Evidence to Support Adolescents as Healthy Lifestyle Behavior Change Agents for Their Families

Background: There are numerous studies in the literature that support the key role of parents in facilitating healthy lifestyle behavior change in their children and families. However, evidence is lacking to support whether children and adolescents can be active change agents for healthy lifestyle behavior change in their parents and families.

Aims: The purpose of this presentation is to: (a) describe the healthy lifestyle behavior changes that occurred in parents and families of high school teens who were participating in a randomized clinical trial to test the efficacy of a 15-session cognitive-behavioral skills building program (COPE: Creating Opportunities for Personal Empowerment) on the teens’ physical, mental health, social skills and academic outcomes, and (b) discuss implications for clinical practice and future research.

Methods: A randomized controlled trial was conducted with 779 culturally diverse high school adolescents enrolled in 11 high schools in the southwest United States. Adolescents who were taking a health course within these high schools received either the 15-session COPE Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, Nutrition) program or an attention control program that covered common adolescent health issues, such as dental hygiene, acne, and motor vehicle safety. The COPE program consisted of 7 cognitive behavioral skills building sessions and 8 sessions focused on nutrition and physical activity. Each of the 15 COPE sessions, approximately 50 minutes in length and taught once a week by the health course teachers, had 20 minutes of physical activity integrated into the session. As part of the COPE program, teens were asked to take a newsletter home to their parents four times during the 15-week program that covered topics that they were learning and to review the newsletter with their parents. Parents completed an evaluation at the end of the 15-week program that asked questions regarding the program’s helpfulness and what behaviors if any they changed based upon the program. For this analysis, post-intervention evaluation data from the parents of the teens in the COPE group was reviewed and analyzed.  Frequencies were calculated, and string data was analyzed and categorized.

Results:  One hundred-thirty four (82%) of the 169 parents of COPE teens who completed the post-intervention evaluation reported that the teens shared the informational newsletters with them. Of the parents who responded, 126 (82%) said the information was helpful to them. One hundred eight parents (69%) indicated they had changed their behaviors as a result of the teen sharing the program material with them. The most common behaviors changed by the parents were an increase in activity (33.2%), improvements in nutrition (24.3%), and an increase in healthy choices and lifestyles (20.1%). 

Conclusions: Adolescents can indeed act as agents of healthy lifestyle behavior change for their families. Clinicians who care for adolescents to facilitate healthy lifestyle behavior change should recognize that they can be key in promoting healthy lifestyle behavior change in their parents. Schools should incorporate parent health promotion newsletters in their health curricula and assign homework to the teens to review this information with the parents. Additional randomized controlled trials are needed to build a body of evidence regarding teens as agents of healthy lifestyle change for their families.