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- Cross-sectional study showed psychosocial variables, gender and family involvement played an important role in an adolescent weight management programmePublication . Prioste, Ana; Fonseca, Helena; Sousa, Pedro Miguel Lopes; Gaspar, Pedro; Machado, Maria do CéuAim: This study aimed to investigate the psychosocial gains perceived by overweightadolescents attending a 12-week weight management programme and to analyse gender-specific differences. Methods: A quantitative cross-sectional study was conducted with a sample of 70overweight adolescents aged between 12 and 18 (52.9% girls), evaluated at baseline andat week 12 using anthropometric measurements and self-reported questionnaires. Weanalysed gender-specific differences related to body self-esteem, social life, relationshipswith their family, physical comfort, health responsibility, perceived benefits of theintervention, self-efficacy and adherence. We further investigated whether the variables atweek 12 would predict changes in their body mass index. Results: While weight had a greater impact on the body self-esteem of girls, both atbaseline and week 12, boys reported higher self-efficacy and adherence as well as agreater perception of the benefits of the intervention at week 12. The body mass indexchange was positively associated with body self-esteem, relationships within the family andself-efficacy and adherence. Conclusion: Gender specifics and the role of psychosocial variables must be taken intoaccount during weight management programmes for adolescents, and it is important toinclude the family throughout the entire process.
- Usability of an internet-based platform (Next.Step) for adolescent weight managementPublication . Sousa, Pedro Miguel Lopes; Fonseca, Helena; Gaspar, Pedro; Gaspar, FilomenaObjective The current study evaluates the usability perception of an e-therapeutic platform (supported by electronic processes and communication), aiming to promote the behavior change and to improve the adolescent health status through increased and interactive contact between the adolescent and the clinical staff. Methods This was a correlational study with a sample of 48 adolescents (12-18 years) who attended a Pediatric Obesity Clinic between January and August of 2012. Participants were invited to access, during 24 weeks, the e-therapeutic multidisciplinary platform (Next.Step) in addition to the standard treatment program. A usability questionnaire was administered and the platform performance and utilization indicators were analyzed. Results The users’ perception of satisfaction, efficiency, and effectiveness regarding the Next.Step platform was clearly positive. However, only 54.17% of the enrolled adolescents accessed the platform, with a mean task-completion rate of 14.55% (SD = 18.853). The higher the number of the platform consulted resources, the greater the tendency to enjoy the platform, to consider it exciting and quick, to consider that the time spent in it was useful, to consider the access to information easy, and to login easier. Post-intervention assessment revealed a significant reduction in anthropometric and behavioral variables, including body mass index z-score, waist circumference percentile, hip circumference, and weekly screen time. Conclusion These results highlight the importance of information and communication technologies in the health information access and the healthcare provision. Despite the limited adherence rate, platform users expressed a positive overall perception of its usability and presented a positive anthropometric and behavioral progress.
- Health promoting behaviors in adolescence: validation of the Portuguese version of the Adolescent Lifestyle ProfilePublication . Sousa, Pedro Miguel Lopes; Gaspar, Pedro; Fonseca, Helena; Hendricks, Constance; Murdaugh, CarolynObjective Reliable and valid instruments are essential for understanding health-promoting behaviors in adolescents. This study analyzed the psychometric properties of the Portuguese version of the Adolescent Lifestyle Profile (ALP). Methods A linguistic and cultural translation of the ALP was conducted with 236 adolescents from two different settings: a community (n = 141) and a clinical setting (n = 95). Internal consistency reliability and confirmatory factor analysis were performed. Results Results showed an adequate fit to data, yielding a 36-item, seven-factor structure (CMIN/DF = 1.667, CFI = 0.807, GFI = 0.822, RMR = 0.051, RMSEA = 0.053, PNFI = 0.575, PCFI = 0.731). The ALP presented a high internal consistency (α = 0.866), with the subscales presenting moderate reliability values (from 0.492 to 0.747). The highest values were in Interpersonal Relations (3.059 ± 0.523) and Positive Life Perspective (2.985 ± 0.588). Some gender differences were found. Findings showed that adolescents from the clinic reported an overall healthier lifestyle than those from the community setting (2.598 ± 0.379 vs. 2.504 ± 0.346; t = 1.976, p = 0.049). Conclusion The ALP Portuguese version is a psychometrically reliable, valid, and useful measurement instrument for assessing health-promoting lifestyles in adolescence. The ALP is cross-culturally validated and can decisively contribute to a better understanding of adolescent health promotion needs. Additional research is needed to evaluate the instrument's predictive validity, as well as its clinical relevance for practice and research.
- Internet-based intervention programme for obese adolescents and their families (Next.Step): research protocol of a controlled trialPublication . Sousa, Pedro Miguel Lopes; Fonseca, Helena; Gaspar, Pedro; Gaspar, FilomenaAim This paper describes the design and rationale of a controlled trial that aims to determine the effectiveness of an intervention programme in which the internet is used. Background Adolescent obesity is a major health problem, there being urgency to find effective interventions that induce behavioural change. The inclusion of the internet in the intervention may improve adolescents' adherence to the weight management programme and lead to adoption of healthier lifestyles. Design A clinical trial with a control group (non‐randomized). Methods Participants are adolescents with appointments at a paediatric obesity clinic (Portugal). Sample size was calculated according to the power analysis. The experimental group will follow the standard treatment protocol and receive free access to the e‐therapeutic platform. The control group will follow the standard treatment protocol and join a waiting list. Intervention length will be 36 weeks (24 weeks of direct intervention with a follow‐up for 12 weeks). This study was approved by the Ethical Committee for Health (Lisbon, Portugal) in January 2012 and funded by the Foundation for Science and Technology (Portugal) in December 2012. Discussion The results of this research will promote reflection on new approaches directed to treat adolescent obesity and on the promotion of healthy behaviours. We expect to gather empirical evidence of the intervention programme effectiveness. The expectations lie on the population health gains, empowerment in decision‐making and adoption of healthier lifestyles.
- Lifestyle and treatment adherence among overweight adolescentsPublication . Sousa, Pedro Miguel Lopes; Gaspar, Pedro; Fonseca, Helena; Gaspar, FilomenaThis study evaluated the influence of overweight adolescents' lifestyle on the adherence to weight control, and identifies their predictors. Participants were 94 adolescents, aged 12-18 years, attending a Paediatric Obesity Clinic. Lifestyle was assessed using the "Adolescent Lifestyle Profile" and treatment adherence through the "Therapeutic Adherence to Weight Control Questionnaire." Adherence to weight control was associated with various lifestyle domains. Several predictors were identified for lifestyle and adherence to weight control among overweight adolescents. A broad array of inter-correlations and predictors were identified and should be taken into account when designing adolescent weight control interventions.
- Development and Preliminary Validation of the Adherence to Weight Control QuestionnairePublication . Sousa, Pedro Miguel Lopes; Gaspar, Pedro; Fonseca, HelenaBackground and Purpose: This study tests the psychometric properties of the Adherence to Weight Control Questionnaire, a new screening tool to measure treatment adherence (TAWC) and the risk of nonadherence to weight control (RNAWC) in adolescents. Methods: Participants are 92 adolescents (12–18 years old) from a pediatric obesity clinic. Construct validity were evaluated using a principal axis factoring method with varimax rotation. Reliability and criterion-related validity of both scales were also checked. Results: Both scales presented good reliability values (.770 and .908). Statistical analyses yielded a 1-factor solution for the RNAWC and a 4-factor solution for the TAWC. Criterion-related validity of scales was also checked. Conclusions: Results showed that this theory-driven measure of adherence to weight control has adequate psychometric properties to support both research and the clinical practice.
- Association between treatment adherence and quality of life among overweight adolescentsPublication . Sousa, Pedro Miguel Lopes; Gaspar, Pedro; Fonseca, Helena; Gaspar, FilomenaOverweight is an extra burden for adolescent development and can trigger severe physical and psychosocial problems. This cross-sectional correlational study aimed to analyze the association between treatment adherence and obesity-related quality of life among overweight adolescents. The sample consisted of 94 adolescents attending a specialized Pediatric Obesity Clinic in Portugal, 48.94% of whom were boys and 51.06% girls, with a median age of 14.17 years (SD = 1.51). A positive correlation was found between obesity-related quality of life and adherence to weight control. The influence of parents and caregivers on the adherence to weight control is significantly associated with increased physical comfort, better social life and family relations. These results highlight the importance of behavioral change and adherence to weight control as pillars of a better quality of life among overweight adolescents. Obesity management programs need to focus on multiple criteria of treatment effectiveness, such as obesity-related quality of life.
- Measuring Health-Promoting Behaviors: Cross-Cultural Validation of the Health-Promoting Lifestyle Profile-IIPublication . Sousa, Pedro Miguel Lopes; Gaspar, Pedro; Vaz, Daniela C.; Gonzaga, Sílvia; Dixe, Maria dos AnjosPurpose Individual lifestyles have emerged as valuable health constructs. This study aims to psychometrically test the Portuguese (European) version of the Health‐Promoting Lifestyle Profile‐II. Methods After an adequate linguistic and cultural adaptation of the Health‐Promoting Lifestyle Profile‐II scale, their psychometric properties were assessed (N = 889) by Cronbach's alpha and confirmatory factor analysis. Findings Results showed an adequate fit to a 52‐item, six‐factor structure. A global alpha of .925 was obtained. Conclusions The Portuguese version demonstrated good validity and reliability in a wide adult sample, and can thus be applied to the Portuguese population. Implications for Nursing Practice This instrument is useful as an evaluation tool for health‐promoting lifestyles and as an instrument for testing the effectiveness of health‐promoting programs.