Global survey study of awareness, care and treatment of adolescents living with obesity, their caregivers and healthcare professionals: ACTION Teens

초록

Background: Obesity rates in children and adolescents have increased dramatically across the globe, and the lifelong impact of obesity is more severe when onset begins at ≤20 years of age. However, the experiences, challenges and needs of adolescents living with obesity (ALwO), their caregivers, and the healthcare providers (HCPs) who treat them are poorly understood. ACTION Teens, the first study of its kind, aims to improve the lives of ALwO by generating evidence to drive awareness around the needs of ALwO and caregivers, and to identify areas of misalignment between ALwO, caregivers and HCPs. Methods: ACTION Teens is a quantitative survey-based study currently collecting data in ten countries (Australia, Colombia, Italy, Korea, Mexico, Saudi Arabia, Spain, Taiwan, Turkey and United Kingdom). The study includes ALwO and their caregivers, as well as HCPs with direct, recent experience of clinical obesity management in adolescents. The survey, designed with guidance from an international steering committee consisting of HCPs and subject matter experts, focuses on several aspects of obesity care. Questions consider attitudes and perceptions about obesity and its impact; weight loss attempts, and motivations and barriers to losing weight; patterns of weight loss conversations; ALwO and caregiver interactions with HCPs about obesity; sources of information used to learn about obesity and weight management; sociodemographics of participants; and overall health and wellbeing of ALwO. The study is targeting 6,150 ALwO, 6,150 caregivers, and 2,300 HCPs with separate, though overlapping, surveys. Sample sizes were selected to reflect the size of the population of ALwO in each country. To maximise the inclusion of ‘matched pairs’ of an ALwO and their specific caregiver, permission will be sought from qualifying caregivers for the relevant child to be involved. The study has been designed to address several specific needs of the ALwO population. Age-specific definitions of obesity were used, most frequently a BMI ≥95th percentile for age and sex, per locally appropriate definitions. Assessment of pubertal stage would have been desirable to evaluate its impact on survey outcomes, but this would not be achievable without inclusion of potentially culturally inappropriate questions. Therefore, a proxy of age subgroups was considered appropriate by the steering committee. Among HCPs, objective rather than subjective criteria to identify advanced formal obesity training were used to reduce false positives. Results: Study results will be reported in 2022. Conclusions: ACTION Teens will provide critical global insights to improve awareness of management, treatment and support for ALwO.