Page 131 - Go4it

Increasing parental involvement
The Go4it program, included 2 parent sessions. We learned, however, during the intervention that parents may be more important than assumed initially and that their knowledge of a healthy lifestyle was inadequate. Besides this, we noticed that the parents had high levels of concern for their obese adolescents well- being, but also a sense of helplessness how to help their children. The main reasons for non-compliance of parents were lack of success in their child’s weight loss. Thus more effort should be devoted to stimulate active involvement of parents including realistic goal setting with respect to weight loss practices and more education about healthy lifestyle and coaching of their child.
Focus on an exercise program
During the development of Go4it, we encouraged participants to go walking or cycling instead of taking the bus or subway. Besides this we also encouraged them to join sports clubs in their neighbourhood instead of organising specific exercise sessions. However, the majority never joined a sports club. Reasons for this were lack of interest, lack of time and financial reasons or being ashamed to go to a sports club, because of their overweight. It seems important to develop specific exercise program for this target group to encourage and support them to become more active. It is shown that exercise is efficacious for reducing percent body fat in overweight and obese adolescents (28). Another study showed that participation in an exercise group can be a predictor of success in outpatient treatment in obese adolescents (29,30). Including an exercise program to the Go4it program might therefore increase the effectiveness of Go4it (28).
Improve measurement tools for the evaluation of obesity treatment programs
In our study it became obvious that the questionnaires were not appropriate for our study sample. Questions were not always clear to them, and the questionnaires were for some adolescents too long. Therefore, more effort should be devoted to the development of measurement tools (such as questionnaires) that are valid, reliable, sensitive to detecting subtle behavioural changes (diet, sedentary and physical activity behaviour) and also attractive and appropriate for the target population. Given todays adolescents' heavy use of smartphones, apps, facebook and videogames it may be a feasible way to promote healthy energy balance-related behaviors such as increasing fruits and vegetables intake, water intake, and physical activity and decreasing intake of snacks and sweetened beverages.
General discussion
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