Long-Term Obesity Prevention and the Motivating Adolescents with Technology to CHOOSE Health™ Program

Background: The Motivating Adolescents with Technology to CHOOSE Health (TM) (MATCH) intervention integrates lifestyle behavior change curriculum within academic subjects taught in seventh grade. This study assesses obesity prevention in participants into high school. Methods: The study compares four-to five-year longitudinal data from a single-site cohort (N = 106, 54% retained from 195 participants at baseline; 82% of those still at the school) pre- and postintervention in a rural middle school with high obesity rates with data from the 2006 Child Survey and 2010 Child and Young Adult Surveys from the National Longitudinal Survey of Youth 1979 (N= 600), which serves as a nationally representative comparison group. Outcome measures include pre- and postchanges in weight category, BMI, BMI z-score, BMI percentile for age and gender, and rates of change per month in BMI measures. Results: At follow-up, change in percent overweight was significantly different between groups, with the MATCH group decreasing (20-12%) and the comparison group increasing (17-19%). Overall, the MATCH group had significantly higher decrease rates in BMI z-scores (p = 0.002) and BMI percentile (p = 0.01) than the comparison group. Of all adolescents at healthy weight at baseline, 2% from MATCH became overweight after five years, whereas 13% of the comparison group increased to overweight or obese (p = 0.02) after four years. Conclusions: Despite a small sample size and a high-risk setting, at long-term follow-up, a greater proportion of MATCH participants than in the comparison group decreased from overweight to healthy weight or remained at healthy weight. The MATCH results suggest that some proportion of high-risk adolescents can have their growth trajectory follow a healthier path than expected.