Colby J. Kipp

Date of Award

Summer 2023

Document Type

Open Access Dissertation



First Advisor

Dawn K. Wilson


African American adolescents in the United States experience a higher prevalence of obesity as compared to their White counterparts. This health inequity presents a public health concern as consequences of weight-related chronic diseases often persist into adulthood and are increasingly problematic. As chronic stress has been found to be higher among African American youth compared to White adolescents, it presents as a potential barrier to participation for African American families in health promotion interventions. Additionally, it may be beneficial to target stress in health promotion programs as a modifiable factor in conjunction with health behaviors that may improve outcomes related to weight-related health. The current study evaluated the feasibility and implementation of the Project LEADS pilot trial (“Linking Exercise for Advancing Daily Stress Management”), a 10-week family-based intervention that integrates stress management and health behavior components to improve adolescent BMI and adolescent well-being by addressing parent and adolescent stress as a fundamental intervention essential element. The intervention incorporated stress management components using a relapse prevention framework with The Families Improving Together (FIT) for weight loss randomized controlled trial, which incorporated behavioral strategies and positive parenting techniques to reduce body mass index (BMI) and improve physical activity (PA) and diet in African American adolescents. Feasibility elements of acceptability, likability, comprehension, and engagement of adolescents and their caregivers were assessed using survey-based assessments. Additionally, process evaluation elements of reach (proportion of intended audience receiving the intervention), dose (completeness of implementation), and fidelity (the extent to which essential elements were delivered as planned) were assessed. Results indicate preliminary support for the feasibility and acceptability of the LEADS behavioral health program. Caregiver and adolescent ratings indicated satisfaction with the unique intervention components (i.e., stress management, coping, racial socialization) and overall enjoyment of the virtual group atmosphere. High dose and fidelity indicate that the intervention was delivered as intended. A larger trial and a longer follow-up period would allow for adequate testing of the intervention efficacy on various health outcomes and an in-depth exploration of key theoretical mediators that may be successful in promoting health behavior change in this population. Furthermore, this research fosters innovative implementation processes for future intervention programs in medical and community settings to address health inequities among African American adolescents and their families.