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BackgroundObesity is among the most significant health challenges facing today’s adolescents. Weight gain during adolescence is related to cardiovascular disease, type 2 diabetes, and some cancers in later life. Presently, adolescents living in Australia have limited access to age-appropriate obesity prevention services. ObjectiveThis study aims to investigate whether a two-way text message program, with optional telephone health counseling, improves body mass index (BMI) z score and lifestyle outcomes in adolescents who are overweight. MethodsThis study will be a single-blind randomized controlled trial (N=150) comparing a two-way text message intervention, with optional telephone health counseling, to usual care in adolescents (13-18 years old, inclusive) who are overweight (recruited from a pediatric weight management clinic and the broader community in Sydney, Australia). The intervention group will receive a six-month text message program, which consists of two-way, semipersonalized, lifestyle-focused text messages (four messages/week) in addition to usual care. The control group will be assigned to receive usual care. The study also includes a follow-up at 12-months. The primary outcome is a change in BMI z score at six months. Secondary outcomes are changes in waist-to-height ratio, diet, physical and sedentary activity levels, sleep quality, quality of life, self-esteem, self-efficacy, social support, and eating disorder and depression symptoms. Also, we will examine acceptability, utility, and engagement with the program through a study-specific process evaluation questionnaire, semi-structured telephone interviews, and an analysis of health counselor communication logs. The analyses will be performed by the intention-to-treat principle to assess differences between intervention and control groups. ResultsThe study opened for recruitment in December 2019. Data collection is expected to be completed by December 2021, and the results for the primary outcome are expected to be published in early 2022. ConclusionsThis study will test the effectiveness of an interactive two-way text message program compared to usual care in improving BMI z score and lifestyle outcomes in adolescents with overweight. This interactive, innovative, and scalable project also aims to inform future practice and community initiatives to promote obesity prevention behaviors for adolescents. Trial RegistrationAustralia New Zealand Clinical Trials Registry (ANZCTR) ACTRN12619000389101; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377158&isReview=true International Registered Report Identifier (IRRID)DERR1-10.2196/16481

Background: Regular contact with specialist care has been linked to better diabetes outcomes for young people with type 1 diabetes (YPwT1D), but evidence is limited to population‐based service usage and outcomes. Aims: This observational 5‐year study sought to capture YPwT1D living in the study catchment area (covering metropolitan, regional and rural Australia) as they transitioned to adult‐based diabetes healthcare services and to describe their glycaemic control and complication rates, service usage and associated factors. Methods: Records between 2010 and 2014 in a public healthcare specialist diabetes database were extracted, care processes and outcomes were described, and associations were sought between episodes of care (EOC) and potentially predictive variables. Results: Annual cohort numbers increased yearly, but without significant differences in demographic characteristics. Each year around 40% had no reported planned specialist care, and the average number of planned EOC decreased significantly year on year. Overall, mean HbA1c levels also reduced significantly, but with higher values recorded for those living in non‐metropolitan than metropolitan areas (achieving significance in 3 out of 5 years). Diabetes complication assessments were only reported in 37–46%, indicating one in five with retinopathy and hypertension affecting one in three to five young people. Conclusions: Findings highlight the importance of investment to address the specific needs of adolescents and young adults and demonstrate the need for better support during these vulnerable early years, particularly for non‐metropolitan residents. This will entail changes to funding mechanisms, the health workforce and infrastructure, and new models of care to provide equity of access and quality of specialist care. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of a peer-led, school-based programme (Students As LifeStyle Activists; SALSA) on energy balance-related behaviours (EBRBs) in Grade 8 students, and the cost of implementing the programme. Design: Pre-post test Setting: High schools in New South Wales, Australia. Methods: Grade 10 students (15- to 16-year-olds) were trained by university students to deliver four lessons on healthy eating and physical activity to Grade 8 students (13- to 14-year-olds). Students completed an online questionnaire pre-post lessons on EBRBs and intentions to change EBRBs over the next month. Items included fruit, vegetable and sugar-sweetened beverage (SSB) intake, frequency of eating breakfast, participation in moderate-to-vigorous physical activity (MVPA) and school-day recreational screen-time. Pre--post changes were analysed using generalised estimating equations, adjusted for clustering. Standard methods were used to estimate implementation costs. Results: In total, 2,056 Grade 8 students from 23 high schools participated. Significant changes included 5.2% increase in eating >2 fruit serves/day (p < 0.001), 2.5% increase in eating >4 vegetable serves/day (p < 0.05), a 4.3% increase in drinking <1 cup/day of SSB (p < 0.001) but limiting screen-time <2 hours/day decreased by 4.4% (p < 0.001). There were significant improvements in students' intentions to change EBRBs over the next month, with the exception of MVPA. The average actual cost of implementing the SALSA programme in 2014-2015 was AU$1,388 (US$958) per school and AU$9.97 (US$6.88) per student. Conclusion: The SALSA peer education programme had a positive impact on most of the dietary EBRBs examined. The cost evaluation showed that it is a relatively low-cost programme to implement.

The cornerstone of obesity treatment is behavioural weight management, resulting in significant improvements in cardio-metabolic and psychosocial health. However, there is ongoing concern that dietary interventions used for weight management may precipitate the development of eating disorders. Systematic reviews demonstrate that, while for most participants medically supervised obesity treatment improves risk scores related to eating disorders, a subset of people who undergo obesity treatment may have poor outcomes for eating disorders. This review summarises the background and rationale for the formation of the Eating Disorders In weight-related Therapy (EDIT) Collaboration. The EDIT Collaboration will explore the complex risk factor interactions that precede changes to eating disorder risk following weight management. In this review, we also outline the programme of work and design of studies for the EDIT Collaboration, including expected knowledge gains. The EDIT studies explore risk factors and the interactions between them using individual-level data from international weight management trials. Combining all available data on eating disorder risk from weight management trials will allow sufficient sample size to interrogate our hypothesis: that individuals undertaking weight management interventions will vary in their eating disorder risk profile, on the basis of personal characteristics and intervention strategies available to them. The collaboration includes the integration of health consumers in project development and translation. An important knowledge gain from this project is a comprehensive understanding of the impact of weight management interventions on eating disorder risk. [ABSTRACT FROM AUTHOR]

Background: There is evidence that physical activity (PA), sitting time, and obesity may impact cognition, but few studies have examined this in young women. Methods: Healthy women (18–35 y), without conditions that impair cognition, were recruited for this cross-sectional study. Participants completed anthropometric and validated computerized cognitive assessments (IntegNeuro™). Performance on 5 cognitive domains (impulsivity, attention, information processing, memory, and executive function) was reported as z scores. Sitting hours and weekly PA calculated from time in low-, moderate-, and high-intensity activity were obtained via the International Physical Activity Questionnaire. Analysis of variance/analysis of covariance, chi-square, and linear regression were used. Results: 299 (25.9 [5.1] y) women (low PA = 19%; moderate PA = 40%; high PA = 41%) participated. High PA women had lower body mass index (high PA = 26.1 [6.5]; moderate PA = 30.0 [8.7]; low PA = 31.0 [11.1] kg/m2; P <.001) and less sitting time (high PA = 6.6 [3.1]; moderate PA = 7.7 [2.8]; low PA = 9.3 [3.6] hr/weekday; P <.0001). Cognitive function was within normal ranges and did not differ between any PA groups (P =.42). Adjusting for body mass index, C-reactive protein, or sitting hours did not alter results. Weak correlations were found between time in high-intensity activity and impulsivity (b = 0.12, r2 =.015; P =.04), and between sitting hours and information processing efficiency (b = −0.18, r2 =.03; P =.002). Valuesare presented as mean (SD). Conclusions: Cognitive function was within the normal range, regardless of PA or sitting time. [ABSTRACT FROM AUTHOR]

Objectives: The Future Proofing Study (FPS) was established to examine factors associated with the onset and course of mental health conditions during adolescence. This paper describes the design, methods, and baseline characteristics of the FPS cohort. Methods: The FPS is an Australian school‐based prospective cohort study with an embedded cluster‐randomized controlled trial examining the effects of digital prevention programs on mental health. Data sources include self‐report questionnaires, cognitive functioning, linkage to health and education records, and smartphone sensor data. Participants are assessed annually for 5 years. Results: The baseline cohort (N = 6388, M = 13.9 years) is broadly representative of the Australian adolescent population. The clinical profile of participants is comparable to other population estimates. Overall, 15.1% of the cohort met the clinical threshold for depression, 18.6% for anxiety, 31.6% for psychological distress, and 4.9% for suicidal ideation. These rates were significantly higher in adolescents who identified as female, gender diverse, sexuality diverse, or Aboriginal and/or Torres Strait Islander (all ps < 0.05). Conclusions: This paper provides current and comprehensive data about the status of adolescent mental health in Australia. The FPS cohort is expected to provide significant insights into the risk, protective, and mediating factors associated with development of mental health conditions during adolescence. [ABSTRACT FROM AUTHOR]