Abstract
Introduction: Despite efforts to improve adherence to physical activity interventions in youth with obesity, low adherence and attrition remain areas of great concern. Objective: The study was designed to determine which physiological and/or psychological factors predicted low adherence in adolescents with obesity enrolled in a 6-month exercise intervention study aimed to improve body composition. Methods: Three hundred four adolescents with obesity aged 14–18 years who volunteered for the HEARTY (Healthy Eating Aerobic and Resistance Training in Youth) randomized controlled trial completed physiological (body mass index, waist circumference, per cent body fat, resting metabolic rate and aerobic fitness) and psychological (body image, mood, self-esteem and self-efficacy) measures. Results: One hundred forty-one out of 228 (62%) randomized to exercise groups had low adherence (completed <70% of the prescribed four exercise sessions per week) to the intervention protocol. Logistic regression revealed that there were no baseline demographic or physiological variables that predicted low adherence in the participants. Appearance concern (a subscale of body image) (odds ratio [OR] 1.46, 95% confidence interval [CI]: 1.01, 2.1, P = 0.04), depressive mood (OR 1.12, 95% CI: 1.01, 1.23, P = 0.03) and confused mood (OR 1.16, 95% CI: 1.05, 1.27, P = 0.003) (two subscales of mood) were significant predictors of low adherence. Conclusions: Adolescents with obesity who had higher appearance concerns and depressive and confused moods were less likely to adhere to exercise. Body image and mood should be screened to identify adolescents who may be at high risk of poor adherence and who may need concurrent or treatment support to address these psychological issues to derive maximal health benefits from an exercise programme.
| Original language | English |
|---|---|
| Pages (from-to) | 437-448 |
| Number of pages | 12 |
| Journal | Obesity Science and Practice |
| Volume | 5 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Oct 1 2019 |
Bibliographical note
Funding Information:The HEARTY trial was supported by a Canadian Institutes of Health Research (CIHR) grant (MCT-71979), Trial Registration: ClinicalTrials.Gov NCT00195858. Dr Alberga was supported by a Doctoral Student Research Award from the Canadian Diabetes Association (now known as Diabetes Canada) during this trial and currently a FRQ-S Junior 1 Chercheur Boursier from les Fonds du Québec- Santé. Dr Goldfield was supported by a New Investigator Award from CIHR for part of the trial and was also supported by an Endowed Research Scholarship from the Children's Hospital of Eastern Ontario Volunteer Association Board. Dr Sigal was supported by a Health Senior Scholar award from Alberta Innovates-Health Solutions and by a Research Chair from the Ottawa Hospital Research Institute during part of this trial. Dr Kenny is supported by a University of Ottawa Research Chair. Dr Sweet is currently supported by an FRQ-S Research Scholar Junior 1 Award. We gratefully acknowledge the HEARTY participants and all the HEARTY research staff who assisted with the exercise training, data collection and analysis.
Publisher Copyright:
© 2019 The Authors. Obesity Science & Practice published by John Wiley & Sons Ltd, World Obesity and The Obesity Society.
ASJC Scopus Subject Areas
- Endocrinology, Diabetes and Metabolism
- Nutrition and Dietetics
