A Randomized Controlled Trial of a Telehealth Family-Delivered Mindfulness-Based Health Wellness (MBHW) Program for Self-Management of Weight by Adolescents with Intellectual and Developmental Disabilities

Abstract

Objectives The prevalence of overweight and obesity is high in adolescents with intellectual and developmental disabilities (IDD), and the availability of and engagement in self-determined health and wellness programs is limited. The objective of the present study was to assess the effectiveness of the Mindfulness-Based Health Wellness (MBHW) program of using telehealth to enable families to teach a field-tested lifestyle change program to their adolescents with IDD. The program encouraged the adolescents to self-determine the parameters of the program that they could use to self-manage their weight through a lifestyle change process. Method Eighty adolescents were randomized into experimental (n = 42) and control (n = 38) groups. The experimental group engaged in the MBHW program as taught by their families, and the control group engaged in treatment as usual (TAU) in a randomized controlled trial. Adolescents in the experimental group self-determined the parameters of each of the five components of the MBHW program and engaged in self-paced weight reduction using a changing-criterion design. Results All 42 adolescents in the experimental group reached their target weights and, on average, reduced their weight by 38 lbs. The 38 adolescents in the control group reduced their weight by an average of 3.47 lbs. by the end of the study. There was a large statistically significant effect of the MBHW program on reduction of both weight and body mass index (BMI) for adolescents in the experimental group. Family members and adolescents rated the MBHW program as having high social validity, and the intervention was delivered with a high degree of fidelity. Conclusions Families can support adolescents with IDD to use the MBHW program to effectively self-manage their weight through a lifestyle change program. Future research should use an active control group, assess maintenance of weight loss across settings and time, use relative fat mass (RFM) for estimating body fat percentage, and evaluate the impact of consuming highly processed foods on weight loss interventions.