This program is for children, adolescents, and young adults up to age 23 who have a body mass index above the 95th percentile, and their families.

The Healthy Lifestyles Program, a primary-care based intervention, is designed to reduce obesity and co-existing health complications in participants.

One retrospective cohort study utilizing a pre-test / post-test design was conducted to evaluate the effectiveness of this program. This study found that the program significantly reduced Body Mass Index (BMI) standard deviation scores and mean insulin values in children. The program also had significant reductions in the proportion of children with an elevated systolic blood pressure, elevated diastolic blood pressure, elevated triglycerides, and elevated insulin resistance.  No statistically significant improvements were observed for fasting glucose, glycohemoglobin, high-density lipoprotein, low-density lipoprotein, alanine aminotransferase, or aspartate aminotransferase.

Initially, laboratory tests are completed for participants 5 to 23 years old. During the initial visit, a clinic nurse measures the child's height, weight, and blood pressure and calculates their BMI. The height, weight, and BMI for the child's parent is also measured. A physician then meets with the family to conduct the following:

• Comprehensive review of lifestyle, birth, medical, family, and social history;
• Physical exam;
• Screening for psychological and disordered eating;
• Explanation of the child's BMI for his or her age and sex; and
• Discussion of the child's risk for disease based on laboratory values, family history, and lifestyle.

At the end of the visit, the physician uses motivational interviewing to facilitate family-centered goals for behavior change, and the physician can refer participants to physical therapists or mental health professionals.

Follow-up visits can include the following:

• Discuss ongoing management of obesity-related conditions and corresponding lifestyle modifications;
• Meet with a registered dietician for medical nutritional therapy;  
• Examine lifestyle history;
• Take anthropometric and blood pressure measurements;
• Conduct a physical exam; and
• Set goals.

The Healthy Lifestyles program began in 2006 and has treated more than 15,000 pediatric patients with obesity since that time. The program is currently offered at Duke University Medical Center.

The Healthy Lifestyles Program must be delivered by a team of medical professionals including nurses, physicians, physical therapists, registered dieticians, and mental health professionals.  All Healthy Lifestyles Program providers receive training in motivational interviewing.

Considerations for implementing this program include understanding that the program is only offered through Duke University Medical Center, recognizing that participation in the program requires referral from a physician, and ensuring commitment and buy-in from parents and participants.  

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

If you are interested in implementing Healthy Lifestyles Program, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu

The first appointment takes a half day, and subsequent clinic visits last 60 minutes.  Upon completion of six visits, children come for follow-up visits once every 6 months until they are 23 years old.

Information on implementation costs was not available.

To move the Healthy Lifestyles Program to the Promising category on the Clearinghouse Continuum of Evidence, at least one evaluation should be performed demonstrating positive effects lasting at least one year from the beginning of the program or at least six months from program completio.

The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals.  Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu

You may also contact Duke Department of Pediatrics by visiting https://pediatrics.duke.edu/about-us/contact-us

https://pediatrics.duke.edu/divisions/healthy-lifestyles and Dolinsky, Armstrong, Walter, and Kemper (2012).