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The Integration of a Family Systems Approach for Understanding Youth Obesity, Physical Activity, and Dietary Programs

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Abstract

Rates of overweight in youth have reached epidemic proportions and are associated with adverse health outcomes. Family-based programs have been widely used to treat overweight in youth. However, few programs incorporate a theoretical framework for studying a family systems approach in relation to youth health behavior change. Therefore, this review provides a family systems theory framework for evaluating family-level variables in weight loss, physical activity, and dietary approaches in youth. Studies were reviewed and effect sizes were calculated for interventions that manipulated the family system, including components that targeted parenting styles, parenting skills, or family functioning, or which had novel approaches for including the family. Twenty-one weight loss interventions were identified, and 25 interventions related to physical activity and/or diet were identified. Overall, family-based treatment programs that incorporated training for authoritative parenting styles, parenting skills, or child management, and family functioning had positive effects on youth weight loss. Programs to improve physical activity and dietary behaviors that targeted the family system also demonstrated improvements in youth health behaviors; however, direct effects of parent-targeted programming is not clear. Both treatment and prevention programs would benefit from evaluating family functioning and parenting styles as possible mediators of intervention outcomes. Recommendations are provided to guide the development of future family-based obesity prevention and treatment programs for youth.

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References

  • Baranowski, T., Baranowski, J., Cullen, K. W., deMoor, C., Rittenberry, L., Hebert, D., et al. (2002). 5 a day achievement badge for African-American boy scouts: Pilot outcome results. Preventive Medicine: An International Journal Devoted to Practice and Theory, 34(3), 353–363.

    Google Scholar 

  • Baranowski, T., Davis, M., Resnicow, K., Baranowski, J., Doyle, C., Lin, L. S., et al. (2000). Gimme 5 fruit, juice, and vegetables for fun and health: Outcome evaluation. Health Education and Behavior, 27(1), 96–111.

    Article  PubMed  Google Scholar 

  • Baranowski, T., Simons-Morton, B., Hooks, P., Henske, J., Tiernan, K., Dunn, J. K., et al. (1990). A center-based program for exercise change among black-American families. Health Education Quarterly, 17(2), 179–196.

    PubMed  Google Scholar 

  • Baumrind, D. (1966). Effects of authoritative control on child behavior. Child Development, 37(4), 887–907.

    Article  Google Scholar 

  • Beavers, W. R., & Hampson, R. B. (1990). Successful families: Assessment and intervention. New York, NY: W.W. Norton & Company.

    Google Scholar 

  • Beech, B. M., Klesges, R. C., Kumanyika, S. K., Murray, D. M., Klesges, L., McClanahan, B., et al. (2003). Child- and parent-targeted interventions: The Memphis GEMS pilot study. Ethnicity and Disease, 13(1 Suppl 1), S40–S53.

    PubMed  Google Scholar 

  • Benton, D. (2004). Role of parents in the determination of the food preferences of children and the development of obesity. International Journal of Obesity and Related Metabolic Disorders, 28(7), 858–869.

    Article  PubMed  Google Scholar 

  • Berkel, L. A., Carlos Poston, W. S., Reeves, R. S., & Foreyt, J. P. (2005). Behavioral interventions for obesity. Journal of the American Dietetic Association, 105(5, Suppl 1), 35–43.

    Article  Google Scholar 

  • Beveridge, R. M., & Berg, C. A. (2007). Parent-adolescent collaboration: An interpersonal model for understanding optimal interactions. Clinical Child and Family Psychology Review, 10(1), 25–52.

    Article  PubMed  Google Scholar 

  • Broderick, C. B. (1993). Understanding family process: Basics of family systems theory. Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Brownell, K. D., Kelman, J. H., & Stunkard, A. J. (1983). Treatment of obese children with and without their mothers: Changes in weight and blood pressure. Pediatrics, 71(4), 515–523.

    PubMed  Google Scholar 

  • CDC (2008). Prevalence of overweight amont children and adolescents: United States: 1999–2002. Retrieved September 10, 2008, from http://www.cdc.gov/nchs/products/pubs/pubd/hestats/overwght99.htm.

  • Coates, T. J., Kilien, J. D., & Slinkard, L. A. (1982). Parent participation in a treatment program for overweight adolescents. International Journal of Eating Disorders, 1(3), 37–48.

    Article  Google Scholar 

  • Darling, N., & Steinberg, L. (1993). Parenting style as context: An integrative model. Psychological Bulletin, 113(3), 487–496.

    Article  Google Scholar 

  • Davis, M., Gance-Cleveland, B., Hassink, S., Johnson, R., Paradis, G., & Resnicow, K. (2007). Recommendations for prevention of childhood obesity. Pediatrics, 120, S229–S253.

  • Davis, S. M., Clay, T., Smyth, M., Gittelsohn, J., Arviso, V., Flint-Wagner, H., et al. (2003). Pathways curriculum and family interventions to promote healthful eating and physical activity in American Indian schoolchildren. Preventive Medicine, 37(6 Pt 2), S24–S34.

    Article  PubMed  Google Scholar 

  • De Bourdeaudhuij, I., & Brug, J. (2000). Tailoring dietary feedback to reduce fat intake: An intervention at the family level. Health Education Research, 15(4), 449–462.

    Article  PubMed  Google Scholar 

  • DeVore, E., & Ginsburg, K. (2005). The protective effects of good parenting on adolescents. Current Opinions in Pediatrics, 17(4), 460–465.

    Google Scholar 

  • Epstein, L. H., McKenzie, S. J., Valoski, A., Klein, K. R., & Wing, R. R. (1994). Effects of mastery criteria and contingent reinforcement for family-based child weight control. Addictive Behaviors, 19(2), 135–145.

    Article  PubMed  Google Scholar 

  • Epstein, L. H., Paluch, R. A., Gordy, C. C., Saelens, B. E., & Ernst, M. M. (2000). Problem solving in the treatment of childhood obesity. Journal of Consulting and Clinical Psychology, 68(4), 717–721.

    Article  PubMed  Google Scholar 

  • Epstein, L. H., Valoski, A., Wing, R. R., & McCurley, J. (1990). Ten-year follow-up of behavioral, family-based treatment for obese children. JAMA, 264(19), 2519–2523.

    Article  PubMed  Google Scholar 

  • Epstein, L. H., Wing, R. R., Koeske, R., Frank, A., & Ossip, D. J. (1981). Child and parent weight loss in family-based behavior modification programs. Journal of Consulting and Clinical Psychology, 49(5), 674–685.

    Google Scholar 

  • Epstein, L. H., Wing, R. R., Koeske, R., & Valoski, A. (1986). Effect of parent weight on weight loss in obese children. Journal of Consulting and Clinical Psychology, 54(3), 400–401.

    Article  PubMed  Google Scholar 

  • Epstein, L. H., Wing, R. R., Koeske, R., & Valoski, A. (1987). Long-term effects of family-based treatment of childhood obesity. Journal of Consulting and Clinical Psychology, 55(1), 91–95.

    Article  PubMed  Google Scholar 

  • Faith, M. S., Pietrobelli, A., Allison, D. B., & Heymsfield, S. B. (1997). Prevention of pediatric obesity. Examining the issues and forecasting research directions. In A. Bendich & R. J. Deckelbaum (Eds.), Preventive nutrition (pp. 471–486). Totowa, NJ: Humana Press.

    Google Scholar 

  • Flodmark, C. E., Ohlsson, T., Ryden, O., & Sveger, T. (1993). Prevention of progression to severe obesity in a group of obese schoolchildren treated with family therapy. Pediatrics, 91(5), 880–884.

    PubMed  Google Scholar 

  • Foerster, S. B., Gregson, J., Beall, D. L., Hudes, M., Magnuson, H., Livingston, S., et al. (1998). The California children’s 5 a day-power play! Campaign: Evaluation of a large-scale social marketing initiative. Family & Community Health, 21(1), 46–64.

    Google Scholar 

  • Freedman, D. S., Dietz, W. H., Srinivasan, S. R., & Berenson, G. S. (1999). The relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa Heart Study. Pediatrics, 103(6 Pt 1), 1175–1182.

    Article  PubMed  Google Scholar 

  • Fulkerson, J. A., Strauss, J., Neumark-Sztainer, D., Story, M., & Boutelle, K. (2007). Correlates of psychosocial well-being among overweight adolescents: The role of the family. Journal of Consulting and Clinical Psychology, 75(1), 181–186.

    Article  PubMed  Google Scholar 

  • Gillis, D., Brauner, M., & Granot, E. (2007). A community-based behavior modification intervention for childhood obesity. Journal of Pediatric Endocrinology and Metabolism, 20(2), 197–203.

    PubMed  Google Scholar 

  • Golan, M. (2006). Parents as agents of change in childhood obesity–from research to practice. International Journal of Pediatric Obesity, 1(2), 66–76.

    Article  PubMed  Google Scholar 

  • Golan, M., Kaufman, V., & Shahar, D. R. (2006). Childhood obesity treatment: Targeting parents exclusively v. parents and children. The British Journal of Nutrition, 95(5), 1008–1015.

    Article  PubMed  Google Scholar 

  • Golan, M., Weizman, A., Apter, A., & Fainaru, M. (1998). Parents as the exclusive agents of change in the treatment of childhood obesity. The American Journal of Clinical Nutrition, 67(6), 1130–1135.

    PubMed  Google Scholar 

  • Goldenberg, I., & Goldenberg, H. (1991). Family therapy: An overview (3rd ed.). Belmont, CA: Thomson Brooks/Cole Publishing Co.

    Google Scholar 

  • Golley, R. K., Magarey, A. M., Baur, L. A., Steinbeck, K. S., & Daniels, L. A. (2007). Twelve-month effectiveness of a parent-led, family-focused weight-management program for prepubertal children: A randomized, controlled trial. Pediatrics, 119(3), 517–525.

    Article  PubMed  Google Scholar 

  • Goran, M. I., & Reynolds, K. (2005). Interactive multimedia for promoting physical activity (IMPACT) in children. Obesity Research, 13(4), 762–771.

    Article  PubMed  Google Scholar 

  • Gortmaker, S. L., Cheung, L. W., Peterson, K. E., Chomitz, G., Cradle, J. H., Dart, H., et al. (1999). Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children: Eat well and keep moving. Archives of Pediatrics and Adolescent Medicine, 153(9), 975–983.

    PubMed  Google Scholar 

  • Hedges, L., & Olkin, I. (1985). Statistical methods for meta-analysis. Orlando, FL: Academic Press.

  • Hopper, C. A., Munoz, K. D., Gruber, M. B., & MacConnie, S. (1996). A school-based cardiovascular exercise and nutrition program with parent participation: An evaluation study. Children’s Health Care, 25(3), 221–235.

    Article  Google Scholar 

  • Hopper, C. A., Munoz, K. D., Gruber, M. B., & Nguyen, K. P. (2005). The effects of a family fitness program on the physical activity and nutrition behaviors of third-grade children. Research Quarterly for Exercise and Sport, 76(2), 130–139.

    PubMed  Google Scholar 

  • Israel, A. C., Guile, C. A., Baker, J. E., & Silverman, W. K. (1994). An evaluation of enhanced self-regulation training in the treatment of childhood obesity. Journal of Pediatric Psychology, 19(6), 737–749.

    Article  PubMed  Google Scholar 

  • Israel, A. C., Stolmaker, L., & Andrian, C. A. (1985). The effects of training parents in general child management skills on a behavioral weight loss program for children. Behavior Therapy, 16(2), 169–180.

    Article  Google Scholar 

  • Janicke, D. M., Sallinen, B. J., Perri, M. G., Lutes, L. D., Huerta, M., Silverstein, J. H., et al. (2008). Comparison of parent-only vs family-based interventions for overweight children in underserved rural settings: Outcomes from project STORY. Archives of Pediatrics and Adolescent Medicine, 162(12), 1119–1125.

    Article  PubMed  Google Scholar 

  • Jelalian, E., & Saelens, B. E. (1999). Empirically supported treatments in pediatric psychology: Pediatric obesity. Journal of Pediatric Psychology, 24(3), 223–248.

    Article  PubMed  Google Scholar 

  • Johnson, S. L., & Birch, L. L. (1994). Parents’ and children’s adiposity and eating style. Pediatrics, 94(5), 653–661.

    PubMed  Google Scholar 

  • Johnson, C. C., Nicklas, T. A., Arbeit, M. L., Harsha, D. W., Mott, D. S., Hunter, S. M., et al. (1991). Cardiovascular intervention for high-risk families: The Heart Smart Program. Southern Medical Journal, 84(11), 1305–1312.

    PubMed  Google Scholar 

  • Kirschenbaum, D. S., Harris, E. S., & Tomarken, A. J. (1984). Effects of parental involvement in behavioral weight loss therapy for preadolescents. Behavior Therapy, 15(5), 485–500.

    Article  Google Scholar 

  • Kitzmann, K. M., & Beech, B. M. (2006). Family-based interventions for pediatric obesity: Methodological and conceptual challenges from family psychology. Journal of Family Psychology, 20(2), 175–189.

    Article  PubMed  Google Scholar 

  • Kitzmann, K. M., Stanley, C. M., Dalton, W. T., Beech, B. M., Reeves, T. P., et al. (2010). Lifestyle interventions for youth who are overweight: A meta-analytic review. Health Psychology, 29(1), 91–101.

    Article  PubMed  Google Scholar 

  • Kitzman-Ulrich, H., Hampson, R., Wilson, D. K., Presnell, K., Brown, A., & O’Boyle, M. (2009). An adolescent weight-loss program integrating family variables reduces energy intake. Journal of the American Dietetic Association, 109(3), 491–496.

    Article  PubMed  Google Scholar 

  • Kremers, S. P. J., Brug, J., de Vries, H., & Engels, R. C. M. E. (2003). Parenting style and adolescent fruit consumption. Appetite, 41(1), 43–50.

    Article  PubMed  Google Scholar 

  • Lowe, C. F., Horne, P. J., Tapper, K., Bowdery, M., & Egerton, C. (2004). Effects of a peer modelling and rewards-based intervention to increase fruit and vegetable consumption in children. European Journal of Clinical Nutrition, 58(3), 510–522.

    Article  PubMed  Google Scholar 

  • Lytle, L., Murray, D., Perry, C., Story, M., Birnbaum, A., Kubik, M., et al. (2004). School-based approaches to affect adolescents’ diets: Results from the TEENS study. Health Education and Behavior, 31(2), 270–287.

    Google Scholar 

  • Manios, Y., Moschandreas, J., Hatzis, C., & Kafatos, A. (1999). Evaluation of a health and nutrition education program in primary school children of Crete over a three-year period. Preventive Medicine, 28(2), 149–159.

    Article  PubMed  Google Scholar 

  • Matthews, C. E., Chen, K. Y., Freedson, P. S., Buchowski, M. S., Beech, B. M., Pate, R. R., et al. (2008). Amount of time spent in sedentary behaviors in the United States, 2003–2004. American Journal of Epidemiology, 167(7), 875–881.

    Article  PubMed  Google Scholar 

  • McCallum, Z., Wake, M., Gerner, B., Baur, L. A., Gibbons, K., Gold, L., et al. (2007). Outcome data from the LEAP (Live, Eat and Play) trial: A randomized controlled trial of a primary care intervention for childhood overweight/mild obesity. International Journal of Obesity (London), 31(4), 630–636.

    Google Scholar 

  • McFarlane, A., Bellissimo, A., & Norman, G. (1995). Family structure, family functioning and adolescent well-being: The transcendent influence of parental style. Journal of Child Psychology and Psychiatry, 36(5), 847–864.

    Article  PubMed  Google Scholar 

  • McGoldrick, M., Giordano, J., Garcia-Preto, N., McGoldrick, M., Giordano, J., & Garcia-Preto, N. (2005). Ethnicity and family therapy (3rd ed.). New York, NY US: Guilford Press.

    Google Scholar 

  • McKenzie, T. L., Nader, P. R., Strikmiller, P. K., Yang, M., Stone, E. J., Perry, C. L., et al. (1996). School physical education: Effect of the child and adolescent trial for cardiovascular health. Preventive Medicine, 25, 423–431.

    Article  PubMed  Google Scholar 

  • Mellin, A. E., Neumark-Sztainer, D., Story, M., Ireland, M., & Resnick, M. D. (2002). Unhealthy behaviors and psychosocial difficulties among overweight adolescents: The potential impact of familial factors. The Journal of Adolescent Health, 31(2), 145–153.

    Article  PubMed  Google Scholar 

  • Mendelson, B. K., White, D. R., & Schliecker, E. (1995). Adolescents’ weight, sex, and family functioning. The International Journal of Eating Disorders, 17(1), 73–79.

    Article  PubMed  Google Scholar 

  • Mendoza, J. A., Drewnowski, A., Cheadle, A., & Christakis, D. A. (2006). Dietary energy density is associated with selected predictors of obesity in U.S. Children. The Journal of Nutrition, 136(5), 1318–1322.

    PubMed  Google Scholar 

  • Munsch, S., Roth, B., Michael, T., Meyer, A. H., Biedert, E., Roth, S., et al. (2008). Randomized controlled comparison of two cognitive behavioral therapies for obese children: Mother versus mother-child cognitive behavioral therapy. Psychotherapy and Psychosomatics, 77(4), 235–246.

    Article  PubMed  Google Scholar 

  • Must, A., & Anderson, S. E. (2003). Effects of obesity on morbidity in children and adolescents. Nutrition in Clinical Care, 6(1), 4–12.

    PubMed  Google Scholar 

  • Must, A., Jacques, P. F., Dallal, G. E., Bajema, C. J., & Dietz, W. H. (1992). Long-term morbidity, mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. The New England Journal of Medicine, 327(19), 1350–1355.

    Article  PubMed  Google Scholar 

  • Nader, P. R., Sallis, J. F., Patterson, T. L., Abramson, I. S., Rupp, J. W., Senn, K. L., et al. (1989). A family approach to cardiovascular risk reduction: Results from the San Diego Family Health Project. Health Education Quarterly, 16(2), 229–244.

    PubMed  Google Scholar 

  • Nader, P. R., Stone, E. J., Lytle, L. A., Perry, C. L., Osganian, S. K., Kelder, S., et al. (1999). Three-year maintenance of improved diet and physical activity: The CATCH cohort. Child and adolescent trial for cardiovascular health. Archives of Pediatrics and Adolescent Medicine, 153(7), 695–704.

    PubMed  Google Scholar 

  • Neumark-Sztainer, D., Story, M., Resnick, M. D., & Blum, R. W. (1996). Correlates of inadequate fruit and vegetable consumption among adolescents. Preventive Medicine, 25(5), 497–505.

    Article  PubMed  Google Scholar 

  • Nicklas, T. A., Johnson, C. C., Myers, L., Farris, R. P., & Cunningham, A. (1998). Outcomes of a high school program to increase fruit and vegetable consumption: Gimme 5–a fresh nutrition concept for students. The Journal of School Health, 68(6), 248–253.

    Article  PubMed  Google Scholar 

  • Nowicka, P., Hoglund, P., Pietrobelli, A., Lissau, I., & Flodmark, C. (2008). Family weight school treatment: 1-year results in obese adolescents. International Journal of Pediatric Obesity, 3, 141–147.

    Google Scholar 

  • Nowicka, P., Pietrobelli, A., & Flodmark, C. E. (2007). Low-intensity family therapy intervention is useful in a clinical setting to treat obese and extremely obese children. International Journal of Pediatric Obesity, 2(4), 211–217.

    Article  PubMed  Google Scholar 

  • Obarzanek, E., Kimm, S. Y., Barton, B. A., Van Horn, L. L., Kwiterovich, P. O., Jr., Simons-Morton, D. G., et al. (2001). Long-term safety and efficacy of a cholesterol-lowering diet in children with elevated low-density lipoprotein cholesterol: Seven-year results of the Dietary Intervention Study in Children (DISC). Pediatrics, 107(2), 256–264.

    Article  PubMed  Google Scholar 

  • Ogden, C. L., Carroll, M. D., & Flegal, K. M. (2008). High body mass index for age among US children and adolescents, 2003–2006. JAMA, 299(20), 2401–2405.

    Article  PubMed  Google Scholar 

  • Ogden, C. L., Yanovski, S. Z., Carroll, M. D., & Flegal, K. M. (2007). The epidemiology of obesity. Gastroenterology, 132(6), 2087–2102.

    Article  PubMed  Google Scholar 

  • Paineau, D. L., Beaufils, F., Boulier, A., Cassuto, D. A., Chwalow, J., Combris, P., et al. (2008). Family dietary coaching to improve nutritional intakes and body weight control: A randomized controlled trial. Archives of Pediatrics and Adolescent Medicine, 162(1), 34–43.

    Article  PubMed  Google Scholar 

  • Patrick, H., Nicklas, T. A., Hughes, S. O., & Morales, M. (2005). The benefits of authoritative feeding style: Caregiver feeding styles and children’s food consumption patterns. Appetite, 44(2), 243–249.

    Article  PubMed  Google Scholar 

  • Prinz, R., Sanders, M., Shapiro, C., Whitaker, D., & Lutzker, J. (2009). Population-based prevention of child maltreatment: The US Triple P system population trial. Prevention Science, 10, 1–12.

    Article  PubMed  Google Scholar 

  • Radziszewska, B., Richardson, J. L., Dent, C. W., & Flay, B. R. (1996). Parenting style and adolescent depressive symptoms, smoking, and academic achievement: Ethnic, gender, and SES differences. Journal of Behavioral Medicine, 19(3), 289–305.

    Article  PubMed  Google Scholar 

  • Ransdell, L. B., Taylor, A., Oakland, D., Schmidt, J., Moyer-Mileur, L., & Shultz, B. (2003). Daughters and mothers exercising together: Effects of home- and community-based programs. Medicine and Science in Sports and Exercise, 35(2), 286–296.

    Article  PubMed  Google Scholar 

  • Reynolds, K. D., Franklin, F. A., Binkley, D., Raczynski, J. M., Harrington, K. F., Kirk, K. A., et al. (2000). Increasing the fruit and vegetable consumption of fourth-graders: Results from the high 5 project. Preventive Medicine, 30(4), 309–319.

    Article  PubMed  Google Scholar 

  • Rhee, K. (2008). Childhood overweight and the relationship between parent behaviors, parenting style, and family functioning. The ANNALS of the American Academy of Political and Social Science, 615(1), 11–37.

    Article  Google Scholar 

  • Rooney, B., Gritt, L., Havens, S., Mathiason, M., & Clough, E. (2005). Growing healthy families: Family use of pedometers to increase physical activity and slow the rate of obesity. Wisconsin Medical Journal, 104(5), 54–60.

    Google Scholar 

  • Shelton, D., Le Gros, K., Norton, L., Stanton-Cook, S., Morgan, J., & Masterman, P. (2007). Randomised controlled trial: A parent-based group education programme for overweight children. Journal of Paediatrics and Child Health, 43(12), 799–805.

    Article  PubMed  Google Scholar 

  • Snyder, D. K., Cozzi, J. J., & Mangrum, L. F. (2002). Conceptual issues in assessing couples and families. In H. A. Liddle, D. A. Santisteban, R. F. Levant, & J. H. Bray (Eds.), Family psychology: Science based interventions. Washington DC: APA.

    Google Scholar 

  • Stolley, M., & Fitzgibbon, M. (1997). Effects of an obesity prevention program on the eating behavior of African American mothers and daughters. Health Education and Behavior, 24(2), 152–164.

    Google Scholar 

  • Tanas, R., Marcolongo, R., Pedretti, S., & Gilli, G. (2007). A family-based education program for obesity: A three-year study. BMC Pediatrics, 7, 33.

    Article  PubMed  Google Scholar 

  • Troiano, R. P., Berrigan, D., Dodd, K. W., Masse, L. C., Tilert, T., & McDowell, M. (2008). Physical activity in the United States measured by accelerometer. Medicine and Science in Sports and Exercise, 40(1), 181–188.

    PubMed  Google Scholar 

  • Turner, H. M., Rose, K. S., & Cooper, M. J. (2005). Schema and parental bonding in overweight and nonoverweight female adolescents. International Journal of Obesity (London), 29(4), 381–387.

    Article  Google Scholar 

  • van der Horst, K., Kremers, S., Ferreira, I., Singh, A., Oenema, A., & Brug, J. (2007). Perceived parenting style and practices and the consumption of sugar-sweetened beverages by adolescents. Health Education Research, 22(2), 295–304.

    Article  PubMed  Google Scholar 

  • Vandongen, R., Jenner, D. A., Thompson, C., Taggart, A. C., Spickett, E. E., Burke, V., et al. (1995). A controlled evaluation of a fitness and nutrition intervention program on cardiovascular health in 10- to 12-year-old children. Preventive Medicine, 24(1), 9–22.

    Article  PubMed  Google Scholar 

  • Wadden, T. A., Stunkard, A. J., Rich, L., Rubin, C. J., Sweidel, G., & McKinney, S. (1990). Obesity in black adolescent girls: A controlled clinical trial of treatment by diet, behavior modification, and parental support. Pediatrics, 85(3), 345–352.

    PubMed  Google Scholar 

  • Ward-Begnoche, W., & Speaker, S. (2006). Overweight youth: Changing behaviors that are barriers to health. Journal of Family Practice, 55(11), 957–963.

    PubMed  Google Scholar 

  • White, M. A., Martin, P. D., Newton, R. L., Walden, H. M., York-Crowe, E. E., Gordon, S. T., et al. (2004). Mediators of weight loss in a family-based intervention presented over the internet. Obesity Research, 12(7), 1050–1059.

    Article  PubMed  Google Scholar 

  • Williamson, D. A., Martin, P. D., White, M. A., Newton, R., Walden, H., York-Crowe, E., et al. (2005). Efficacy of an internet-based behavioral weight loss program for overweight adolescent African-American girls. Eating and Weight Disorders, 10(3), 193–203.

    PubMed  Google Scholar 

  • Williamson, D. A., Walden, H. M., White, M. A., York-Crowe, E., Newton, R. L., Jr., Alfonso, A., et al. (2006). Two-year internet-based randomized controlled trial for weight loss in African-American girls. Obesity (Silver Spring), 14(7), 1231–1243.

    Article  Google Scholar 

  • Wilson, D. K. (2009). New perspectives on health disparities and obesity interventions in youth. Journal of Pediatric Psychology, jsn137.

  • Wilson, D. K., & Kitzman-Ulrich, H. (2008). Cultural considerations in the development of pediatric weight management interventions. In E. Jelalian & R. Steele (Eds.), Handbook of childhood and adolescent obesity (pp. 293–310). New York: Springer.

    Google Scholar 

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Acknowledgments

This article was supported by a grant funded by the Office of Research at The University of South Carolina and a grant (R01 HD 045693) funded by the National Institutes of Child Health and Human Development to Dawn K.Wilson, Ph.D.

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  1. Primary Care Research Institute, Family Medicine Department, University of North Texas Health Science Center, 855 Montgomery, Ft. Worth, TX, 76107, USA

    Heather Kitzman-Ulrich

  2. Department of Psychology, The University of South Carolina, Columbia, SC, USA

    Dawn K. Wilson, Sara M. St. George, Hannah Lawman, Michelle Segal & Amanda Fairchild

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  1. Heather Kitzman-Ulrich
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Kitzman-Ulrich, H., Wilson, D.K., St. George, S.M. et al. The Integration of a Family Systems Approach for Understanding Youth Obesity, Physical Activity, and Dietary Programs. Clin Child Fam Psychol Rev 13, 231–253 (2010). https://doi.org/10.1007/s10567-010-0073-0

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