Background: The Fast Track study was a 12-month intervention for adolescents living with obesity and associated complications. It consisted of a 4-week very low-energy diet, followed by an intermittent (IER) or continuous energy-restricted (CER) dietary plan with routine multidisciplinary support. This study aimed to explore adolescents, parents, and dietitians' perspectives of the intervention's acceptability.
Methods: A mixed-method evaluation using a convergent parallel study design was conducted. General acceptability questionnaires were collected at 16 and 52 weeks from adolescents (Week 16: n=113, Week 52: n=88) and parents (Week 16: n=108, Week 52: n=80). Semi-structured interviews were conducted with adolescents (n=14), parents (n=11), and dietitians (n=6) at 52 weeks. Data were analysed using descriptive statistics or thematic analysis. Findings were mapped to the Theoretical Framework of Acceptability.
Results: Quantitative findings identified no differences in adolescent ratings of enjoyability at week 16 [Mean (SD) rating out of 100 – IER: 61.2(24.1) vs. CER: 69.6(19.1), p=0.055] or 52 [IER: 67.2(18.1) vs. CER: 61.0(23.4), p=0.198)] between the IER and CER meal plans. The majority of parents reported benefits for their child at week 16 (IER: 86% Vs. CER: 93%, p=0.263) and week 52 (IER: 79% Vs. CER: 83%, p=0.717). Adolescents rated their experience with the dietitian positively. Qualitative findings highlighted novel perspectives on each dietary plan. Clear, practical dietary advice, easy and frequent access to regular dietitian/ multidisciplinary support, continuity of care, and meaningful family engagement influenced intervention acceptability.
Conclusions: The mixed-method evaluation suggested that both dietary patterns were acceptable to the target group. Tailoring the intervention to each adolescent's and family's needs and providing regular access to multidisciplinary support is necessary to enable lifestyle changes. Study findings provide valuable insights that can inform the development of acceptable specialist treatment options for adolescents seeking obesity treatment within tertiary care.