(PS3-D89) From Research to Clinic: Translating a Behavioral Weight Management Intervention for Adolescents to Clinic Telehealth Delivery

Randomized clinical trials have demonstrated efficacy of family-based behavioral weight management interventions. Translational science is needed to increase intervention availability. This presentation reports use of translational science to adapt the Families Improving Together (FIT) for Weight Loss intervention to treat obesity among African American youth in South Carolina, USA, (Wilson et al., 2022) for telehealth in a specialty clinic serving diverse youth in the Upper Midwest USA. The project followed a dissemination and translational framework (Escoffery al., 2019) to address several gaps in the pediatric behavioral weight management literature including: (1) translation of evidenced-based protocols for weight loss and health promotion to use in clinical practice; (2) adaptation of formats for telehealth to increase accessibility for families, particularly those in rural communities, that have limited access to treatment; and (3) development of interventions relevant to a diverse population of adolescents (Cardel et al., 2021). We present the systematic process and key steps in our translational process defined by leading translational frameworks (Escoffery et al., 2019) that included selecting the evidence-based intervention (EBI), adapting the EBI, preparing for adapted EBI delivery, and implementing and evaluating the adapted EBI. We describe how we followed each step from selection of the EBI to preparing for delivery of the adapted EBI, including integration of stakeholder input. The selection of FIT was based on its consistency with evidence-based practice and inclusion of components identified as necessary by stakeholders including patients, parents, and the clinical team. Specifically, FIT provides developmentally relevant guidance for parents of adolescents focused on modeling autonomy support and shared decision-making as well as behavioral skills such as goal-setting and self-monitoring, to establish lifelong habits for healthy weight management for overweight adolescents. Stakeholder input for adapting FIT included adjusting for racial and gender diversity, structuring sessions to allow for adolescent-only discussions and support, and creating opportunities for reflective discussion around sensitive topics. Stakeholders also provided suggestions for creating a smooth referral process for reducing barriers to family participation. Additional modifications to the program structure and intervention delivery were made to adjust to clinical norms, processes, and delivery unique to the group telehealth format. We also modified language choices associated with FIT behaviors to emphasize actions to increase rather than decrease (e.g., building healthy habits over setting dietary limits). We describe plans for evaluating the implementation and outcomes of the adapted EBI. For example, we developed process evaluation methods to include assessment of behavioral changes, consistent with our shift in focus from calorie counting to behavioral goals associated with nutrition, physical activity, and sedentary behavior. We highlight a need for additional illustrative models to guide adaptation of EBIs into clinical practice while maintaining fidelity to the EBI’s core elements.