Date of Award
Master of Public Health (MPH)
School of Public Health
Marney A. White
While responses to the obesity epidemic have largely encompassed top-down approaches with a focus on health-related outcome evaluation, for successes to be sustained, a greater emphasis is needed on local initiatives and intervention process evaluation. Pediatric weight management programs in the healthcare and community settings represent local initiatives that have had considerable health-related impacts, yet are often limited by high attrition rates. Because adolescence is marked by substantial weight shifts and the formation of long-lasting health habits, it represents a critical point for implementing obesity prevention and treatment. Accordingly, this study sought to assess factors that promote adolescent participant engagement with the Yale Bright Bodies healthy lifestyle program, a 12-week program for children ages 7-16 in New Haven, CT. Through adolescent and instructor surveys, adolescent engagement was examined in relation to program-related factors and weight outcomes—with additional insight into the program process offered through program observations. Despite the high attrition often seen in this setting, over half of this diverse, inner-city sample completed ≥ 3 12-week program cycles (≥ 36 weeks). Moreover, improvements in body composition were observed, with significant reduction in starting and ending body fat percentages (p=0.012) and borderline significant reduction in BMI (p=0.055). Adolescents and instructors highlighted the importance of the instructor-participant and participant-participant bonds, engaging activities, and a family-based approach. In support of these findings, higher adolescent rankings of instructor-related factors were significantly correlated with positive weight outcomes. Because adolescents highly valued the relationships with program instructors, future efforts should evaluate the impact of instructor-adolescent relationship building on program retention/attrition and weight outcomes in other settings where adolescents have consistent, supportive relationships with clinicians.
Samaras, Athena Theodora, "Perspectives For Adolescent Engagement: The Bright Bodies Program" (2016). Public Health Theses. 1255.