Effectiveness of cognitive-behavioral therapy on nutrition improvement and weight of overweight and obese adolescents: a randomized controlled trial

Aim: To assess the effectiveness of a cognitive-behavioral treatment (CBT) program on weight reduction among Iranian adolescents who are overweight. Methods: Using a randomized controlled trial design, 55 adolescents who were overweight (mean [SD] age=14.64 [1.69] years; zBMI=2.18 [0.65]) were recruited in the CBT program and 55 in the treatment as usual (TAU; mean age=14.88 [1.50]; zBMI=2.09 [0.57]) group. All the participants completed several questionnaires (Child Dietary Self-Efficacy Scale; Weight Efficacy Lifestyle questionnaire; Physical Exercise Self-Efficacy Scale; Pediatric Quality of Life Inventory; and self-reported physical activity and diet) and had their anthropometrics measured (height, weight, waist and hip circumferences, and body fat). Results: The CBT group consumed significantly more fruits and juice, vegetables, and dairy in the 6-month follow- up as compared with the TAU group (p-values <0.001). The CBT group consumed significantly less sweet snacks, salty snacks, sweet drinks, sausages/processed meat, and oils in the six-month follow-up compared with the TAU group (p-values<0.001). Additionally, the waist circumference, BMI, waist-hip ratio, and fat mass were significantly decreased in the CBT group in the six-month follow-up compared with the TAU group (p-values<0.005). The CBT group significantly improved their psychosocial health, physical activity, and health-related quality of life (p-values<0.001). Conclusion: The CBT program showed its effectiveness in reducing weight among Iranian adolescents who were overweight. Healthcare providers may want to adopt this program to treat excess weight problems for adolescents

Intervenção educacional com base em modelo para aumentar a atividade física entre adolescentes iranianos

OBJETIVO: Avaliar um programa educacional com base no modelo de promoção da saúde (MPS) e nos estágios de mudança para melhorar a atividade física (AF) entre adolescentes iranianos. MÉTODOS: Este foi um ensaio randomizado controlado com 165 participantes divididos em dois grupos (intervenção/controle). Os dados foram coletados através de questionários de autopreenchimento com base em componentes do MPS (benefícios e barreiras para a ação, autoeficácia, sentimentos em relação ao comportamento, influências interpessoais e situacionais). A escala de estágios de mudança foi utilizada para selecionar participantes aptos (classificados nos estágios de pré-contemplação, contemplação ou preparação) e para avaliar a tendência. Após a coleta dos dados de base, a intervenção foi realizada nos participantes e os dados de acompanhamento foram coletados 3 meses depois. RESULTADOS: Ao todo, 88 meninos e 77 meninas com idade média de 13,99±0,4 participaram do estudo. As diferenças em todos os componentes do MPS, exceto os sentimentos em relação ao comportamento e as influências sociais, foram significantes (p < 0,01) entre os valores de base e de acompanhamento. Comparados aos do grupo de controle, os adolescentes do grupo de intervenção foram categorizados nos estágios de ação (70%) ou preparação (30%) no acompanhamento. A análise de regressão múltipla revelou que preferências concorrentes, normas sociais, modelos sociais (variáveis com p < 0,001) e o compromisso com o plano de ação podem prever consideravelmente o comportamento quanto à AF. O modelo representou 22,5% da variação da AF. CONCLUSÕES: Intervenções educacionais com base nos estágios de mudança podem ter implicações importantes na melhora da AF entre adolescentes em mais componentes do MPS

Level of Educational Objectives Achievement in Health and Community Medicine Internship Course; Interns Viewpoint

Aims:&nbsp;Nowadays, the community oriented medicine education model has been mainly noticed. The aim of this study was to survey the interns about achievement to the educational goals confirmed by Health Ministry in health internship and community medicine courses.&nbsp; &nbsp; Instrument & Methods: In the descriptive cross-sectional study, 56 health internship and community medicine students of one of the military universities of medical sciences in Tehran were studied in 2014 and 2015. The subjects were selected via available sampling method. Data was collected by a questionnaire based on the educational goals confirmed by Health Ministry. Data was analyzed by SPSS 19 software using descriptive indices and step-by-step regression test. Findings: 70, 68, and 60% of the students agreed to knowledge earning, achieving an attitude, and new skill earning, respectively. The highest knowledge earning levels were in health care factors (72%) and the method to monitor and assess the state health program (72%) and the lowest was in overall support (56%). The highest level of achieving an attitude was in family physician functioning (76%) and the lowest levels were in overall support (44%) and social factors effective on health (44%). There were significant correlations between knowledge earning (p=0.016) and achieving an attitude (p=0.032) and the scored given to the theoretical issues. In addition, there was a significant correlation between skill earning and the score given to the personal exercises (p=0.015). &nbsp; Conclusion: The levels of knowledge earning, achieving an attitude, and skill earning in health internship and community medicine courses were unfavorable, especially in some goals.&nbsp