The proposed study is designed to determine the effects of including mastery criteria for teaching eating and exercise behavior change as part of a family-based treatment program for childhood obesity. Behavioral programs for childhood obesity specify the target behavior to be changed and arrange reinforcement contingencies for these changes. However, there is still considerable variability in the extent to which children learn these new eating and exercise behaviors, and consequently considerable variability in the weight losses achieved. This study assesses the effects of introducing mastery criteria, in which a child and parent will progress through the program at the rate he/she has mastered the material, and demonstrated the desired behavior change. This Paced/Mastery program will be compared to a fixed-pace/Non-mastery Control group, which constitutes the conventional treatment protocol, and a Paced/Yoked Control group, in which progress through the program is dependent on the progress of a child or parent in the Paced/Mastery group. It is predicted that children and their parents that are provided with mastery criteria will show better learning and retention of the written material and the behavioral skills than subjects in the two control groups. In addition, weight losses in the three groups should be different, with the weight changes showing the same pattern of results as the behavioral skills.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
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Social Sciences and Population Study Section (SSP)
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University of Pittsburgh
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Epstein, L H; Goldfield, G S (1999) Physical activity in the treatment of childhood overweight and obesity: current evidence and research issues. Med Sci Sports Exerc 31:S553-9
Myers, M D; Raynor, H A; Epstein, L H (1998) Predictors of child psychological changes during family-based treatment for obesity. Arch Pediatr Adolesc Med 152:855-61
Epstein, L H (1996) Family-based behavioural intervention for obese children. Int J Obes Relat Metab Disord 20 Suppl 1:S14-21
Epstein, L H; Coleman, K J; Myers, M D (1996) Exercise in treating obesity in children and adolescents. Med Sci Sports Exerc 28:428-35
Epstein, L H; Myers, M D; Anderson, K (1996) The association of maternal psychopathology and family socioeconomic status with psychological problems in obese children. Obes Res 4:65-74
Epstein, L H; Valoski, A M; Kalarchian, M A et al. (1995) Do children lose and maintain weight easier than adults: a comparison of child and parent weight changes from six months to ten years. Obes Res 3:411-7
Epstein, L H; McKenzie, S J; Valoski, A et al. (1994) Effects of mastery criteria and contingent reinforcement for family-based child weight control. Addict Behav 19:135-45
Epstein, L H; Wisniewski, L; Weng, R (1994) Child and parent psychological problems influence child weight control. Obes Res 2:509-15
Epstein, L H; Klein, K R; Wisniewski, L (1994) Child and parent factors that influence psychological problems in obese children. Int J Eat Disord 15:151-8
Epstein, L H; Smith, J A; Vara, L S et al. (1991) Behavioral economic analysis of activity choice in obese children. Health Psychol 10:311-6

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