Promoting adolescent cardio-metabolic health through a psychological need-supportive online lifestyle intervention: a mixed-methods pilot and feasibility study

Abstract Purpose This study aimed to evaluate the feasibility, acceptability, and preliminary efficacy of a 12-week self-determination theory-centered online lifestyle intervention for Hispanic adolescents with obesity. Method Nineteen adolescents (intervention n = 11; control n = 8) participated in this study. The intervention consisted of two 60-min moderate-to-vigorous exercise sessions and one 30-min nutrition lesson delivered via Zoom each week for 12 weeks. Feasibility and acceptability outcomes included recruitment, retention, session attendance and adherence, intervention fidelity, perceived need support, and qualitative acceptability. Preliminary efficacy outcomes were examined using baseline-adjusted analyses of covariance, with adjusted between-group differences and 95% confidence interval ( CI ). Result Of 43 screened-eligible adolescents, 22 enrolled (51.2%), and 19 completed post-test assessments, yielding an overall retention rate of 86.4%. Among intervention completers, mean attendance was 73.1% for exercise sessions and 74.3% for nutrition sessions. Fidelity measures indicated moderate-to-vigorous exercise intensity and high perceived need-support, and qualitative findings supported program acceptability and feasibility. Exploratory analyses showed baseline-adjusted between-group differences favoring the intervention for body mass index (adjusted difference = − 0.89 kg/m 2 , 95% CI [− 1.55, − 0.23]), abdominal muscular endurance and strength (adjusted difference = 14.28 curl-ups, 95% CI [6.23, 22.33]), and physical activity level (adjusted difference = 0.74, 95% CI [0.23, 1.25]). Conclusion This online lifestyle intervention demonstrated feasibility and acceptability and has the potential to promote cardio-metabolic health in adolescents. Further evaluation is needed to determine whether these promising feasibility signals translate into sustained health benefits in a fully powered randomized trial.