An interventional study of TEENS+Parents as Coaches and TEENS+Parent Weight Loss in Pediatric Obesity, sponsored by Virginia Commonwealth University. Completed at 1 site in United States. Open to participants aged 12 Years to 16 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-12-12.
Sponsored by Virginia Commonwealth University · Not applicable, Interventional, and Treatment
A randomized control trial to compare the efficacy of two distinct parent treatments on weight loss maintenance for adolescents with obesity participating in a lifestyle intervention including nutrition education, exercise and behavioral support.
Funding support from NIH via 1R01HD095910
Investigators will recruit adolescents with overweight or obesity (BMI>85th percentile) and a parent (BMI > 25 kg/m2). Families will participate in one of two 4-month treatments: 1) TEENS+ Parents as Coaches (PAC), engaging parents as helpers in their child's weight management, or 2) TEENS+ Parent Weight Loss (PWL), engaging parents in their own weight management. All adolescents will participate in TEENS+, which includes behavioral support, nutrition education, and supervised physical activity.
For adolescents, the intervention will consist of weekly behavioral weight management group sessions and weekly 1 hour exercise sessions. Each adolescent also has a monthly individual session with a behavior coach. Parent groups meet weekly for 1 hour according to treatment arm (PAC or PWL). All PWL sessions are separate from their adolescent. Bi-weekly sessions in the PAC arm are combined with parents and adolescent. Assessments will consist of anthropometric measures, psychological surveys and dietary and PA evaluations. Assessments will be completed at baseline, 2 months, 4 months (post-test), 8 months and 1 year.
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Adolescent Inclusion Criteria:
Parent Inclusion Criteria:
Exclusion Criteria:
Adolescent Exclusion Criteria:
Parent Exclusion Criteria:
Parents are taught strategies to support and facilitate child weight management via family-based change. Each visit includes group psychoeducation and discussion, focused on strategies to facilitate healthy weight management in their child(ren). Topics include role modeling, strategies for healthy lifestyle changes, and how to be a coach to your teen. They receive personalized feedback throughout the program. All adolescents participate in a group-based empirically supported behavioral weight management treatment, that includes dietary and physical activity goals, and instructions to self-monitor key information. Adolescents will receive training in core behavioral weight loss strategies (e.g. goal setting, stimulus control) and techniques to help them achieve these goals. They also receive personalized feedback throughout the program.
Behavioral: TEENS+Parents as Coaches
Parents are given a weight loss goal of 1-2 lbs/week, and specific calorie and fat prescriptions, PA goals, and instructions to self-monitor key information. Parents receive training in core behavioral weight loss strategies (e.g. goal setting, stimulus control) and techniques to help them achieve these goals. They also receive personalized feedback throughout the program. All adolescents participate in a group-based empirically supported behavioral weight management treatment, that includes dietary and physical activity goals, and instructions to self-monitor key information. Adolescents receive training in core behavioral weight loss strategies (e.g. goal setting, stimulus control) and techniques to help them achieve these goals. They also receive personalized feedback throughout the program.
Behavioral: TEENS+Parent Weight Loss
Parents as Coaches teaches parenting strategies to facilitate healthy weight loss in adolescent children; adolescents are in a group based behavioral weight management treatment.
Also known as: Parents as Champions for TEENS (PACT)
Parent Weight loss teaches core behavioral weight loss strategies and techniques for parent weight loss; adolescents are in a group based behavioral weight management treatment.
Also known as: Healthy You!
Body Mass Index (BMI) Change
Body Mass Index (BMI) change (kg/m2; adolescent) during the maintenance phase (4-month to 12-month).
Time frame: 4 months to 12 month [follow up phase]
Body Mass Index
National Health and Nutrition Examination Survey (NHANES) Anthropometry methods were used to measure height and weight to calculate Body Mass Index (BMI). At 0, 2, 4, 8, 12 months, trained staff measured adolescent height and weight (in light clothing and after a 12 hour fast) to the nearest 0.1cm and 0.1kg using a precision stadiometer and digital scale, respectively.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Parent Weight
Trained staff will measure weight (in light clothing and after a 12 hour fast) to the nearest 0.1kg using digital scale at baseline, 2-, 4-, 8- and 12-months.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Parent Weight Change
Trained staff will measure weight (in light clothing and after a 12 hour fast) to the nearest 0.1kg using digital scale at baseline and 4-months. Weight change will be calculated from these values.
Time frame: baseline to 4 month [intervention phase] and 4 month to 12 month [maintenance phase]
Physical Activity
Accelerometers were worn for 1 week by adolescents and parents for each assessment period (0, 4, 8, and 12 months) to assess adolescent and parent physical activity. Results represent total time (minutes/day) spent in moderate/vigorous activity (MVPA). Data reported is based off the average MVPA minutes per day of valid wear days.
Time frame: Baseline, 4-, 8-, and 12-months
Physical Activity Change
To assess adolescent and parent physical activity change during the maintenance physical (post-intervention) phase of the program from 4-months to 12-months. Results represent the change in total time (minutes/day) spent in moderate/vigorous activity (MVPA).
Time frame: 4-month to 12-month
Physical Activity Energy Expenditure
Accelerometers will be worn for 1 week by adolescents and parents for each assessment period (0, 4, 8, and 12 months) to assess adolescent and parent physical activity energy expenditure (EE). Results represent the average daily physical activity energy expenditure (kilocalories/day) estimated via accelerometer. Results are based off EE = (Metabolic Equivalent of Task \[MET\] value of activity x body weight kg x \[minutes of activity/60\]) with MET values of 2.5, 4, and 7 utilized for light, moderate, and vigorous activities, respectively.
Time frame: Baseline, 4-, 8-, and 12-months
Physical Activity Energy Expenditure Change
To assess adolescent and parent physical activity energy expenditure change during the maintenance physical (post-intervention) phase of the program from 4-months to 12-months. Results represent the change in total kilocalories per day from physical activity.
Time frame: 4-month to 12-month
Dietary Intake
Adolescent and parent participants completed a 3-day food record to track dietary intake for 2 weekdays and 1 weekend day in the week prior to their assessment (0, 4, 8, 12m). Recall data was entered the Nutrition Data System for Research Software (NDSR) by trained staff. Parent and adolescent average total energy intake (kilocalories/day) from the logged days is reported.
Time frame: Baseline, 4-, 8-, and 12-months
Home Food Environment
The Home Food Inventory (HFI) was used to assess the availability of types of food in the home and calculate an overall obesogenic score. Scores range from 0-60, with high scores indicating a more obesogenic food environment.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Parent Reported Parenting Style
The Parenting Styles and Dimension Questionnaire (PSDQ) was administered to parents to assess parent self-report of authoritative parenting style. Results reflect the participating parent's perception of their parenting style. Scores range from 1-5 with higher scoring indicating a greater frequency of authoritative parenting behaviors.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Role Modeling
At 0, 2, 4, 8, 12 months, adolescents will complete the Family Experiences Related to Food Questionnaire (FERFQ) is an 8 or 9-item measure (father and mother version, respectively) that will assess family commentary about weight and shape as well as family modeling of diet and weight concerns. Scores range from 1-5 with higher scores indicating more negative role modeling of dietary behaviors. Results reflect the adolescent's perception on their parent (mom or dad) participating in the study.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Restrictive Child Feeding Practices
Parents will complete the Child Feeding Questionnaire (CFQ; Adolescent version) to assess restrictive feeding style. Scores range from 1-5 with higher scores indicating a greater degree of restrictive feeding practices.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Overall Weight Control Practices
Adolescents and parents will complete the Weight Control Strategies Scale (WCSS) which will assess the use of healthy weight control practices (e.g., dietary choices, self-monitoring, and physical activity) at 0, 2, 4, 8, 12 months. A total of 30 items are included in the measure, rated from 0-4. Total scores (ranging from 0-4) are calculated by averaging the scores of the 30 items. Higher scores indicate greater engagement in weight management behaviors.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Self Monitoring Weight Control Practices
Adolescents and parents will complete the Weight Control Strategies Scale (WCSS) self-monitoring subscale which will assess the use of self-monitoring weight control practices at 0, 2, 4, 8, 12 months. A total of 7 items are included in the measure, rated from 0-4. Scores are calculated by averaging the scores of the 7 items. Higher scores indicate greater engagement in self-monitoring weight management behaviors.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Dietary Choices Weight Control Practices
Adolescents and parents will complete the Weight Control Strategies Scale (WCSS) dietary choices subscale which will assess the use of dietary choice weight control practices at 0, 2, 4, 8, 12 months. A total of 10 items are included in the measure, rated from 0-4. Scores range from 0 to 4 and are calculated by averaging the scores of the 10 items. Higher scores indicate greater engagement in dietary choice weight management behaviors.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Physical Activity Weight Control Practices
Adolescents and parents will complete the Weight Control Strategies Scale (WCSS) physical activity subscale which will assess the use of physical activity weight control practices at 0, 2, 4, 8, 12 months. A total of 6 items are included in the measure, rated from 0-4. Scores range from 0 to 4 and are calculated by averaging the scores of the 6 items. Higher scores indicate greater engagement in physical activity weight management behaviors.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Psychological Coping Weight Control Practices
Adolescents and parents will complete the Weight Control Strategies Scale (WCSS) psychological coping subscale which will assess the use of psychological coping weight control practices at 0, 2, 4, 8, 12 months. A total of 7 items are included in the measure, rated from 0-4. Scores range from 0 to 4 and are calculated by averaging the scores of the 7 items. Higher scores indicate greater engagement in psychological coping weight management behaviors.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Adolescent Reported Responsiveness Parenting Style
The Authoritative Parenting Index (API) was used to assess adolescent-report of responsiveness parenting style and will be administered at 0, 2, 4, 8, 12 months. Scores range from 9-36 with higher scores indicating greater perceived responsiveness from the parent. Results reflect the adolescent's perception on the parent (mom or dad) participating in the study.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Adolescent Reported Demandingness Parenting Style
The Authoritative Parenting Index (API) was used to assess adolescent-report of demandingness parenting style and will be administered at 0, 2, 4, 8, 12 months. Scores range from 7-28 with higher scores indicating greater perceived demandingness from the parent. Results reflect the adolescent's perception on their parent (mom or dad) participating in the study.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Adolescent Reported Authoritative Parenting Style
The Authoritative Parenting Index (API) was used to assess adolescent-report of authoritative parenting style and was administered at 0, 2, 4, 8, 12 months. Scores range from 16-64 with higher scores indicating the adolescent perceives their parent to have a higher level of authoritative parenting behavior. Results reflect the adolescent's perception on their parent (mom or dad) participating in the study.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Home Exercise Environment
The Exercise Environment Questionnaire (EEQ) assessed the availability of types exercise equipment in the home. Measures will be completed at 0, 4, 8, 12 months. Scores are calculated by summing responses. Scores range from 0-39 with higher scores indicating more exercise equipment in the home.
Time frame: Baseline, 4-, 8-, and 12-months
Monitoring Child Feeding Practices
Parents will complete the Child Feeding Questionnaire (CFQ; Adolescent version) to assess monitoring feeding style. Scores range from 1-5 with higher scores indicating a greater degree of monitoring feeding practices.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Autonomy Support
At 0, 2, 4, 8, 12 months, adolescents will complete the Perceived Parental Autonomy Support Scale (P-PASS) to assess adolescent perception of 1) autonomy-supportive parenting behaviors and 2) controlling parenting behaviors. Items are rated on a 7-point Likert scale from 1-7. The average score across all items is calculated. Higher scores indicate a greater perception of parental autonomy support. Lower scores indicate less support and more controlling behaviors.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Parent Child Relationship
The Conflict Behavior Questionnaire (CBQ; Parent and Adolescent Versions) will assess parent and adolescent report of parent-child relational factors at 0, 2, 4, 8, 12 mo. Scores range from 0-20. Higher score indicate more conflict between parent and child and lower scores indicating less conflict. Results reflect the adolescent's perception on their parent (mom or dad) participating in the study.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Parent Self-efficacy
The Parent Efficacy for Child Healthy Weight Behavior (PECHWB) will assess parent self-efficacy in promoting healthy weight behaviors in their adolescents. Scores range from 0-100 with higher scores indicating higher self-efficacy.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Social Support
At 0, 2, 4, 8, 12 months, adolescents will complete family and friend social support scales from the Patient-based Assessment and Counseling for Physical Activity and Nutrition (PACE+) questionnaires to assess adolescent report of family and friend social support across 3 domains: 1) fruit and vegetable intake, 2) fat intake, and 3) physical activity. Scores range from 1-5 with higher indicating greater social support.
Time frame: Baseline, 2-, 4-, 8-, and 12-months
Recruitment for the trial occurred from March 2019 through August 2023 with more strategized recruitment methods occurring 3-4 months prior to the start of each cohort. We implemented a comprehensive recruitment plan which included: establishing relationships with community practices for provider referrals; physician-endorsed letters; direct mail; social media and targeted digital ads; local newspaper/magazine/radio ads; flyers/posters in medical offices/hospital; listservs; community events.
| Milestone | Teens with parents in PAC | Teens with parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| Started | 107 | 104 | 105 | 102 |
| Completed | 86 | 94 | 84 | 92 |
| Not completed | 21 | 10 | 21 | 10 |
Body Mass Index (BMI) change (kg/m2; adolescent) during the maintenance phase (4-month to 12-month).
| kg/m^2 | Teens with parents in PAC | Teens with parents in PWL |
|---|---|---|
| Body Mass Index (BMI) Change | 1.51 ± 2.44 | 0.91 ± 2.27 |
National Health and Nutrition Examination Survey (NHANES) Anthropometry methods were used to measure height and weight to calculate Body Mass Index (BMI). At 0, 2, 4, 8, 12 months, trained staff measured adolescent height and weight (in light clothing and after a 12 hour fast) to the nearest 0.1cm and 0.1kg using a precision stadiometer and digital scale, respectively.
| kg/m^2 | Teens with parents in PAC | Teens with parents in PWL |
|---|---|---|
| Baseline | 34.27 ± 6.49 | 34.71 ± 6.97 |
| 2-month | 33.58 ± 6.55 | 34.16 ± 7.03 |
| 4-month | 33.21 ± 6.39 | 33.92 ± 7.13 |
| 8-month | 33.66 ± 6.99 | 34.56 ± 7.49 |
| 12-month | 34.09 ± 7.26 | 34.79 ± 7.51 |
Trained staff will measure weight (in light clothing and after a 12 hour fast) to the nearest 0.1kg using digital scale at baseline, 2-, 4-, 8- and 12-months.
| Kilograms | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|
| Baseline | 99.18 ± 22.93 | 100.62 ± 26.17 |
| 2-month | 97.39 ± 20.16 | 98.51 ± 26.17 |
| 4-month | 98.50 ± 24.31 | 96.06 ± 24.65 |
| 8-month | 97.29 ± 23.04 | 96.69 ± 25.37 |
| 12-month | 95.97 ± 22.33 | 98.25 ± 25.74 |
Trained staff will measure weight (in light clothing and after a 12 hour fast) to the nearest 0.1kg using digital scale at baseline and 4-months. Weight change will be calculated from these values.
| Kilograms | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|
| 0-4 month change | -1.20 ± 4.11 | -3.47 ± 4.51 |
| 4-12 month change | -0.32 ± 6.59 | 0.49 ± 1.76 |
Accelerometers were worn for 1 week by adolescents and parents for each assessment period (0, 4, 8, and 12 months) to assess adolescent and parent physical activity. Results represent total time (minutes/day) spent in moderate/vigorous activity (MVPA). Data reported is based off the average MVPA minutes per day of valid wear days.
| minutes per day | Teens with parents in PAC | Teens with parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| Baseline | 11.99 ± 12.11 | 11.92 ± 11.75 | 21.05 ± 17.83 | 22.51 ± 18.54 |
| 4-month | 12.03 ± 15.85 | 12.41 ± 12.35 | 19.75 ± 16.99 | 24.65 ± 18.46 |
| 8-month | 10.78 ± 14.39 | 15.48 ± 13.74 | 19.09 ± 13.88 | 21.93 ± 17.69 |
| 12-month | 9.83 ± 12.44 | 13.90 ± 16.14 | 17.99 ± 13.26 | 21.55 ± 21.14 |
To assess adolescent and parent physical activity change during the maintenance physical (post-intervention) phase of the program from 4-months to 12-months. Results represent the change in total time (minutes/day) spent in moderate/vigorous activity (MVPA).
| minutes per day | Teens with parents in PAC | Teens with parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| Physical Activity Change | -3.21 ± 14.05 | 3.24 ± 14.11 | -1.28 ± 15.77 | -3.68 ± 14.35 |
Accelerometers will be worn for 1 week by adolescents and parents for each assessment period (0, 4, 8, and 12 months) to assess adolescent and parent physical activity energy expenditure (EE). Results represent the average daily physical activity energy expenditure (kilocalories/day) estimated via accelerometer. Results are based off EE = (Metabolic Equivalent of Task \[MET\] value of activity x body weight kg x \[minutes of activity/60\]) with MET values of 2.5, 4, and 7 utilized for light, moderate, and vigorous activities, respectively.
| kilocalories per day | Teens with parents in PAC | Teens with parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| Baseline | 915.73 ± 370.39 | 897.27 ± 385.31 | 1486.38 ± 448.30 | 1506.10 ± 546.61 |
| 4-month | 815.05 ± 317.61 | 856.47 ± 303.50 | 1349.37 ± 357.90 | 1542.45 ± 583.33 |
| 8-month | 872.27 ± 337.40 | 900.97 ± 347.12 | 1399.80 ± 394.07 | 1541.63 ± 618.11 |
| 12-month | 832.10 ± 333.46 | 871.07 ± 317.98 | 1347.41 ± 389.41 | 1496.42 ± 575.02 |
To assess adolescent and parent physical activity energy expenditure change during the maintenance physical (post-intervention) phase of the program from 4-months to 12-months. Results represent the change in total kilocalories per day from physical activity.
| kilocalories per day | Teens with parents in PAC | Teens with parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| Physical Activity Energy Expenditure Change | 10.30 ± 298.35 | 67.74 ± 244.26 | 9.57 ± 352.50 | -36.39 ± 417.73 |
Adolescent and parent participants completed a 3-day food record to track dietary intake for 2 weekdays and 1 weekend day in the week prior to their assessment (0, 4, 8, 12m). Recall data was entered the Nutrition Data System for Research Software (NDSR) by trained staff. Parent and adolescent average total energy intake (kilocalories/day) from the logged days is reported.
| kilocalories per day | Teens with parents in PAC | Teens with parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| Baseline | 1830 ± 493 | 1807 ± 546 | 1699 ± 511 | 1817 ± 622 |
| 4-month | 1539 ± 501 | 1502 ± 529 | 1491 ± 432 | 1451 ± 405 |
| 8-month | 1478 ± 466 | 1510 ± 493 | 1463 ± 736 | 1516 ± 483 |
| 12-month | 1587 ± 475 | 1611 ± 447 | 1499 ± 470 | 1593 ± 447 |
The Home Food Inventory (HFI) was used to assess the availability of types of food in the home and calculate an overall obesogenic score. Scores range from 0-60, with high scores indicating a more obesogenic food environment.
| score on a scale | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|
| Baseline | 22.16 ± 7.44 | 22.28 ± 8.24 |
| 2-month | 15.89 ± 6.35 | 18.54 ± 7.42 |
| 4-month | 15.97 ± 6.81 | 17.09 ± 7.26 |
| 8-month | 16.84 ± 7.22 | 17.95 ± 7.57 |
| 12-month | 17.81 ± 7.29 | 18.20 ± 7.92 |
The Parenting Styles and Dimension Questionnaire (PSDQ) was administered to parents to assess parent self-report of authoritative parenting style. Results reflect the participating parent's perception of their parenting style. Scores range from 1-5 with higher scoring indicating a greater frequency of authoritative parenting behaviors.
| score on a scale | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|
| Baseline | 4.08 ± 0.47 | 4.12 ± 0.50 |
| 2-month | 4.07 ± 0.45 | 4.10 ± 0.49 |
| 4-month | 4.12 ± 0.52 | 4.15 ± 0.52 |
| 8-month | 4.13 ± 0.51 | 4.14 ± 0.42 |
| 12-month | 4.12 ± 0.54 | 4.16 ± 0.49 |
At 0, 2, 4, 8, 12 months, adolescents will complete the Family Experiences Related to Food Questionnaire (FERFQ) is an 8 or 9-item measure (father and mother version, respectively) that will assess family commentary about weight and shape as well as family modeling of diet and weight concerns. Scores range from 1-5 with higher scores indicating more negative role modeling of dietary behaviors. Results reflect the adolescent's perception on their parent (mom or dad) participating in the study.
| score on a scale | Teens with parents in PAC | Teens with parents in PWL |
|---|---|---|
| Baseline | 2.54 ± 0.77 | 2.57 ± 0.85 |
| 2-month | 2.46 ± 0.68 | 2.52 ± 0.75 |
| 4-month | 2.33 ± 0.72 | 2.46 ± 0.82 |
| 8-month | 2.29 ± 0.75 | 2.53 ± 0.88 |
| 12-month | 2.32 ± 0.67 | 2.46 ± 0.83 |
Parents will complete the Child Feeding Questionnaire (CFQ; Adolescent version) to assess restrictive feeding style. Scores range from 1-5 with higher scores indicating a greater degree of restrictive feeding practices.
| score on a scale | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|
| Baseline | 3.54 ± 0.86 | 3.64 ± 0.77 |
| 2-month | 3.36 ± 0.77 | 3.34 ± 0.84 |
| 4-month | 3.17 ± 3.17 | 3.23 ± 0.89 |
| 8-month | 3.12 ± 0.89 | 3.35 ± 0.84 |
| 12-month | 3.20 ± 0.89 | 3.09 ± 0.87 |
Adolescents and parents will complete the Weight Control Strategies Scale (WCSS) which will assess the use of healthy weight control practices (e.g., dietary choices, self-monitoring, and physical activity) at 0, 2, 4, 8, 12 months. A total of 30 items are included in the measure, rated from 0-4. Total scores (ranging from 0-4) are calculated by averaging the scores of the 30 items. Higher scores indicate greater engagement in weight management behaviors.
| score on a scale | Teens with parents in PAC | Teens with parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| Baseline | 1.23 ± 0.67 | 1.12 ± 0.59 | 1.35 ± 0.75 | 1.22 ± 0.58 |
| 2-month | 2.25 ± 0.77 | 2.22 ± 0.72 | 1.87 ± 0.69 | 2.18 ± 0.58 |
| 4-month | 2.11 ± 2.11 | 2.10 ± 0.78 | 1.80 ± 0.70 | 2.20 ± 0.72 |
| 8-month | 1.76 ± 0.80 | 1.77 ± 0.74 | 1.58 ± 0.75 | 1.76 ± 0.69 |
| 12-month | 1.69 ± 0.80 | 1.58 ± 0.75 | 1.64 ± 0.75 | 1.52 ± 0.67 |
Adolescents and parents will complete the Weight Control Strategies Scale (WCSS) self-monitoring subscale which will assess the use of self-monitoring weight control practices at 0, 2, 4, 8, 12 months. A total of 7 items are included in the measure, rated from 0-4. Scores are calculated by averaging the scores of the 7 items. Higher scores indicate greater engagement in self-monitoring weight management behaviors.
| score on a scale | Teens with parents in PAC | Teens with parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| Baseline | 0.61 ± 0.75 | 0.52 ± 0.64 | 0.76 ± 0.83 | 0.53 ± 0.66 |
| 2-month | 2.29 ± 0.98 | 2.25 ± 1.01 | 1.31 ± 1.02 | 2.46 ± 0.63 |
| 4-month | 1.88 ± 1.08 | 1.84 ± 1.03 | 1.21 ± 0.96 | 2.23 ± 1.08 |
| 8-month | 1.23 ± 1.00 | 1.20 ± 0.97 | 1.08 ± 0.98 | 1.32 ± 0.95 |
| 12-month | 1.21 ± 1.02 | 1.02 ± 0.85 | 1.10 ± 0.97 | 1.00 ± 0.81 |
Adolescents and parents will complete the Weight Control Strategies Scale (WCSS) dietary choices subscale which will assess the use of dietary choice weight control practices at 0, 2, 4, 8, 12 months. A total of 10 items are included in the measure, rated from 0-4. Scores range from 0 to 4 and are calculated by averaging the scores of the 10 items. Higher scores indicate greater engagement in dietary choice weight management behaviors.
| score on a scale | Teens with parents in PAC | Teens with parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| Baseline | 1.90 ± 0.76 | 1.84 ± 0.74 | 2.22 ± 0.74 | 2.27 ± 0.66 |
| 2-month | 2.65 ± 0.76 | 2.65 ± 0.68 | 2.82 ± 0.61 | 2.65 ± 0.63 |
| 4-month | 2.63 ± 0.77 | 2.59 ± 0.76 | 2.75 ± 0.65 | 2.71 ± 0.61 |
| 8-month | 2.35 ± 0.75 | 2.42 ± 0.71 | 2.46 ± 0.84 | 2.51 ± 0.62 |
| 12-month | 2.23 ± 0.84 | 2.23 ± 0.79 | 2.51 ± 0.71 | 2.42 ± 0.66 |
Adolescents and parents will complete the Weight Control Strategies Scale (WCSS) physical activity subscale which will assess the use of physical activity weight control practices at 0, 2, 4, 8, 12 months. A total of 6 items are included in the measure, rated from 0-4. Scores range from 0 to 4 and are calculated by averaging the scores of the 6 items. Higher scores indicate greater engagement in physical activity weight management behaviors.
| score on a scale | Teens with parents in PAC | Teens with parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| Baseline | 1.09 ± 0.96 | 0.91 ± 0.82 | 1.13 ± 1.06 | 0.86 ± 0.86 |
| 2-month | 1.95 ± 1.00 | 1.88 ± 0.97 | 1.44 ± 1.05 | 1.68 ± 0.90 |
| 4-month | 1.79 ± 1.14 | 1.81 ± 1.03 | 1.45 ± 0.99 | 1.78 ± 1.03 |
| 8-month | 1.60 ± 1.14 | 1.60 ± 1.02 | 1.24 ± 1.00 | 1.34 ± 1.00 |
| 12-month | 1.51 ± 1.02 | 1.46 ± 1.07 | 1.28 ± 1.09 | 1.11 ± 1.04 |
Adolescents and parents will complete the Weight Control Strategies Scale (WCSS) psychological coping subscale which will assess the use of psychological coping weight control practices at 0, 2, 4, 8, 12 months. A total of 7 items are included in the measure, rated from 0-4. Scores range from 0 to 4 and are calculated by averaging the scores of the 7 items. Higher scores indicate greater engagement in psychological coping weight management behaviors.
| score on a scale | Teens with parents in PAC | Teens with parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| Baseline | 1.31 ± 0.87 | 1.21 ± 0.82 | 1.28 ± 0.90 | 1.20 ± 0.80 |
| 2-month | 2.12 ± 0.96 | 2.09 ± 0.86 | 1.92 ± 0.86 | 1.94 ± 0.73 |
| 4-month | 2.15 ± 0.86 | 2.15 ± 0.88 | 1.78 ± 0.90 | 2.08 ± 0.83 |
| 8-month | 1.84 ± 1.00 | 1.84 ± 0.93 | 1.53 ± 0.90 | 1.88 ± 0.84 |
| 12-month | 1.82 ± 0.91 | 1.64 ± 0.92 | 1.65 ± 0.91 | 1.55 ± 0.89 |
The Authoritative Parenting Index (API) was used to assess adolescent-report of responsiveness parenting style and will be administered at 0, 2, 4, 8, 12 months. Scores range from 9-36 with higher scores indicating greater perceived responsiveness from the parent. Results reflect the adolescent's perception on the parent (mom or dad) participating in the study.
| score on a scale | Teens with parents in PAC | Teens with parents in PWL |
|---|---|---|
| Baseline | 27.59 ± 5.52 | 28.09 ± 4.90 |
| 2-month | 28.00 ± 5.66 | 28.84 ± 4.86 |
| 4-month | 28.84 ± 5.15 | 29.12 ± 5.27 |
| 8-month | 28.52 ± 5.64 | 28.67 ± 5.81 |
| 12-month | 28.58 ± 5.32 | 28.10 ± 5.84 |
The Authoritative Parenting Index (API) was used to assess adolescent-report of demandingness parenting style and will be administered at 0, 2, 4, 8, 12 months. Scores range from 7-28 with higher scores indicating greater perceived demandingness from the parent. Results reflect the adolescent's perception on their parent (mom or dad) participating in the study.
| score on a scale | Teens with parents in PAC | Teens with parents in PWL |
|---|---|---|
| Baseline | 21.78 ± 4.07 | 21.59 ± 4.21 |
| 2-month | 22.11 ± 4.16 | 21.87 ± 3.97 |
| 4-month | 22.31 ± 4.29 | 21.75 ± 3.86 |
| 8-month | 22.18 ± 4.16 | 22.04 ± 4.10 |
| 12-month | 21.70 ± 4.58 | 21.40 ± 4.43 |
The Authoritative Parenting Index (API) was used to assess adolescent-report of authoritative parenting style and was administered at 0, 2, 4, 8, 12 months. Scores range from 16-64 with higher scores indicating the adolescent perceives their parent to have a higher level of authoritative parenting behavior. Results reflect the adolescent's perception on their parent (mom or dad) participating in the study.
| score on a scale | Teens with parents in PAC | Teens with parents in PWL |
|---|---|---|
| Baseline | 49.37 ± 7.62 | 49.68 ± 7.12 |
| 2-month | 50.11 ± 8.01 | 50.70 ± 7.15 |
| 4-month | 51.15 ± 8.00 | 50.87 ± 7.46 |
| 8-month | 50.69 ± 8.06 | 50.72 ± 8.47 |
| 12-month | 50.28 ± 8.58 | 49.50 ± 8.75 |
The Exercise Environment Questionnaire (EEQ) assessed the availability of types exercise equipment in the home. Measures will be completed at 0, 4, 8, 12 months. Scores are calculated by summing responses. Scores range from 0-39 with higher scores indicating more exercise equipment in the home.
| score on a scale | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|
| Baseline | 11.51 ± 5.51 | 11.11 ± 4.80 |
| 4-month | 13.66 ± 5.35 | 12.74 ± 4.74 |
| 8-month | 13.02 ± 6.36 | 12.23 ± 4.90 |
| 12-month | 14.15 ± 5.31 | 13.33 ± 5.03 |
Parents will complete the Child Feeding Questionnaire (CFQ; Adolescent version) to assess monitoring feeding style. Scores range from 1-5 with higher scores indicating a greater degree of monitoring feeding practices.
| score on a scale | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|
| Baseline | 3.30 ± 0.99 | 3.21 ± 1.06 |
| 2-month | 3.77 ± 0.94 | 3.41 ± 0.96 |
| 4-month | 3.55 ± 1.04 | 3.25 ± 1.08 |
| 8-month | 3.35 ± 1.09 | 3.21 ± 0.95 |
| 12-month | 3.32 ± 1.04 | 3.08 ± 1.04 |
At 0, 2, 4, 8, 12 months, adolescents will complete the Perceived Parental Autonomy Support Scale (P-PASS) to assess adolescent perception of 1) autonomy-supportive parenting behaviors and 2) controlling parenting behaviors. Items are rated on a 7-point Likert scale from 1-7. The average score across all items is calculated. Higher scores indicate a greater perception of parental autonomy support. Lower scores indicate less support and more controlling behaviors.
| score on a scale | Teens with parents in PAC | Teens with parents in PWL |
|---|---|---|
| Baseline | 2.82 ± 4.01 | 3.00 ± 4.13 |
| 2-month | 2.82 ± 4.00 | 2.75 ± 3.72 |
| 4-month | 2.95 ± 3.87 | 3.02 ± 4.13 |
| 8-month | 3.15 ± 4.61 | 3.00 ± 4.46 |
| 12-month | 2.34 ± 3.58 | 3.31 ± 4.94 |
The Conflict Behavior Questionnaire (CBQ; Parent and Adolescent Versions) will assess parent and adolescent report of parent-child relational factors at 0, 2, 4, 8, 12 mo. Scores range from 0-20. Higher score indicate more conflict between parent and child and lower scores indicating less conflict. Results reflect the adolescent's perception on their parent (mom or dad) participating in the study.
| score on a scale | Teens with parents in PAC | Teens with parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| Baseline | 2.82 ± 4.01 | 3.00 ± 4.13 | 3.53 ± 4.66 | 3.82 ± 4.54 |
| 2-month | 2.82 ± 4.00 | 2.75 ± 3.72 | 3.32 ± 4.34 | 3.47 ± 4.55 |
| 4-month | 2.95 ± 3.87 | 3.02 ± 4.13 | 3.79 ± 4.44 | 3.31 ± 4.13 |
| 8-month | 3.15 ± 4.61 | 3.00 ± 4.46 | 4.09 ± 5.03 | 3.36 ± 3.74 |
| 12-month | 2.34 ± 3.58 | 3.31 ± 4.94 | 3.78 ± 4.82 | 3.47 ± 4.31 |
The Parent Efficacy for Child Healthy Weight Behavior (PECHWB) will assess parent self-efficacy in promoting healthy weight behaviors in their adolescents. Scores range from 0-100 with higher scores indicating higher self-efficacy.
| score on a scale | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|
| Baseline | 67.75 ± 23.24 | 66.58 ± 17.96 |
| 2-month | 69.29 ± 18.33 | 62.44 ± 21.54 |
| 4-month | 70.78 ± 16.99 | 59.42 ± 23.01 |
| 8-month | 65.37 ± 17.86 | 62.11 ± 20.62 |
| 12-month | 68.44 ± 20.34 | 57.59 ± 20.76 |
At 0, 2, 4, 8, 12 months, adolescents will complete family and friend social support scales from the Patient-based Assessment and Counseling for Physical Activity and Nutrition (PACE+) questionnaires to assess adolescent report of family and friend social support across 3 domains: 1) fruit and vegetable intake, 2) fat intake, and 3) physical activity. Scores range from 1-5 with higher indicating greater social support.
| score on a scale | Teens with parents in PAC | Teens with parents in PWL |
|---|---|---|
| Baseline | 3.04 ± 0.95 | 2.95 ± 0.78 |
| 2-month | 3.58 ± 0.82 | 3.41 ± 0.86 |
| 4-month | 3.44 ± 0.96 | 3.36 ± 0.99 |
| 8-month | 3.21 ± 1.03 | 3.25 ± 0.92 |
| 12-month | 3.05 ± 0.89 | 3.00 ± 1.07 |
Collected over 4-, 8-, and 12-months. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Teens With Parents in PAC | 0/107 (0%) | 1/107 (0.9%) | 13/107 (12.1%) |
| Teens With Parents in PWL | 0/104 (0%) | 2/104 (1.9%) | 17/104 (16.3%) |
| Parents as Coaches (PAC) | 0/105 (0%) | 3/105 (2.9%) | 19/105 (18.1%) |
| Parent Weight Loss (PWL) | 0/102 (0%) | 5/102 (4.9%) | 13/102 (12.7%) |
| Event | Teens With Parents in PAC | Teens With Parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| HysterectomySurgical and medical procedures | 0/107 | 0/104 | 1/105 | 2/102 |
| Breast reduction surgery requiring hospitalizationSurgical and medical procedures | 0/107 | 0/104 | 0/105 | 1/102 |
| Transient ischemic attackNervous system disorders | 0/107 | 0/104 | 0/105 | 1/102 |
| Chemotherapy for Non-Hodgkin's lymphomaImmune system disorders | 0/107 | 0/104 | 0/105 | 1/102 |
| Psychiatric hospitalizationPsychiatric disorders | 0/107 | 1/104 | 0/105 | 0/102 |
| Gall bladder removal surgerySurgical and medical procedures | 0/107 | 1/104 | 0/105 | 0/102 |
| Severe headache requiring hospitalizationNervous system disorders | 0/107 | 0/104 | 1/105 | 0/102 |
| Non-ST-elevation myocardial infarctionCardiac disorders | 0/107 | 0/104 | 1/105 | 0/102 |
| Asthma attack requiring hospitalizationRespiratory, thoracic and mediastinal disorders | 1/107 | 0/104 | 0/105 | 0/102 |
| Event | Teens With Parents in PAC | Teens With Parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) |
|---|---|---|---|---|
| Muscle/Bone InjuryMusculoskeletal and connective tissue disorders | 11/107 | 13/104 | 10/105 | 7/102 |
| Minor medical procedureeSurgical and medical procedures | 2/107 | 4/104 | 9/105 | 6/102 |
| Age, Continuous(years) | Teens With Parents in PAC | Teens With Parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) | Total |
|---|---|---|---|---|---|
| Mean | 13.5 ± 1.3 | 13.54 ± 1.4 | 44.44 ± 6.8 | 43.87 ± 7.7 | 28.69 ± 16.2 |
| Sex: Female, Male(Participants) | Teens With Parents in PAC | Teens With Parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) | Total |
|---|---|---|---|---|---|
| Female | 61 | 60 | 89 | 85 | 295 |
| Male | 46 | 44 | 16 | 17 | 123 |
| Ethnicity (NIH/OMB)(Participants) | Teens With Parents in PAC | Teens With Parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) | Total |
|---|---|---|---|---|---|
| Hispanic or Latino | 11 | 9 | 5 | 4 | 29 |
| Not Hispanic or Latino | 95 | 95 | 99 | 97 | 386 |
| Unknown or Not Reported | 1 | 0 | 1 | 1 | 3 |
| Race (NIH/OMB)(Participants) | Teens With Parents in PAC | Teens With Parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) | Total |
|---|---|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 | 0 | 0 |
| Asian | 5 | 5 | 5 | 3 | 18 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 | 0 | 0 |
| Black or African American | 53 | 43 | 51 | 44 | 191 |
| White | 43 | 39 | 46 | 46 | 174 |
| More than one race | 4 | 10 | 2 | 3 | 19 |
| Unknown or Not Reported | 2 | 7 | 1 | 6 | 16 |
| Region of Enrollment(participants) | Teens With Parents in PAC | Teens With Parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) | Total |
|---|---|---|---|---|---|
| United States | 107 | 104 | 105 | 102 | 418 |
| Body Mass Index (BMI)(kg/m^2) | Teens With Parents in PAC | Teens With Parents in PWL | Parents as Coaches (PAC) | Parent Weight Loss (PWL) | Total |
|---|---|---|---|---|---|
| Mean | 34.27 ± 6.49 | 34.71 ± 6.97 | 36.02 ± 8.10 | 36.27 ± 7.75 | 35.31 ± 7.37 |
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