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HELP trial: Healthy Eating Lifestyle Programme for adolescents
ISRCTN ISRCTN99840111
DOI 10.1186/ISRCTN99840111
ClinicalTrials.gov identifier
EudraCT number
Public title HELP trial: Healthy Eating Lifestyle Programme for adolescents
Scientific title HELP trial: randomised controlled trial of the Healthy Eating Lifestyle Programme for adolescents
Acronym HELP Trial
Serial number at source 9623
Study hypothesis Aim:
To improve management of adolescent obesity by conducting an efficacy trial of the Healthy Eating Lifestyle Programme (HELP) within primary care.

Hypotheses:
1. Primary: That a motivational and solution-focused family-based weight management programme (the Health Eating Lifestyle Programme: HELP) individually delivered over 6 months is more efficacious in improving body mass index (BMI) in obese adolescents than enhanced standard care
2. Secondary: That the HELP intervention over 6 months is more efficacious in improving quality of life, reducing waist circumference and cardiovascular risk factors and improving psychological function in obese adolescents than enhanced standard care

Design:
MRC complex intervention phase III efficacy randomised clinical trial. Subjects will be individually randomised to receiving either the HELP intervention or enhanced standard care for 6 months. Subjects will be aware of allocation status but assessments will be undertaken blind to allocation status.
Lay summary Background and study aims
The Healthy Eating and Lifestyle Programme (HELP) has shown promising results in an initial hospital-based study and this is now the main study. The treatment uses motivational and solution focused psychological techniques, combined with up-to-date information on nutrition and lifestyle. HELP was developed in consultation with healthcare professionals from multi-disciplinary backgrounds and in response to specific feedback from young people and health care workers who took part in the HELP initial study.

Who can participate?
Young people aged 12 to 19 struggling with overweight in London and surrounding boroughs

What does the study involve?
Young people will be randomly allocated to one of two methods of managing weight:
1. Intervention (HELP): 12 x 45-minute solution-focused, motivational interviewing sessions with a trained health care worker and delivered in the young person’s community.
2. Control: 1 x 45-minute educational session based upon current Department of Health guidelines regarding healthy lifestyle, delivered by a practise nurse at the young person’s GP surgery.
All young people in the study will be seen at regular intervals at the Great Ormond Street Hospital (GOSH) Clinical Research Facility for psychological and physical assessment (including fasting blood tests). During these assessments, any significant medical or mental health issues will be referred on appropriately if identified. Researchers will not know which group the young people are in. Everyone involved with running the study receives safety and child protection training and has been CRB checked.

What are the possible benefits and risks of participating?
• Health benefits: Possible weight maintenance or loss, improved fitness and increased self-confidence.
• Listening and working with the young person: HELP focuses on motivating and empowering young people to find change from within, listening to their thoughts and ideas about weight and lifestyle, with an emphasis on harnessing existing strengths and skills in the management of their overweight.
• Free to young people involved: We cover public transport expenses to and from sessions and give young people a £40 iTunes or high street store voucher as a thank you for participating.

Where is the study run from?
The trial is based at the UCL Institute of Child Health in London. A broad team of researchers including paediatricians, psychologists, and public health physicians are involved. The lead investigators for the trial are Dr Russell Viner, a consultant paediatrician at University College London Hospital (UCLH), and Dr Deborah Christie, a consultant clinical psychologist at UCLH. Both are clinical and academic experts in the fields of child and adolescent obesity.

When is the study starting and how long is it expected to run for?
The study started recruitment in January 2011 and will recruit young people until May 2013. The study is expected to run until November 2013.

Who is funding the study?
The National Institute of Health Research (Programme Grants for Applied Research)

Who is the main contact?
Anne Mathiot , Trial Manager (+44 020 3286 2778)
a.mathiot@ich.ucl.ac.uk
Ethics approval West London Research Ethics Committee 3 approved on the 27th August 2010 (ref: 10/H0706/54)
Study design Single centre randomised interventional treatment trial
Countries of recruitment United Kingdom
Disease/condition/study domain Topic: Primary Care Research Network for England; Subtopic: Not Assigned; Disease: All Diseases
Participants - inclusion criteria Current inclusion criteria as of 13/07/2012:
1. Young people aged 12 - 19 years, either sex
2. Obese (body mass index [BMI] greater than 95th centile for age and sex)

Previous inclusion criteria until 13/07/2012:
1. Young people aged 13 - 17 years, either sex
2. Obese (body mass index [BMI] greater than International Obesity Task Force [IOTF] thresholds for age and sex)
Participants - exclusion criteria Current exclusion criteria as of 13/07/2012:
1. Participants with significant mental health problems or undergoing mental health treatment
2. Other chronic illness, known secondary obesity, monogenic obesity syndrome or use of medications known to promote obesity
3. Participants with significant learning disability
4. Participants with lack of command of English sufficient to render them unable to participate effectively in the planned intervention. The great majority of eligible young people from black or minority ethnic groups in this population have good command of English. Given the importance of standardising the intervention, it will not be possible to use interpreters to enable parents with poor English to participate. To allow as many young people as possible to participate while maintaining the external validity of the study, we will allowing another relative with good English to participate alongside the young person (if they wish it).
5. Participation in behavioural weight management programmes in the past 12 months. This does not include participation in commercial programmes such as Weight Watchers.
6. Young people with BMI greater than or equal to 45 kg/m2. We exclude this group as the evidence suggests they are unlikely to benefit from a community based intervention such as HELP.

Previous exclusion criteria until 13/07/2012:
6. Young people with BMI greater than or equal to 40 kg/m2. We exclude this group as the evidence suggests they are unlikely to benefit from a community based intervention such as HELP.
Anticipated start date 05/01/2011
Anticipated end date 01/09/2014
Status of trial Ongoing
Patient information material Not available in web format, please use the contact details below to request a patient information sheet
Target number of participants Planned sample size: 162
Interventions Intervention (81 subjects):
HELP programme: A solution-focused and motivational weight management programme. Young people and families will attend twelve 40 - 45 minute sessions over 6 months. HELP has 4 components:
1. Modifying eating behaviours and encouraging regular eating patterns
2. Decreasing sedentary behaviour and increasing lifestyle and programme activity
3. Reducing intake of energy dense foods, and increasing healthy nutritional choices
4. Addressing emotional eating triggers
The intervention duration is 6 month (12 sessions).

Control (81 subjects):
As we wish the controls to represent, as closely as possible, the current standardised care in the United Kingdom, we will offer the control group a single education session provided by the young person's GP Practice nurse.

Assessment for control and intervention groups at 0, 13, 26, 52 weeks (follow up assessment). Anticipated end date of recruitment: May 2013.
Primary outcome measure(s) BMI (kg/m2), measured at 0, 13, 26, 52 weeks (follow up assessment)
Secondary outcome measure(s) 1. Health-related quality of life (HR-QOL) assessed using two measures (0, 26, 52 weeks)
2. Anthropometric measures (0, 13, 26, 52 weeks)
3. Psychological factors: Assess the impact of the intervention on psychological function and enable examination of pathways by which the intervention may influence QOL and BMI change (0, 26, 52 weeks)
4. Lifestyle (0, 26, 52 weeks)
5. Cardiometabolic risk factors (0, 26 weeks)
6. Health economic assessment data (0, 13, 26, 52 weeks)
Sources of funding National Institute for Health Research (NIHR) (UK) - Programme Grant for Applied Research (PGfAR) (ref: RP-PG-0608-10035)
Trial website
Publications 1. 2011 protocol in http://www.ncbi.nlm.nih.gov/pubmed/22088133
Contact name Ms  Anne  Mathiot
  Address 30 Guilford Street
  City/town London
  Zip/Postcode WC1N 1EH
  Country United Kingdom
  Email a.mathiot@ich.ucl.ac.uk
Sponsor Institute of Child Health (ICH) (UK)
  Address 30 Guilford Street
  City/town London
  Zip/Postcode WC1N 1EH
  Country United Kingdom
  Sponsor website: http://www.ucl.ac.uk/ich/homepage
Date applied 21/01/2011
Last edited 13/07/2012
Date ISRCTN assigned 21/01/2011
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