• Bernadette Mazurek Melnyk, Leigh Small, Dianne Morrison-Beedy, Anne Strasser, Lisa Spath, Richard Kreipe, Hugh Crean, Diana Jacobson, Stephanie Kelly, and Judith O'Haver.
• Arizona State University College of Nursing & Healthcare Innovation, 500 N 3rd St, Phoenix, AZ 85004, USA. Bernadette.Melnyk@asu.edu
• J Pediatr Health Care. 2007 Sep 1;21(5):315-22.

IntroductionThere has been a paucity of theory-based interventions to improve health outcomes in overweight adolescents. Therefore, two intervention studies were conducted to: (a) determine the feasibility of implementing the Creating Opportunities for Personal Empowerment (COPE) Healthy Lifestyles Thinking, Emotions, Exercise, and Nutrition (TEEN) program with overweight adolescents; (b) obtain feedback that could be used to refine the program; and (c) examine the preliminary efficacy of the COPE program on the adolescents' weight and body mass index (BMI).MethodPhase I and Phase II clinical trials were conducted with 23 overweight teens. The Phase 1 trial used a pre-experimental design with one group of 11 urban adolescents. The Phase 2 trial was conducted with 12 suburban teens using a randomized controlled pilot study. COPE teens received a 15-session cognitive-behavioral skills building program that included physical activity, while the control group received an attention control program. Weight change and BMI were the key outcomes.ResultsCOPE teens experienced a significantly greater reduction in weight and BMI than did teens in the control group, who gained weight over time. Although the COPE program was well received by all of the teens, retention of subjects across time and parent involvement in the program were challenges in the urban high school.DiscussionThese studies provide preliminary data to indicate that the implementation of COPE is feasible and may lead to a reduction in weight and BMI in overweight teens. Implementing COPE within the context of the school day may be more successful in sustaining adolescent involvement in the program versus using an after-school format.

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