The results suggest that an Internet-facilitated, family-based, and theory-driven program for prevention of childhood obesity can decrease waist-to-hip ratio and DBP while improving physical activity, vegetable and fruit intake, and knowledge about food intake and physical activity over a course of 8 months in Chinese American adolescents.
The involvement of parents is critical to overweight management in children. Our Web-based program included information for parents related to their adolescent’s weight-related health behaviors (eating, physical activity, and coping) and way to improve these behaviors and healthy lifestyles and healthy weight. Other studies had suggested that parental involvement can improve healthy weight in children and adolescents [33
]. As Chinese parents are typically heavily involved in every aspect of their children’s lives, the involvement of parents in a healthy lifestyle and healthy weight program is imperative [36
Although we did not find a reduction in BMI, the waist-to-hip ratio and DBP were decreased significantly in the intervention group. The possible explanation for no difference was found in BMI could due to short follow up time (only 6 months). Future study needs to examine the impact of health lifestyles intervention with longer follow up. Nonetheless, our intervention suggests that improvements in DBP last 6 months after the intervention. Maintaining healthy weight and healthy lifestyle in adolescents is critical in improving their cardiovascular health.
Adolescents in the intervention group also increased vegetable and fruit intake and physical activity level in all follow-up assessments in the study. Moreover, we found that children in the intervention group also improved their knowledge about physical activity and nutrition. Results of this study are consistent with results of other studies that indicated that Web-based interventions can improve food intake and physical activity in children and adolescents [11
]. The successful of the program in improving adolescents’ weight-related health behaviors and knowledge may be attributable to the interactive nature and individualization of the Web-based program. The Web-based program includes several components that involve setting realistic and achievable goals, and monitoring eating and physical activity in the form of documenting number of steps reported per day via our secure Web site. Thus, intervention for healthy weight management in Chinese American adolescents should incorporate information related to adequate diet and active lifestyles and should be tailored to the individual’s needs.
Although this study is one of the first to examine the feasibility and efficacy of a Web-based behavioral intervention program for Chinese American adolescents and their families, we acknowledge several limitations. These limitations include convenience sampling, parents with high education, use of self-report measures, involving only Chinese American adolescents, and follow-up for only 6 months after the intervention. In addition, the use of food diary for recording dietary intake in adolescents needs to be examined for its reliability and validity. Future research should examine the long-term effects of this program on weight-related health behaviors and other related cardiovascular functions as well.
In conclusion, the results of this study indicate significant improvements in waist-to-hip ratio, DBP, fruit and vegetable intake, and physical activity in Chinese American adolescents; all proxies for improved general health. Given the significant impact of being overweight on Chinese American adolescents’ health and the high financial cost of running an individual or group consulting program for behavioral change and weight management, a Web-based behavioral program can involve more families who may not otherwise be able to participate—and at substantially lower total cost.