Evaluation of a Participant Co-designed Lifestyle Change Program for Youth

Abstract

Introduction: Increasing obesity in children leads to an increase in the risk of Type 2 diabetes (T2D). Therefore, it is important to promote healthier lifestyles in youths and encourage their caregivers(s) to provide a healthy lifestyle environment. The PowerHouse program focuses on improving food choices, increasing physical activity, and adopting behavior changes for the reduction of obesity and the prevention of T2D. Method: The aim of this study was to assess the effects of implementing the PowerHouse program on both clinical and quality of life outcomes in high-risk, low-income youth and their caregivers. Primary outcomes were BMI standard deviation and BMI percentile in youths. Secondary outcomes included physical activity of youths and quality of life for both youths and their caregivers. Attendance rates were also calculated. Linear effect mixed models were used to test for time effects for all outcomes. Results: Clinical outcomes did not improve over time, except for youth HbA1c (p-value = 0.0447). Some improvements in youth quality-of-life outcomes were noted: specifically, the Sports Index score of the Fels Physical Activity Questionnaire for Children (adjusted p-value = 0.0213) and the Physical Summary (p-value = 0.0407), Psychosocial Summary (p-value = 0.0167), and Total score (p-value = 0.0094) for the youth-reported Pediatric Quality of Life Inventory. Quality of life did not change over time for caregivers. For attendance, there was an improvement after the intervention was modified to improve access to fresh produce (p-value = 0.0002). Conclusion: HbA1c and quality of life improved over time for youth; however, there was not an improvement in caregiver outcomes over time. The data suggest that more time may be needed to see the full effects of the intervention, and/or that a booster intervention may be needed.