EI) and healthy eater identity (HEI). The present study investigates disparities and changes in identity and subsequent health behavior in two cohorts of adolescent girls following a brief, multicomponent intervention. A sample of normal-weight adolescent girls from a health promotion camp and an elevated body mass index (BMI) sample from an obesity treatment camp participated in the study. Both camps ran one-week in duration and delivered comparable intervention components. All families were given access to the same eight-week eHealth program post-camp. Significant EI and HEI role-identity disparities between the health promotion and obesity treatment cohorts were apparent at baseline. Following the one-week camp intervention, EI and HEI scores increased in both groups. At follow-up, the treatment group had increased EI and HEI role-identities in such that the groups no longer significantly differed. Positive changes in health behaviors were experienced in each group. This pilot study demonstrates that EI and HEI differ between normal-weight and obese adolescent girls and weight-dependent identity disparities may be mitigated following brief, multicomponent interventions.

Keywords: adolescents; diet; health behavior; health disparities; identity; obesity; physical activity.

Figure 1

Overview of camp programming provided at the health promotion cohort (Colorado, CO) and the obesity treatment cohort (Wisconsin, WI). Total time spent in physical activity: 2–3 h (CO); 2–4 h (WI). N/A: not applicable.

Figure 2

Visualization of differing changes in exercise and healthy eater role-identity between the Colorado (CO; health promotion) and Wisconsin (WI; obesity treatment) camps: (a) The magnitude of change from baseline to post-camp (Post) in ERI in the obesity treatment cohort appears greater than in the health promotion cohort; (b) An increase in HERI was observed in the obesity treatment cohort versus a plateau in HERI in the health promotion cohort (Baseline to Post).

Figure 3

Overview of the eHealth program weekly lessons and webpage traffic: (a) total weekly views and visitors to the eHealth program peaked within the first few weeks; S.M.A.R.T. Goal-Setting denotes specific, measurable, attainable, realistic, and time-bound goals; F.I.T.T. Plan denotes frequency, intensity, type, and time chosen by the camper for physical activity participation (b) viewership and participation in the eHealth program peaked in the introductory week and dropped to a plateau throughout the eight-week curriculum; transparent bars represent total weekly views and opaque bars represent total weekly webpage visitors (the orange bar represents the final week of the eHealth program).