Page 130 - Go4it

Chapter 8
Relevance and Implications for public health and clinical practice
This paragraph describes the public health implications of our results and directions for future research. However, to give a complete overview it is necessary to have insight into current treatment options.
Focus on motivation and compliance
More attention should be paid to measure (by questionnaire) and improve the motivation of the adolescents and their parents to health behaviour change. In order to increase compliance, a few options were described below to decrease the barriers some parents and children experienced.
Focus on implementation of evidence-based treatment programs for obese adolescents
The Go4it intervention showed some promising effects on BMIsds, body composition and quality of life. Still we believe there are some adjustments needed to implement the Go4it intervention, such as better tailoring to non- western ethnicities, adding a physical activity program, and a location closer to their home environment.
Focus on practical constraints before disseminating the Go4it intervention
Since travel distance and the limited time of working parents and schoolchildren was one of the main reasons for non-compliance, implementation of the intervention nearby, home or school may improve compliance.
Consider subgroups in ethnicity
The Go4it study clearly showed differences in behaviour and intervention effects between western and non-western ethnic groups. In order to optimize the intervention, more attention should be paid to the tailoring of the intervention program to specific subgroups e.g. taking into account the ethnical differences in parental and child beliefs according to obesity and lifestyle habits.
Focus on behavioural problems
A study by Melnyk and colleagues (2006) indicated that, higher levels of depressive and anxiety symptoms and lower self-esteem in overweight teens were associated with less confidence about their ability to engage in healthy lifestyle behaviors (27). It seems useful to assess the levels of anxiety, depressive symptoms and self-esteem in obese teens, and if necessary to adapt the Go4it sessions e.g. by extra attention to these symptoms or individual guidance of a psychologist.
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