Adolescent obesity management: Understanding the communication and support preferences of underserved youth School of Public Health-Health Services PURPOSE: Adolescence is a time when health decisions can have a major impact in creating habits that affect youth for rest of their lives. Poor nutrition, insufficient physical activity, and sleep deficits are associated with increased risk for weight gain. Less than half of adolescents in this country meet the daily recommended amount of physical activity and a significant number of adolescents do not have healthy eating or sleep habits. Consequently, approximately 20.5% of US adolescents are overweight or obese. Ethnic/racial minorities and families of lower socioeconomic status are disproportionately affected by the obesity epidemic and have limited access to obesity prevention and treatment interventions; living outside of an urban center may also reduce access to interventions. Understanding communication preferences of diverse populations can improve impact of clinical interventions. Few studies exist focusing on what youth from disenfranchised backgrounds view as useful modalities to receive guidance regarding making healthy lifestyle changes. In this study, we sought to learn about communication and support preferences related to nutrition, physical activity, and sleep, to inform development of equitable strategies that fit the needs of youth who are currently from globally diverse and underserved backgrounds. METHODS: We qualitatively interviewed 20 adolescents attending an obesity managementprogram at a tertiary referral center in Seattle using a semi-structured script. We deliberately sought to include a high proportion of youth who lived outside of Seattle. Sessions were audio recorded and transcribed. Responses were coded using thematic analysis techniques to identify similarities and differences amongst the groups. Subjects received $10 for participation, and all materials/procedures were approved by an institutional review board. RESULTS: Participants' ages ranged between 15 to 21 years; 70% were 18 years or younger. Participants were from diverse backgrounds; half were from disenfranchised racial/ethnic communities (30% Latino/Hispanic, 5% African American/Black, 5% Asian, 10% multiracial), 1 participant was transgender female, 1 participant was gender non-binary, 20% of participants spoke Spanish at home, 40% lived in an apartment and the vast majority, 80%, lived in a city other than Seattle. Some common co-morbidities amongst participants include hypertension, anxiety, depression, pre-diabetes and elevated lipids.Main themes regarding communication and support preferences included that patients desired: 1.Written health recommendations and healthy lifestyle tips in electronic form such as social media, website or email rather than paper form. 2.Desire for representative images that are reflective of a diverse group of youth from different racial/ethnic backgrounds, genders, and body types. 3.Tips or examples for nutrition and physical activity that ...

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