The Activity School in Finnmark for Overweight Children

• Change in Systolic Blood Pressure compared to baseline [ Time Frame: 3 years ] [ Designated as safety issue: No ]
  Measured with an automated blood pressure monitor at baseline, at 3 months- , 1 year-, 2 year- and 3-year follow-up. Primary measures at the end (2 years) of continuous lifestyle modification. Last measurement at 1 year after last counseling and active treatment has stopped, 3 years from baseline.
• Change in Body fat compared to baseline [ Time Frame: 3 years ] [ Designated as safety issue: No ]
  Measured with bioelectrical impedance analysis at baseline and at 3 months- , 1 year-, 2 year- and 3-year follow-up.Primary measures at 2 years of continuous lifestyle modification. Last measurement at 1 year after last counseling and active treatment has stopped, 3 years from baseline.
• Change in activity level / Counts per min compared to baseline [ Time Frame: 3 years ] [ Designated as safety issue: No ]
  Measured with accelerometers at baseline, 1 year-, 2 year- and 3-year follow-up. Primary measures at 2 years of continuous lifestyle modification. Last measurement at 1 year after last counseling and active treatment has stopped, 3 years from baseline.
• Change in Waist circumference compared to baseline [ Time Frame: 3 years ] [ Designated as safety issue: No ]
  Measured with measuring tape mid-point between the lowest rib and the top of the iliac crest at baseline, 3 months- , 1 year-, 2 year- and 3-year follow-up. Primary measures at 2 years of continuous lifestyle modification. Last measurement at 1 year after last counseling and active treatment stopped, 3 years from baseline.
• Change in Homa Score / HOMA IR compared to baseline [ Time Frame: 3 years ] [ Designated as safety issue: No ]
  Homa score calculated from the cross product of fasting plasma insulin and plasma glucose divided with a factor of 22.5. Fasting plasma insulin and glucose will be measured at baseline, at 1 year-, 2 year- and 3-year follow-up. Primary measures at 2 years of continuous lifestyle modification.Last measurement at 1 year after last counseling and active treatment has stopped, 3 years from baseline.
• Change in triceps skinfold compared to baseline [ Time Frame: 3 years ] [ Designated as safety issue: No ]
  Measured with Holtain Tanner /Whitehouse Skinfold Caliper at baseline,3 months- , 1 year-, 2 year- and 3-year follow-up. Primary measures at 2 years of continuous lifestyle modification.Last measurement at 1 year after last counseling and active treatment has stopped, 3 years from baseline.
• Change in self-concept compared to baseline [ Time Frame: 3 years ] [ Designated as safety issue: Yes ]
  Measured with SPPC, Self Perception Profile for Children at baseline, at 6 months- , 1 year-, 2 year- and 3-year follow-up. Primary outcome measured at 2 years of continuous lifestyle modification. Last measurement at 1 year after last counseling and active treatment has stopped.
• Change in psychiatric health compared to baseline [ Time Frame: 3 years ] [ Designated as safety issue: Yes ]
  Measured with Strengths and difficulties Questionnaire ( SDQ-S)at baseline, at 6 months- , 1 year-, 2 year- and 3-year follow-up. Primary measurement at 2 years of continuous lifestyle modification. Last measurement at 1 year after last counseling and active treatment has stopped.
• Change in fitness from baseline [ Time Frame: 3 years ] [ Designated as safety issue: No ]
  Measured with Andersen's test (shuttle test) at baseline, 1 year-, 2 year- and 3-year follow-up. Primary measures at 2 years of continuous lifestyle modification. Last measurement at 1 year after last counseling and active treatment has stopped, 3 years from baseline.
• Change in quality of life compared to baseline [ Time Frame: 3 years ] [ Designated as safety issue: Yes ]
  Measured with KINDL (Kinder Lebensqualitet Fragebogen) at baseline, 6 months-, 1 year-, 2 year- and 3-year follow-up. Primary measures at 2 years of continuous lifestyle modification. Last measurement at 1 year after last counseling and active treatment has stopped, 3 years from baseline.

• Quality of life [ Time Frame: After 2 years, last control after 3 years ] [ Designated as safety issue: Yes ]
• Measures of metabolic changes [ Time Frame: After 2 years, last control after 3 years ] [ Designated as safety issue: No ]
• Measures of body fat distribution [ Time Frame: After 2 years, last control after 3 years ] [ Designated as safety issue: No ]
• Change in weekly activity level [ Time Frame: After 2 years, last control after 3 years ] [ Designated as safety issue: No ]

The purpose of this study is to evaluate the effectiveness of a life style counseling programme designed for overweight and obese children and their parents in groups compared to traditional individual counseling in the pediatric outpatient clinic and the community. The two interventions are both hospital and community based.

Randomized study design with two parallel groups.Active intervention in two years, last follow-up after 3 years.

• Obesity
• Overweight

• Behavioral: Lifestyle counseling in groups

  The activity school in Finnmark. Lifestyle counseling (physical activity and dietary modification) in groups both at the hospital and in their own municipality.

  They meet a multidisciplinary team, receive organized physical activity in the municipality and are invited to a 3 days camp after 4-6 months.

• Behavioral: Individual intervention
  Conventional lifestyle counseling individually by single health professionals, both in hospital and in municipality.

• Experimental: Group intervention
  Lifestyle counseling (physical activity and dietary modification) in groups both at the hospital and in their own municipality. They meet a multidisciplinary team, receive organized physical activity in the municipality and are invited to a 3 days camp after 4-6 months.
  Interventions:

  • Behavioral: Lifestyle counseling in groups
  • Behavioral: Individual intervention
• Active Comparator: Individual intervention
  Lifestyle counseling for each separate family practiced by single health professionals both in hospital and municipality. A more conventional model.
  Intervention: Behavioral: Individual intervention

Inclusion Criteria:

• Overweight or obese.
• BMI > IOTF (International Obesity TaskForce) cut-points 27,5. kg/ m2.

Exclusion Criteria:

• Diseases not compatible with normal physical activity.
• Disorders not compatible with group treatment.

• Finnmark Hospital Trust, Norway
• The Royal Norwegian Ministry of Health
• Norwegian Foundation for Health and Rehabilitation
• The Norwegian Directorate of Health