A program encouraging overweight or obese adolescents to increase their physical activity through use of their everyday environment, rather than organized classes or sports programs, produced significant increases in participants’ daily physical activity that were sustained for at least three to four months. A report on a pilot study conducted at the Massachusetts General Hospital (MGH) health center in Revere, Mass., is being published online in the Journal of Adolescent Health.
“There is an alarming rate of obesity in this country, and we know that most kids are not getting enough physical activity,” says Nicolas Oreskovic, MD, MPH, of MassGeneral Hospital for Children (MGHfC), a pediatrician at MGH Revere, and lead author of the study. “Past efforts have not been very successful in getting kids to increase their physical activity, but as far as we know, no one has tested whether using their ‘built environment’ – parks, playgrounds, walking paths they may pass by every day – could elp increase daily activity.”
Beginning in the fall of 2013, the study enrolled 60 adolescents ages 10 to 16 who were either overweight or obese and were randomly assigned to either the intervention group or a control group. During a week prior to their first meeting with study staff, all participants wore both a GPS device, which recorded their location, and a research-quality activity monitor that measured any moderate-to-vigorous physical activity they engaged in. At the first study meeting control participants received a handout outlining their current activity level, based on the recorded data, along with standard recommendations regarding diet and exercise.
Intervention group participants and a parent or guardian met with Oreskovic to discuss their physical activity during a recorded week and then reviewed a map showing their home, school, and locations where they had traveled during the week. They discussed specific locations and facilities in the area that participants could use to increase their physical activity and ways they might like to do so – skipping rope in a park, skate boarding at a skate park, using walking paths or even just sidewalks to walk to and from school. Each participant set his or her own goal for a new physical activity to achieve two or three times a week.
During the study period, intervention participants received weekly text or phone messages reminding them of their goal and a low-cost gift – such as a ball, frisbee or jump rope — to encourage physical activity. Participants wore the GPS and activity monitors for another week one month after the first study meeting and again two or three months later. Follow-up meetings were held after each recorded week, during which participants’ progress was reviewed. If the activity goals had been met, participants and their families received small monetary rewards. All intervention group participants competed for a more valuable prize awarded to the one who had achieved the greatest increase in moderate-to-vigorous physical activity by the final meeting.