The efficacy of the Choose Health Program has been demonstrated in two randomized controlled clinical trials and a third is currently underway. Combined the completed studies demonstrate improvements in eating and activity habits, body composition, psychological and social functioning in overweight and obese adolescents following participation in the Choose Health Program. Results of these studies have been used to improve treatment, assessments, and research methodology. The high and increasing prevalence of adolescent overweight and obesity, combined with the strong tracking of adolescent obesity into adulthood, and the negative biopsychosocial consequences of excess weight in adolescence highlight the need for effective intervention approaches in this population. Despite this recognised need and recent calls for action, overweight and obese adolescents have received very little research attention and few treatment options are available to them. Further development of the Choose Health program is required to broaden the reach and increase accessibility of the program. The use of a range of treatment delivery methods will increase treatment access for overweight and obese adolescents, particularly for those who are geographically and socially isolated. This paper will outline the results and learning from the Choose Health research program. Future research aimed at assessing the effectiveness of the program (1) when delivered by a range of health professionals in community settings and (2) when delivered using a range of treatment modalities will also be described. The findings of these studies will inform the broader dissemination of an effective evidence-based program that improves physical, psychological and social wellness in overweight and obese adolescents.

The CHOOSE HEALTH Program has been designed to assist overweight and obese adolescents to improve aspects of physical, psychological and social health. It is a 10-session cognitive behavioural therapy (CBT) program which aims to promote sustainable improvements in eating and activity habits by providing psycho-education surrounding healthy habits, and focusing on psychological, social, cognitive and emotional barriers and supports for long-term lifestyle changes. Treatment was conducted with a 15-year-old obese female (BMI = 35.66kg/m2, 49.4% body fat), and her mother (BMI = 42.85kg/m2). Small, but clinically meaningful changes were demonstrated in multiple adolescent body composition measures across pre, 12-week post, and 24- week maintenance assessments for BMI (35.66kg/m2 , 35 kg/m2, 35.4 kg/m2), percent body fat (49.4%, 46.8%, to 48.8%), fat mass (44.3kg, 41kg, to 42.7kg), and lean mass (42.8kg, 44kg, to 44.77kg). In addition, clinically meaningful changes were achieved across the pre-, and 12-week post assessments for body weight (90.73kg to 88.5kg), and waist circumference (95.75cm to 94.75cm), however, a degree of relapse in these areas was demonstrated during the maintenance phase (body weight: 91.2kg; waist circumference: 99.1cm). Measures of psychosocial functioning across the pre-, post-, and maintenance phases remained within the healthy range, which indicates that treatment did not have a detrimental effect upon psychosocial health in this instance. A qualitative analysis of 7-day food and activity records taken during each assessment period revealed improvements in total weekly physical activity (490mins to 2140mins), total weekly sedentary activity (1065mins to 300mins), total weekly screen-time (885mins to 300mins), as well as increases in low fat dairy, fruit, vegetable, and high fibre cereal and bread consumption. This clinical case-study is used to demonstrate program implementation and provide a comparison of the varied effects of the support phase and the maintenance phase of the CHOOSE HEALTH program.

The CHOOSE HEALTH Program, a cognitive behavioural (CBT) program designed specifically for the treatment of adolescent overweight and obesity, has demonstrated its effectiveness in the treatment of adolescent overweight and obesity when delivered by psychologists. However, the delivery of effective interventions by a range of health professionals is required to meet the growing need to provide effective treatment to the increasing population of overweight and obese adolescents. Previous research suggests that non-psychologists, such as dieticians, nurses and diabetes educators, can deliver effective CBT based treatments for a range of health disorders, including diabetes and eating disorders. Evidence as to the feasibility of exercise leaders delivering CBT intervention to improve health behaviours is limited, but early trials with older adults appear promising. The current study seeks to evaluate the training of exercise leaders to effectively deliver a CBT intervention aimed at improving health behaviour among overweight and obese adolescents accompanied by a supporting parent. This will be accomplished by the use of a combination of techniques to explore the impact of 1) trainee characteristics, 2) training components and 3) teaching methods on the effective delivery of a CBT intervention. Research suggests that trainee characteristics such as formal education and theoretical orientation have not been well studied and these will be measured via questionnaire. Knowledge of program content and CBT principles will be assessed in post-training questionnaires. Trainees will also be required to demonstrate their intervention skills and implementation of the cognitive behavioural intervention. These practical competencies will be assessed via role-plays conducted in the post-training period, and observation of in-session clinician performance. Evaluation at the training stages will provide direction for future studies and contribute knowledge towards the capacity of exercise leaders and other allied health professionals to effectively deliver a CBT program for the treatment of adolescent overweight and obesity.

Self-monitoring is the cornerstone of cognitive behavioural interventions, and is a strong predictor of outcome in the treatment of a range of disorders requiring changes to behaviours and/or cognitions. The majority of weight loss interventions incorporate some aspects of self-monitoring. Self-monitoring of eating habits is associated with greater weight loss and improved maintenance of weight loss in the treatment of overweight and obese adults. Similarly, both adolescent and parental monitoring of adolescent eating habits are predictors of treatment outcomes in adolescent obesity interventions. Despite strong evidence regarding the importance of self-monitoring in obesity interventions, this treatment component is a commonly cited reason for treatment attrition. Thus, treatment retention may be improved if the demands of self-monitoring can be reduced. Research is required to determine the format and quantity of self-monitoring that maximises treatment outcomes, and minimises treatment attrition. This poster describes the methodology of a study designed to explore the impact of the quantity and quality of self-monitoring on a range of treatment outcomes. Self-monitoring data collected from over 70 adolescent and parent pairs of participants in the Choose Health study will be used to develop a system for rating the comprehensiveness and quality of adolescent and parent self-monitoring. This study aims to answer numerous research questions including the necessary components of self-monitoring for weight loss, the relationship between self-monitoring and specific behaviour changes, and the minimal level of self-monitoring required to achieve significant and sustainable behaviour change. Results of this study will allow for refinement of the use of self-monitoring in weight loss intervention so as to reduce treatment attrition, and maximise treatment outcomes.