Ray Wilks

Parent- and Adolescent-Reported Barriers to Participation in an Adolescent Overweight and Obesity Intervention

This study explored reported barriers to treatment completion in a sample of adolescents and their parents who either completed or did not complete family‐based cognitive behavioral lifestyle intervention for overweight and obese adolescents. The sample comprises 56 overweight or obese adolescents (52% female) aged 11.5–18.9 years (mean = 14.5, s.d. = 1.8) and a parent. 57% of families did not complete treatment and maintenance phases of the intervention. A telephone‐administered questionnaire assessing barriers to participation was completed by 96% of adolescents and 91% of parent completers and 100% of adolescents and 94% of parent noncompleters. Adolescents and parents most commonly reported barriers to participation related to research demands, treatment approach, program components/strategies, practical barriers, and other individual/family demands. Parents also noted adolescent effort, parent‐adolescent conflict, and adolescent unhappiness as barriers to participation. While both completers and noncompleters experienced barriers to participation, families who discontinued treatment reported experiencing more treatment barriers. Findings of the current study suggest that adolescents and parents may find it easier to participate in adolescent overweight and obesity interventions if research and out‐of‐session program demands are minimized, efforts are made to enhance adolescent motivation, and treatment is offered in a convenient location and scheduled around school holidays and other family demands. Results also suggest that targeting adolescent unhappiness, family stressors, and parent‐adolescent conflict in treatment may improve retention. Future research should explore the impact of these modifications on treatment completion and outcomes.

The efficacy of written teacher advice (tip sheets) for managing classroom behaviour problems

This study evaluated the efficacy of a set of tip sheets developed to provide written advice to teachers about the management of common classroom behaviour problems. Twenty teachers were involved in the trial of the tip sheets. Teachers selected a child in their grade who demonstrated one of the behaviour problems, and after a baseline period, implemented the written advice for a period of 4 weeks. Outcome measures included teacher collected data, Goal Achievement Scale scores, Sutter-Eyberg Student Behavior Inventory, Teacher Report Form and consumer satisfaction. Measures of treatment integrity were also collected. Results indicated that 13 of the children showed substantial or moderate improvement. Of the seven who did not improve, four had high levels of general behaviour problems prior to intervention, and three had teachers who were not following the written advice completely. However, high levels of general behaviour problems did not prevent some other children still demonstrating improvements in behaviour (n = 5). The written advice in the tip sheets was found to be highly acceptable to the teachers.

Physiological and behavioural outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents

AIM This study evaluates the efficacy of the Choose Health program, a family-based cognitive behavioural lifestyle program targeting improved eating and activity habits, in improving body composition, cardiovascular fitness, eating and activity behaviours in overweight and obese adolescents. METHOD The sample comprised 29 male and 34 female overweight (n = 15) or obese (n = 48) adolescents aged 11.5-18.9 years (M = 14.3, SD = 1.9). Participants were randomly allocated to treatment or waitlist control conditions; waitlist condition participants were offered treatment after 6 months. DEXA-derived and anthropometric measures of body composition; laboratory-based cycle ergometer and field-assessed cardiovascular fitness data; objective and self-report physical activity measures; and self-report measures of eating habits and 7-day weighed food diaries were used to assess treatment outcome. Adherence to treatment protocols was high. RESULTS Treatment resulted in significant (p < .05) and sustained improvements in a range of body composition (body fat, percent body fat, lean mass) and anthropometric measures (weight, BMI, BMI-for-age z-score and percentiles). Minimal improvements were seen in cardiovascular fitness. Similar results were obtained in completer and intention-to-treat analysis. Poor adherence to assessment protocols limits conclusions that can be drawn from physical activity and dietary data. CONCLUSIONS Participation in the Choose Health program resulted in significant improvement in body composition. Longer-term follow up is required to determine the durability of intervention effects. Alternative approaches to the measurement of diet and physical activity may be required for adolescents.

A Consultation and Training Role for the Behaviourally Oriented Educational Psychologist in School Settings: A Clinical Note

A 1981 national survey of 335 American educational psychologists found psychological/educational assessment and consultation with teachers and parents are the two most frequently engaged in activities of school psychologists. A behavioural approach to these two activities is considered in the literature to be more effective than a number of other approaches and practices. This clinical note describes a behavioural consultation and training role for educational psychologists which was applied to the issue of improving the reading skills of 12 integrated primary school children. The behavioural consultation involved four phases: problem identification, problem analysis, intervention, and evaluation. Results of the consultation and training indicated a substantial increase in the number of books read, letter-sound knowledge, sight vocabulary, and passage comprehension of the 12 integrated children. Informal assessment of teacher satisfaction with this approach to consultation and training was found to be very positive.