Introduction
The prevalence of obesity among adolescents aged 12 years to 18 years is alarmingly high, with the condition posing severe health problems across the globe. Among the health risks of obesity, this demographic has a high chance of facing include cardiovascular diseases, type 2 diabetes, musculoskeletal problems and psychological issues. Despite the intensive measures taken to resolve this problem, the weight issue among adolescents is prevalent, indicating the urgency for proper management. It is an identifiable problem that requires the translation of lifestyle changes such as diet modifications and increased physical activity into action to minimize the ill effects of obesity among teens. Moreover, the routine practices usually incorporated into most conventional approaches include dietary counselling and exercise recommendations. However, the efficacy of these approaches in attaining sustained weight loss and preventing obesity-related complications is still uncertain (Salam et al., 2020). This paper synthesises evidence-based research and proposes an intervention strategy that targets controlling obesity-associated complications in teens of 12 to 18 years of age through lifestyle changes.
Problem Statement
In the present day, the obesity rate in teenagers aged 12 to 18 years has reached a critical level in society worldwide, challenging the health systems. Obesity brings along several health problems that this group is at risk of, like cardiovascular diseases, type 2 diabetes, musculoskeletal issues, and psychiatric disorders (Hannon & Arslanian, 2023). Despite exhaustive measures directed at combating this problem, adolescent obesity is still a major concern, reflecting a need for immediate and effective strategies. The main task in question is the translation of lifestyle recommendations, dietary changes, and exercise into actions for teenagers aimed at minimizing the negative consequences of obesity. Traditional approaches usually include commonly used measures such as dietary counselling and exercise referrals. However, their true effectiveness in achieving sustained weight loss and disease prevention in an obese population is not well defined.
The issue is of great concern as it has deep consequences on the physical and mental status of the youth and the overall dimensions of society. Not only does obesity lead to many chronic diseases, but it also increases the risks of reduced quality of life, academic performance, and social interactions. Economic survival is also attributable to the cost of obesity-related healthcare and loss of productivity. Obesity is a complex phenomenon with multiple perspectives and teenagers’ health across various cultures and societies. While a lifestyle intervention could be a primary strategy, these should be executed and managed correctly (Lee et al., 2021). The factors, including dietary habits, physical activity levels, socioeconomic status, and psychosocial issues, could affect the intervention results, which would require a multifaceted approach.
Understanding this particular issue requires prejudging the complicated relationship between many biological, environmental, and behavioural factors which lead to obesity among teens. Some of the factors that make adolescent obesity difficult to defeat include lifestyle factors such as inactivity, the abundance of easily available processed foods, and social and economic inequalities. Furthermore, the social norms and family members’ influence impact adolescents’ diet and physical activity perception, emphasising the importance of culturally sensitive interventions. The increasing prevalence of obesity among adolescents is a major public health problem, which calls for an urgent intervention in order to put a stop to the threat it imposes (Stabouli et al., 2021). The development of lifestyle modifications to meet the wishes and needs of adolescents at risk of obesity presents a promising approach to dealing with this problem. However, there is a need for research to evaluate their effectiveness and the net clinical outcome of reducing obesity complications within a one-year timeframe.
Organizational Culture and Readiness
Culture in an organizational context is pertinent to the success of initiatives designed to fight obesity among adolescents aged between 12 – 18 years. The organizational culture in the healthcare system is a concept that includes the values, norms, beliefs, and practices that drive the behaviour of healthcare professionals and influence the delivery of care. This can be done by creating culturally appropriate education and support materials, offering translating services and hiring a workforce that includes people from the communities. Organizational culture determines the adoption and impact of lifestyle modifications to treat adolescent obesity. A key factor in ensuring the successful implementation of evidence-based innovations in healthcare systems is a supporting culture that values innovation including cultural competence (Bellantuono et al., 2021). Healthcare organizations that operate a culture of health and wellbeing will reduce obesity-related complications and promote positive long-term health outcomes for adolescents.
Organizational readiness is the key determinant which plays a very important role in the successful implementation of interventions aimed at obesity prevention among teenagers aged 12 to 18 years. An organisation’s readinessThe readiness is how much the organization is prepared to support and drive change successfully. Within the framework of implementing lifestyle changes among obese adolescents, organizational readiness consists of several dimensions: leadership support, employees’ commitment, resources’ availability, and capacity for change. The organisation’s leadership must ensure that the right tone, direction, and resources are available for the implementation and success of the lifestyle interventions. Leaders must make adults realize the need to eliminate adolescent obesity, provide clear targets and objectives and build a conducive climate for alterations (Hanelt et al., 2020). Staff involvement is also necessary, as frontline healthcare workers take centre stage in delivering and reinforcing health or lifestyle interventions. Incorporating staff from the start, offering training and guidance, and promoting feelings of possession and duty encourage them to accept new procedures and approaches.
Organizational readiness includes having the resources needed, that is, personnel, equipment, space and information systems, to successfully deliver lifestyle interventions. Having sufficient staff, access to specialized knowledge and reliable infrastructure are the prerequisites to providing comprehensive and coordinated care to adolescents with obesity. Additionally, the organization must possess the capacity for change, including adapting processes, workflows, and policies to accommodate new interventions and incorporating feedback for continuous improvement. Assessing and enhancing organizational readiness involves thoroughly evaluating existing structures, processes, and resources, identifying potential barriers and facilitators, and developing strategies to address gaps and build capacity (Hanelt et al., 2020). By proactively addressing organizational readiness factors, healthcare organizations can optimize their ability to implement lifestyle modifications effectively and ultimately improve the health outcomes of adolescents with obesity.
Literature Review
Obesity and Related Complications
Obesity has emerged as a global epidemic, with significant implications for public health and healthcare systems worldwide. Defined as excessive fat accumulation that poses a health risk, obesity is a complex and multifaceted condition influenced by genetic, environmental, behavioural, and socioeconomic factors. According to data from the World Health Organization (WHO), the prevalence of obesity has nearly tripled worldwide since 1975, with an estimated 650 million adults and 124 million children and adolescents classified as obese in 2016. This alarming trend is particularly concerning given the numerous health complications associated with obesity, which extend beyond physical health to encompass psychological, social, and economic wellbeing (Diao et al., 2020). One of the most concerning aspects of obesity is its association with a wide range of chronic diseases and health conditions, collectively referred to as obesity-related complications. These complications can affect virtually every organ system in the body, leading to increased morbidity, mortality, and healthcare costs. Cardiovascular diseases, including hypertension, coronary artery disease, stroke, and heart failure, are among the most prevalent and serious complications of obesity.
Obesity is a significant risk factor for the development of cardiovascular diseases, with excess body weight contributing to elevated blood pressure, dyslipidemia, insulin resistance, and inflammation, all of which can promote the progression of atherosclerosis and increase the likelihood of adverse cardiovascular events. Obesity also shows a strong link with metabolic abnormalities, for example, type 2 diabetes mellitus and non-alcoholic fatty liver disease (NAFLD). Type 2 diabetes has reached the proportions of a pandemic on a global scale, with obesity being the main culprit for most of the cases (Jones et al., 2018). The manifestation of insulin resistance and disturbed glucose metabolism, which are both triggered by obesity, are factors that contribute to the progression of type 2 diabetes. If untreated, type 2 diabetes can eventually lead to the development of serious complications such as neuropathy, nephropathy, retinopathy, and cardiovascular events.
NAFLD, characterized by the buildup of fat in the liver, is now a common problem, together with the rising rates of obesity. NAFLD may develop into more aggravated forms of liver disease, such as NASH, cirrhosis, and hepatocellular carcinoma, which, in turn, brings on health system challenges on a worldwide scale. Obesity is also linked with elevated risk of particular types of cancer, such as breast, colorectal, endometrial, and kidney. The obesity-cancer association has a complex, multifactorial Etiopathogenesis, including epigenetic changes, chronic inflammation, hormonal alterations, dysregulation of the immune system, and metabolic dysfunction (Kebbe et al., 2019). Obesity-related cancers worldwide are known to contribute to a large share of cancer deaths, underscoring the importance of designing effective prevention and treatment approaches.
While physical health problems may be the most serious obesity impacts, they can also have significant psychological and social consequences: poor self-esteem, body image dissatisfaction, depression, anxiety, and social stigma. People suffering from obesity can have a willingness to discriminate and prejudice in many areas of their lives, including employment, education, healthcare, and interpersonal relationships, which make their condition even worse. Obesity and its related consequences are a major public health challenge resulting in widespread negative implications for individuals, communities and healthcare systems across the globe. Sustaining the obesity epidemic calls for a diversified cross-sectoral approach focusa on the root causes of obesity and supplythe of accessible evide,nce-based preventive measures (Kebbe et al., 2020). By working collaboratively in multidisciplinary and multi-sectoral ways, we can enhance efforts to eliminate the burden of obesity and promote the health and quality of life of individuals and populations worldwide.
Lifestyle Modifications
A key aspect of managing obesity complications is lifestyle modification, which adopts a comprehensive approach wherein the underlying causes of obesity and its associated risks are addressed. Statistical findings from different studies point to the efficacy of lifestyle modifications in managing obesity-related complications and improving health outcomes. A systematic review and meta-analysis, carried out and published in the International Journal of Obesity, has looked at the effect of lifestyle modifications, comprising dietary modifications and increased physical activity, on weight loss and metabolic parameters in adults with obesity. The study, consisting of data from over 60 randomized controlled trials, found that lifestyle interventions successfully brought significant weight loss, reduced waist circumference reduction, and improved lipid profile, glycemic control and blood pressure. In particular, the study stated a mean weight loss of 5-10% of body weight at the beginning in the participants following lifestyle modifications for six months or more. Lifestyle interventions are linked to increases in insulin sensitivity, glycemic control, and lipid profile, suggesting a lessened risk of progression to type 2 diabetes and cardiovascular disease (Lee et al., 2021). Such findings emphasize the key role of lifestyle modifications as a first-line strategy for coping with obesity-complicated issues and preventing the development of metabolic disorders.
In addition, evidence from large-scale community activities and public health programs provides further evidence for the benefits of lifestyle changes in fighting co-morbidities of obesity. The Diabetes Prevention Program (DPP), a landmark clinical trial from the United States, showed the efficacy of intensive lifestyle interventions in preventing or delaying the onset of type 2 diabetes among at-risk individuals. Disparate translation efforts, i.e., NDPP, have proven that community-based lifestyle interventions, including group-based education sessions and individualized coaching, can produce similar results in diverse populations. Based on data obtained from the Centers for Disease Control and Prevention (CDC), the participants of the NDPP achieved approximately 5-7% loss of initial body weight and a 58% decrease in the risk of diabetes in three years of follow-up (Stabouli et al., 2021). This suggests that lifestyle modification programs can be successfully implemented in practice and have the potential to relieve the systems and society from the enormous burden of obesity-related diseases.
Additionally, research looking at the long-term impact of lifestyle modifications on health outcomes gives an idea of whether or not the changes are enduring. The LOOK AHEAD trial, a multicentre randomized controlled trial conducted in the United States, assessed the effect of a lifestyle intervention on cardiovascular morbidity and mortality among adults with type 2 diabetes and obesity. As for the primary outcome of cardiovascular events, there was no statistical significance. However, the lifestyle intervention group showed improvements in weight loss, physical fitness, and quality of life among study participants compared to the standard care group. Throughout the Look AHEAD project, follow-up analysis has demonstrated sustained improvement in cardiovascular risk factors, including blood pressure, glycemic control, and lipid levels, up to 10 years into the intervention (Wing, 2021). This data stresses the utility of the long-term application of lifestyle modifications in the prevention of obesity complications and better outcomes in health overall.
Lifestyle modifications play a key role in the management of comorbidities in obese patients, representing a low-cost, efficient, and lifelong option for improving health outcomes. Analyzing data and statistics from live clinical trials, community programs, and long-term studies enables us to conclude conclude that lifestyle interventions are highly efficient in reducing body weight, improving metabolic parameters, and preventing type 2 diabetes and cardiovascular disease (Wing, 2021). By including lifestyle modifications in an overall treatment plan and a public health strategy, healthcare providers and policymakers can help patients living with obesity succeed in the long run by managing their condition and reducing the effect of obesity-related complications on individuals, families and society.
Literature Evaluation
Diao et al. (2020) carried out an exercise and dietary intervention model experiment with obesity as the research subject, significantly improving adolescents’ health quality. The sample comprised 948 persons randomly allocated to the intervention group (n = 518) and the control group (n = 430). The intervention group participated in one year of obesity-related health education, physical exercises, and diet control. QoL in each group was assessed using a self-developed Adolescent Quality of Life Scale and a basic information questionnaire. A body mass index (BMI) obtained and used as a baseline was calculated for all participants. The study findings indicated a real difference (P < 0.05) in the psychological, social, and pubertal dimensions of QoL and total QoL between the intervention and the control groups. The psychological component of quality of life revealed the most notable robust improvement with higher scores by the intervention group compared to the healthcare group in the psychological, pubertal, and overall QoL. However, unlike physical exercise-related effects on the physical QoL dimension found in previous literature, the study did not find any differences between the control and intervention groups. The effectiveness of the intervention strategy differed among boys and girls, noticed more as an effect in boys. This is perhaps due to boys’ choice of sports and better compliance with intervention programs. Nevertheless, more research should be conducted to investigate the gender-based differences in quality of life improvement and to generalize these findings to other groups.
A study by Morell-Azanza, et al. (2019) assessed the effect of a multidisciplinary lifestyle intervention on the anthropometric indices, biological parameters, and objectively measured physical activity (PA) levels in children with abdominal obesity. Administered as a randomized control trial, 106 children and adolescents with abdominal obesity were then divided into the control group (usual care group) and the intensive care group for an 8-week intervention period. The PA was objectively measured using accelerometry for four days, and both groups were advised to increase their PA by 3.33 hours of PA per week. At baseline, most (n = 60) participants (75%) did not meet the WHO recommendation of 60 minutes of MVPA daily. However, there were no statistically significant changes in biochemical indices or physical activity levels of both groups, regardless of the significant improvement in anthropometric indices, including body composition indices.
Interestingly, the intensive care group showed a significant increase in MVPA, which amounted to an average of 5.5 minutes per day. This suggests that the intervention positively affected the engagement in moderate to vigorous physical activity. Between the intensive care group and the lifestyle intervention group, in their effect on anthropometric indices and light physical activity in children with abdominal obesity, the lifestyle interventions showed a decrease, but only the intensive care group showed an increase. The results indicate that multifactorial lifestyle interventions combine different approaches to PA levels in children and highlight the need to focus on MVPA to manage obesity in this group of children.
A study by Kebbe et al. (2020) in Canada investigated how healthcare providers provide weight management health services for obese adolescents and described the extent to which their reported practices correspond with recent clinical practice guidelines (CPG) for managing pediatric obesity. Conducted as a qualitative approach, the study was conducted between July 2017 and January 2018. HCPs with experience in adolescent weight management working in multidisciplinary pediatric weight management clinics in Edmonton and Ottawa, Canada, were recruited. Data was collected through an audio-recorded focus group interview with 16 HCPs, including dietitians, exercise specialists, nurses, paediatricians, psychologists, and social workers. Three main themes emerged from the qualitative analysis: (i) addressing the actual expectations towards weight management, (ii) individualizing weight management, and (iii) showing inexplicit, non-discriminatory attitudes and practices. They were later compared to the recommendations from recent CPGs for pediatric obesity in the 2017 guidelines from the Endocrine Society. As the findings show, HCPs made all four CPG recommendations of the practice. They underscored the need to talk about realistic predictions, switching attention from weight to health, and the role of family connectedness. Personalizing weight management was touched upon, overcoming individual factors that hinder change. HCPs, in their work, demonstrate impartial attitudes and behaviours that do not blame the patients and avoid assumptions.
A study byby Watanabe et al. (2019) examined the SPRAT intervention, a school-based dietary and lifestyle education strategy involving parents/guardians, on adolescents’ subjective psychosomatic symptoms (SPS) and dietary behaviour modification. Carried out as a randomized controlled trial that lasted for six months, participants were junior high school students in Japan who agreed to participate in the study. The outcome measures included SPS scores at baseline and at 2, 4 and 6 months after base and proportions of dietary and lifestyle factors assessed by FFQW82, such as enjoyment of school life and dietary intakes. The primary outcome was a six-month (6-month) change from baseline (CFB). The ITT analysis was done for 951 individuals in the SPRAT group and 1035 individuals in the control group. The 6-month SPRAT scores, adjusted for baseline, showed that the CFB for the SPRAT group was lower than the control group, but the difference was not statistically significant (-0.29 vs. 0.62, respectively; p = 0.093). The primary outcome, however, needed to show a prominent enough improvement in the SPRAT group.
Nevertheless, some secondary outcomes had a certain number of favourable effects, and a statistically significant treatment interactioninteractions with baseline was found in different dietary intakes. This implies the direction of the CFBs of dietary intake was towards the favourable side for those with low baseline intake, particularly in the SPRAT group. This suggests that the SPRAT program can bring positive changes to the dietary habits of adolescents, which could contribute to alleviating subjective psychosomatic symptoms. However, more investigations are required to support these claims and find out the reasons behind these effects.
Change Framework
The Social-Ecological Model (SEM) is more comprehensive that explaining the complex interactions between many factors in health behaviour and outcomes. The SEM is, therefore, the most suitable for lifestyle modification strategies for obesity-related complications in adolescents aged 12 to 18 (Hu et al., 2021). At the individual level,, interventions will concentrate on creating awareness and knowledge about healthy dietary choices, the importance of physical activity, promoting self-efficacy and developing behavioural skills that can facilitate behaviour change. This will include organizing educational sessions, establishing realistic targets, and providing tailored assistance to increase motivation and self-efficacy in activity changes. At the interpersonal level, the interventions will focus on social support systems such as families, peers and schools using their power to promote good behaviours and having an environment that supports the needs.
Strategies to enrich social support and favourable norms that foster healthy behaviours include engaging parents and caregivers at home to promote healthy eating and active living, encouragingencouraging peer support networks, and integrating theintegrating health education into the school curriculum. Moving to the community level, interventions will consider shaping the physical and social environments to enable and support healthy lifestyle choices. Such measures will encompass providing children with affordable and nutritious food, establishing safe environments for physical activities, and introducing regulations limiting unhealthy food advertising to adolescents (Hu et al., 2021). Furthermore, local partners such as community groups, business entities, and policymakers are important for building a supportive environment and making calls for more systematic changes.
At the societal level, the interventions will be directed towards the social, cultural, and economic environments which impact human behaviour and outcomes. This could be solved by removing the gaps in nutrition and recreation (such as access to healthy foods and recreational facilities) and working on body image perception issues in society, as well as creating policies that put health equity and social justice at heart. SEM engages in the analysis of multiple effect levels simultaneously, which makes it possible to develop a comprehensive solution to obesity problems in adolescents, taking into account the fact that behavioural change is highly influenced by the interactions between individual, interpersonal, community, and societal factors (Hu et al., 2021). By coordinating these levels of intervention combined, interventions create environments that accentuate healthy ways of living to reinforce healthy lifestyle decisions, thus leading to reduced obesity-related complications and improved health outcomes for youth.
Implementation Plan
Implementation of the proposed strategy to tackle obesity-related complications in adolescents (12 to 18 years) is tailored to address the problem using lifestyle modifications; this involves a multifunctional approach that combines several strategies at the individual, interpersonal, community, and societal levels. At the level of the individual health provider, they will be closely working with adolescents to deliver customized interventions based on the individual needs, preferences, and stage of readiness to change. This could entail performing complete assessments to detect specific obesity-related complications, including insulin resistance and vascular risk factors, and providing personalized care plans whose main elements are diet modifications and increased physical activity. A key goal of the program is to make adolescents more aware of the choices they can make towards a healthy lifestyle. This will include advice on planning daily meals, portion control, and including regular exercise in their routines.
The behavior support techniques employed include goal-setting, self-monitoring, and problem-solving, which will improve motivation and self-efficacy to ensure long-term behavior change. Personalizing into the interpersonal level, families, caregivers, and friends will be very important in providing social support and creating suitable environments for healthy living. Family-oriented interventions will entail getting parents on board in home, promoting eating healthy foods and active lifestyles,,, such as preparing meals, shopping for groceries, and participating in shared physical activities. Adolescent peer support networks will be created to motivate adolescents to be active together. Networks help adolescents to form good behaviours outside of clinical settings. Schools will work closely with the community as partners in promoting health and wellness. Some of the activities undertaken include integrating nutrition education and physical activity into the curriculum, providing healthy food options in cafeterias and creating a chance for active play or exercise in the school.
At the community level, working with local organizations, businesses, and policy-makers will be critical for developing ideal conditions that would make healthy behaviours easy to practice. Partnerships are developed to provide people in poor communities with access to nutritious foods, increase the availability of safe and accessible facilities for physical activity, and advocate for health policies that reduce inequity and determine obesity due to the environment. Such community-based programs wi, after-school leagues, cooking classes, and wellness workshops in or will be includedw in adolescents and their families for continuous support and education, which thatds beyond the clinical space.
At a societal level, endeavours will be undertaken to manage the holistic social, cultural, and economic factors that play a role in obesity complications. This can entail contesting the common conceptions of body image and weight, supporting policies controlling fthe ood marketing to teens, and lobbying for social justice and fair treatment in distthe ribution of resources and health opportunities. The public health campaigns intend to increase awareness of the benefits of healthy lifestyles and the dangers of obesity by emphasising adolescents so that they can realize whether they are at risk and make appropriate choices. Achievement of the proposed approach would involve the cooperation and coordination of the various stakeholders,, including healthcare givers, families, schools, community groups and policymakers. Acknowledging obesity-related complications through a multi-level and comprehensive approach can create an enabling environment targeted at healthier living and, overall, improve health outcomes and quality of life of teenagers living with obesity.
Evaluation Plan
The evaluation plan for the implemented intervention in those who aim to tackle obesity-related complications in young adolescents aged 12 to 18 years through lifestyle modifications will be comprehensive and multifaceted and will assess the effectiveness, feasibility and sustainability of the intervention on various dimensions. To begin with, the evaluation comprises the outcome measures linked to the primary objectives of the intervention, emphasising, the changes in obesity-related outcomes, for instance, BMI, waist circumference, blood pressure, lipid profiles, and glycemic control, within the one-year period. This assessment will provide quantitative data on the effect of the intervention on physiological health outcomes. It will be compared to the baseline and usual care outcomes to determine the magnitude of change relating to the intervention. Furthermore, subjective measures such as self-reported dietary beliefs and practices, physical activity, quality of life, and satisfaction with the intervention will be recorded by the participants using validated questionnaires at multiple visits throughout the intervention period.
Doing this will give a chance to assess comprehensively the perceptions, experiences, and level of adherence to intervention components with the participants and obtain crucial information from them about the acceptability and feasibility of the intervention. In addition, a process evaluation will be undertaken to evaluate the intervention’s success, especially the extent to which the components were delivered with fidelity, reach and acceptability, and the barriers and facilitators encountered during implementation. The qualitative data collection methods of the interviews, focus groups and observations with intervention providers, participants and key stakeholders will be employed to engage and capture rich contextual information to highlight the areas for improvements and optimization of the intervention delivery.
The evaluation will have a sustainability assessment, to explore the effects after a long time and how the intervention can be implemented on a larger scale. Sustainability will entail keeping track of key indicators, such as continued engagement and participation rates, retention of behaviour change, implementation of the intervention components into routine practice or policy, and stakeholder support and commitment to the sustainability of the intervention. Noticeably, an evaluative framework that combines different data sources and methods to rigorously examine the impact, feasibility, and sustainability of the executed program will be used. This will be helpful in forming future practice, policy, and research in the context of adolescent obesity management.
Conclusion
Treating obesity-related complications in teenagers 12—18 years old needs a multidimensional transformation that considers the individual, interpersonal, socio-cultural, and environmental factors. Through implementing the suggested intervention plan derived from evidence-based research and taking the Social Ecological Model (SEM) as the guide, healthcare providers, politicians, and stakeholders can cooperate to create environments that promote a healthy lifestyle among adolescents. Through a joint effort spanning different points of control, the deleterious effects of obesity can be alleviated, healthy outcomes achieved, and the quality of life made better for youth afflicted by this ubiquitous health concern. The intervention’s effectiveness, feasibility, and sustainability of the intervention will serve as bases for implementing similar interventions, making policies and doing further research on managing adolescent obesity. In addition, it will contribute to the fight against the global epidemic.
References
Bellantuono, N., Nuzzi, A., Pontrandolfo, P., & Scozzi, B. (2021). Digital Transformation Models for the I4.0 Transition: Lessons from the Change Management Literature. Sustainability, 13(23), 12941. https://www.mdpi.com/2071-1050/13/23/12941
Diao, H., Wang, H., Yang, L., & Li, T. (2020). The impacts of multiple obesity-related interventions on quality of life in children and adolescents: a randomized controlled trial. Health and Quality of Life Outcomes, 18(1). https://doi.org/10.1186/s12955-020-01459-0
Hanelt, A., Bohnsack, R., Marz, D., & Antunes, C. (2020). A systematic review of the literature on digital transformation: insights and implications for strategy and organizational change. Journal of Management Studies, 58(5), 1159–1197. https://onlinelibrary.wiley.com/doi/abs/10.1111/joms.12639
Hannon, T. S., & Arslanian, S. (2023). Obesity in Adolescents. The New England Journal of Medicine, 389(3), 251–261. https://doi.org/10.1056/nejmcp2102062
Hu, D., Zhou, S., Crowley-McHattan, Z. J., & Liu, Z. (2021). Factors That Influence Participation in Physical Activity in School-Aged Children and Adolescents: A Systematic Review from the Social Ecological Model Perspective. International Journal of Environmental Research and Public Health, 18(6), 3147. https://doi.org/10.3390/ijerph18063147
Jones, H. M., Al‐Khudairy, L., Melendez‐Torres, G. J., & Oyebode, O. (2018). Viewpoints of adolescents with overweight and obesity attending lifestyle obesity treatment interventions: a qualitative systematic review. Obesity Reviews, 20(1), 156–169. https://doi.org/10.1111/obr.12771
Kebbe, M., Perez, A., Buchholz, A., McHugh, T.-L. . F., Scott, S. D., Richard, C., Dyson, M. P., & Ball, G. D. C. (2019). End-user perspectives to inform policy and program decisions: a qualitative and quantitative content analysis of lifestyle treatment recommendations by obese adolescents. BMC Pediatrics, 19(1). https://doi.org/10.1186/s12887-019-1749-3
Kebbe, M., Perez, A., Buchholz, A., Scott, S. D., McHugh, T-L. F., Dyson, M. P., & Ball, G. D. C. (2020). Health care providers’ weight management practices for adolescent obesity and alignment with clinical practice guidelines: a multi-centre, qualitative study. BMC Health Services Research, 20(1), 850. https://doi.org/10.1186/s12913-020-05702-8
Lee, A. M., Szurek, S. M., Dilip, A., Dillard, J. R., Miller, D. R., Theis, R. P., Zaman, N., Krieger, J., Thompson, L. A., Janicke, D. M., & Cardel, M. I. (2021). Behavioural Weight Loss Intervention Preferences of Adolescents with Overweight/Obesity. Childhood Obesity. https://doi.org/10.1089/chi.2020.0296
Morell-Azanza, L., Ojeda-Rodríguez, A., Ochotorena-Elicegui, A., Martín-Calvo, N., Chueca, M., Marti, A., & Azcona-San Julian, C. (2019). Changes in objectively measured physical activity after a multidisciplinary lifestyle intervention in children with abdominal obesity: a randomized control trial. BMC Pediatrics, 19(1). https://doi.org/10.1186/s12887-019-1468-9
Salam, R. A., Padhani, Z. A., Das, J. K., Shaikh, A. Y., Hoodbhoy, Z., Jeelani, S. M., Lassi, Z. S., & Bhutta, Z. A. (2020). Effects of Lifestyle Modification Interventions to Prevent and Manage Child and Adolescent Obesity: A Systematic Review and Meta-analysis. Nutrients, 12(8), 2208. https://doi.org/10.3390/nu12082208
Stabouli, S., Erdine, S., Suurorg, L., Jankauskienė, A., & Lurbe, E. (2021). Obesity and Eating Disorders in Children and Adolescents: The Bidirectional Link. Nutrients, 13(12), 4321. https://doi.org/10.3390/nu13124321
Watanabe, J., Watanabe, M., Yamaoka, K., Adachi, M., Suzuki, A., Tango, T., & Professor, V. (2022). Effects of “SPRAT” programme for dietary and lifestyle education to improve psychosomatic symptoms and dietary habits among adolescents: a cluster randomised controlled trial. BMC Public Health, 22(1). https://doi.org/10.1186/s12889-022-12832-7
Wing, R. R. (2021). Does Lifestyle Intervention Improve Health of Adults with Overweight/Obesity and Type 2 Diabetes: Findings from the Look AHEAD Randomized Trial. Obesity. https://doi.org/10.1002/oby.23158
TimeLine
Week 1-2: Preparation and Orientation
Develop program materials and resources
Recruit participants and obtain consent
Conduct orientation sessions for participants
- Week 3-4: Education and Goal Setting
Deliver educational sessions on nutrition and physical activity
Assist participants in setting personalized goals for lifestyle modifications
- Week 5-6: Implementation and Support
Initiate dietary changes and increased physical activity
Provide ongoing support and guidance to participants
Monitor progress and address barriers to adherence
- Week 7-8: Continued Implementation and Monitoring
Continue lifestyle modifications and behavior change efforts
Monitor participants’ adherence and progress towards goals
Offer additional support and resources as needed
- Week 9-10: Evaluation and Wrap-Up
Collect final data on outcomes and participant feedback
Analyze results and assess program effectiveness
Conduct closing sessions to review achievements and provide follow-up recommendations.
write