Engaging Overweight Adolescents in a Health and Fitness Program Using Wearable Activity Trackers

Marian Wilson, PhD, MPH, RN-BC; Samantha Ramsay, PhD, RDN, LD; Kimberly J. Young, MS, RDN, LD


J Pediatr Health Care. 2017;31(4):e25-e34. 

In This Article

Abstract and Introduction


Introduction: Our objectives were to (a) examine feasibility and receptivity of overweight adolescents joining a community-based group fitness program and (b) test preliminary efficacy of a 12-week pilot intervention designed to promote health, fitness, and self-efficacy for the identified teens.

Methods: The 12-week fitness program for overweight adolescents was developed and included planned physical activities, nutrition classes, and goal-setting sessions. A one-group pre-/posttest study design evaluated 20 participants from grades 10 through 12 who enrolled in the program pilot study. Participants were given a wearable activity tracker that captured data using an Internet-based platform. Outcome measures included body mass index, screen time, fitness, and cardiovascular measures.

Results: A community fitness program for overweight adolescents was successfully implemented. High school students were receptive to the intervention and reported high program satisfaction. Positive effects included measurements of strength, systolic blood pressure, weight, and screen time behaviors.

Discussion: This study provides evidence to support the feasibility, acceptance, and preliminary effects of the pilot program with overweight adolescents.


Childhood obesity is a global health concern. Approximately 170 million children (<18 years of age) are estimated to be overweight (World Health Organization [WHO], 2012). Obesity has nearly doubled worldwide since 1980 (WHO, 2012); 20.5% of U.S. adolescents ages 12 to 19 years are estimated to be overweight or obese (Centers for Disease Control and Prevention [CDC], 2015). Childhood overweight and obesity carries into adulthood, increasing risk for preventable diseases that kill 2.8 million adults annually (WHO, 2012). Obesity has immediate and long-term consequences on the health and quality of life of adolescents. Immediate impacts include greater risk for experiencing psychosocial problems such as depression, poor self-image, and low self-esteem and physical health complications such as insulin resistance, joint problems, and sleep apnea (Daniels et al., 2005).

Prevention has been called the only feasible solution for children in developed and developing countries (Lobstein, Baur, &, Uauy, 2004). However, effective interventions for children who are currently overweight and obese are necessary to address their suffering and health risks as well. Generally, in Western cultures, the burden remains on the primary care provider to manage the care of an obese person, despite the absence of a known cure (Whitlock, Williams, Gold, Smith, & Shipman, 2005). Treatment often requires a multidisciplinary professional team including a dietitian, exercise physiologist, physician, and psychologist (Lobstein et al., 2004). Behaviorally based interventions focused on modifiable lifestyle factors are considered first-line treatments for obese adolescents and can improve weight and adiposity (Whitlock, O'Connor, Williams, Beil, & Lutz, 2010). However, how teens are to access these treatments remains unclear. Such treatments in the United States often require a primary care referral and a third-party payment plan, leaving them inaccessible to many. Additionally, many primary care providers lack confidence in skills such as motivational interviewing that are needed to engage their patients in behavior changes (Gonzalez, 2016). Development and promotion of early detection and treatment programs for childhood and adolescent obesity are considered crucial to addressing the obesity epidemic and associated obesity-related noncommunicable diseases (WHO, 2012). Although schools have been identified as an optimal environment to implement exercise and diet programs (Hsieh and FitzGerald, 2005; Flynn et al., 2006), limited information is available on how to develop and deliver sustainable and cost-effective programs. Because of the complex nature of obesity interventions, age-appropriate, feasible, culturally sensitive, and effective multidisciplinary curriculums are needed that can be reproduced in communities of all socioeconomic levels (Gonzalez, 2016; Militello, Melnyk, Hekkler, Small, & Jacobson, 2016).

Therefore, this article describes the development, implementation and evaluation of a 12-week health and fitness program targeting students in a U.S. public high school who were classified as overweight using current body mass index (BMI) charts. The primary purpose of the project was to evaluate how a community-based health and fitness program could be successfully delivered to address unmet needs. The objectives of this study were to (a) test the feasibility of a novel weight management intervention that would pool community and school resources using Internet-based activity tracking and online support; (b) measure participants' receptivity using satisfaction surveys, level of attendance, and participation; and (c) determine whether any changes could be detected in health, fitness, weight, and healthy behavior assessment measurements over time.