This study demonstrates how SMART (Specific, Measurable, Attainable, Realistic and Timely) goals set by children in a lifestyle intervention contributed favorably to weight outcomes. Children (6-12 years) set goals with a registered dietitian over six months. Goals were classified according to their type (diet or activity), direction, (increase healthy or decrease unhealthy), and theoretical constructs. Theoretical constructs included the Theory of Planned Behavior's attitudes (i.e., changing beliefs about behaviour outcomes), subjective norm (i.e., incorporation of health recommendations) and perceived behavioural control (i.e., over goal barriers and facilitators).Constructs from a Socio-Ecological Model (family or individual) were also applied.Participants who maintained or decreased their body mass index for-age-and-sex z-scores (BAZ) after six months created significantly more goals related to the subjective norm compared to those whose BAZ increased (p = 0.003). Future interventions using SMART goals should incorporate health recommendations (i.e., the subjective norm) through actionable items among children to promote success.

Objectives The Shapedown BC program (British Columbia, Canada) is a provincially funded 10-week family-based behavioural lifestyle intervention for children and adolescents (ages six to 17 years old) living with obesity (or an overweight condition with one comorbidity) delivered by a multidisciplinary team. Since 2006, this program has been offered in-person until the COVID-19 pandemic forced it to be provided in the virtual format only. It is unknown how this online format compares to the in-person intervention in eliciting health behaviour changes and consequent body mass index (BMI; kg/m2) outcomes in participants. Therefore, this study aims to explore the efficacy of a virtual Shapedown BC group program compared to in-person delivery on improving BMI-z. Secondary aims investigate the differences in program attendance and attrition, health behaviours, and metabolic markers among children. Methods This retrospective chart review study of n = 40 children (ages 10 to 17 years old) will use non-identifying data collected by the Shapedown BC multidisciplinary team. Data of participants in the virtual intervention (n = 20; September 2021 to March 2022) will be matched by age, sex, and BMI-z at baseline and compared with data from the in-person intervention (n = 20; 2016 to 2019). E-surveys at pre-and post-intervention are used to analyze changes in sociodemographic, diet quality (vegetable and sugary drink consumption), exercise, sitting behaviours, and family habits. Anthropometric measurements are collected during an in-person clinical visit at intake, pre-intervention, and then again at post-intervention. Attendance is collected throughout the intervention. Bloodwork (ALT- liver enzymes, fasting glucose, triglycerides, total cholesterol, high- and low-density lipoproteins) is collected at intake and again at week 10 for participants with abnormal levels. Results N/A Conclusions Results from this study will provide insight into the efficacy of a virtual multidisciplinary family-based behavioural lifestyle intervention, which will contribute to future design of virtual weight management programs for preventing childhood and adolescent obesity. Funding Sources The University of British Columbia, Faculty of Land and Food Systems; BC Children's Hospital Shapedown-BC Program.