Development of palatable, effective health interventions that work: From design to policy.

I. Scientific excellence

This project will be supervised by a world-leading interdisciplinary team, which combines synergistic expertise in designing 'real-world' training interventions with state-of- the-art methods to measure skeletal muscle metabolic health (AW), micro-/macrovascular function (DT), physical activity in the home environment (RN) and psychosocial strategies to enhance motivation/adherence (PW).

II. Clear aim and hypothesis

Our aim is to establish the effectiveness of a novel lifestyle change intervention for adolescents who are obese (HOME-HIT). This is highly relevant, since extensive data exist to suggest obese adolescents remain obese throughout adulthood and older age and are subjected to increased morbidity and early mortality associated with type 2 diabetes, cardiovascular disease and cancer. To reduce later life ill-health, the Department of Health (2011) recommends adolescents to be physically active at moderate-to-vigorous intensity for 60-min/day. For obese adolescents this may be challenging due to physical and psychosocial barriers, preventing them from joining exercise and sports clubs. HOME-HIT involves low-impact, brief, interval exercise that can be done in individual's homes or local community venues. Pilot work revealed HOME-HIT may be more efficacious compared than traditional endurance training in adults. It is hypothesised that:

1) HOME-HIT will be more efficacious in improving metabolic and (micro-/macro-)vascular health compared to traditional endurance exercise training.
2) HOME-HIT, which includes behaviour change support, has superior exercise adherence and metabolic/vascular health benefits 6 months post-intervention compared with traditional training.

III. Methodology and innovations

The novel interdisciplinary approach combines world-class physiological research (AW, DT) with physical activity (RN) and behaviour change/intervention development expertise (PW) to develop an intervention that is both efficacious and ecologically valid for "real-world" implementation.

-In study 1, we will compare the efficacy of HOME-HIT (n=50) against traditional endurance training (n=50) in obese, sedentary adolescents in a randomised controlled trial. HOME-HIT involves ‘on the spot’ exercise using one's body weight to generate intermittent, high-intensity exercise bouts. To improve real-world implementation of HOME-HIT, we will co-produce (together with obese adolescents) a lifestyle change intervention that includes behaviour change support. Before and after 3-months HOME-HIT, we will examine insulin sensitivity as the primary parameter. Secondary measures are physical activity, maximal exercise capacity, mitochondrial/lipid droplet density, oxidative enzymes, capillary density, nitric oxide action, micro- (laser-Doppler) and macro-vascular function (flow-mediated dilation, carotid artery reactivity) and psychosocial outcomes.

-In study 2, we will explore the long-term effects of the co-produced HOME-HIT on exercise adherence, metabolic, physiological and psychological markers at 6-months post-intervention in both the HOME-HIT and traditional training groups.

IV. Strategic relevance

Adolescent obesity is a major concern since, due to the high cardiometabolic risk, this group is exposed to “accelerated ageing”. Whilst exercise training has multiple benefits, very little is known about the optimum form of exercise for (long-term) benefits in this group. By co-developing the novel HOME-HIT, our study has potential to produce long-term behavioural change to facilitate sustainable improvements in healthy lifestyles in obese adults. Targeting the lifestyle of adolescents is of special importance since adolescent lifestyle is the strongest predictor for lifestyle behaviour later in life.

V. Interdisciplinarity and fit with relevant DTA-programme

Interdisciplinarity. The interdisciplinary nature and synergistic knowledge of the supervision team mitigate risk for future implementation of HOME-HIT. Accordingly, this project likely leads to substantial clinical and social care benefits for the target population.
Fit DTA-programme. Healthy ageing is considered a process that starts at very young age, with adolescent lifestyle being the single, strongest predictor for lifestyle later in life. Targeting this group, especially given the cardiometabolic risk of this population, fits within ‘healthy ageing’.

Applications

Applicants must apply using the online form on the University Alliance website at https://unialliance.ac.uk/dta/cofund/how-to-apply/. Full details of the programme, eligibility details and a list of available research projects can be seen at https://unialliance.ac.uk/dta/cofund/

The final deadline for application is Monday 8 October 2018. There will be another opportunity to apply for DTA3 projects in the spring of 2019. The list of available projects is likely to change for the second intake.