1 Department of Health, Kinesiology and Applied Physiology Concordia University Montreal Canada.
2 Departments of Medicine, Cardiac Sciences and Community Health Sciences, Faculties of Medicine and Kinesiology University of Calgary Calgary Canada.
3 School of Human Kinetics, Faculty of Health Sciences University of Ottawa Ottawa Canada.
4 Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa Canada.
5 Department of Kinesiology and Physical Education McGill University Montreal Canada.
6 Community Health and Epidemiology Dalhousie University Halifax Canada.
7 Werklund School of Education University of Calgary Calgary Canada.
8 Prevention and Rehabilitation Centre University of Ottawa Heart Institute Ottawa Canada.
9 Institut du Savoir Montfort Ottawa Canada.
10 Healthy Active Living and Obesity Research Group (HALO) Children's Hospital of Eastern Ontario Research Institute Ottawa Canada.

Understanding low adherence to an exercise program for adolescents with obesity: the HEARTY trial.

Obes Sci Pract. 2019 Oct;5(5):437-448

Authors: Alberga AS, Sigal RJ, Sweet SN, Doucette S, Russell-Mayhew S, Tulloch H, Kenny GP, Prud'homme D, Hadjiyannakis S, Goldfield GS

Abstract

Introduction: Despite efforts to improve adherence to physical activity interventions in youth with obesity, low adherence and attrition remain areas of great concern.

Objective: The study was designed to determine which physiological and/or psychological factors predicted low adherence in adolescents with obesity enrolled in a 6-month exercise intervention study aimed to improve body composition.

Methods: Three hundred four adolescents with obesity aged 14-18 years who volunteered for the HEARTY (Healthy Eating Aerobic and Resistance Training in Youth) randomized controlled trial completed physiological (body mass index, waist circumference, per cent body fat, resting metabolic rate and aerobic fitness) and psychological (body image, mood, self-esteem and self-efficacy) measures.

Results: One hundred forty-one out of 228 (62%) randomized to exercise groups had low adherence (completed <70% of the prescribed four exercise sessions per week) to the intervention protocol. Logistic regression revealed that there were no baseline demographic or physiological variables that predicted low adherence in the participants. Appearance concern (a subscale of body image) (odds ratio [OR] 1.46, 95% confidence interval [CI]: 1.01, 2.1, P = 0.04), depressive mood (OR 1.12, 95% CI: 1.01, 1.23, P = 0.03) and confused mood (OR 1.16, 95% CI: 1.05, 1.27, P = 0.003) (two subscales of mood) were significant predictors of low adherence.

Conclusions: Adolescents with obesity who had higher appearance concerns and depressive and confused moods were less likely to adhere to exercise. Body image and mood should be screened to identify adolescents who may be at high risk of poor adherence and who may need concurrent or treatment support to address these psychological issues to derive maximal health benefits from an exercise programme.

PMID: 31687168 [PubMed]