Pilot of Lifestyle Behavior Intervention for Non-Alcoholic Fatty Liver Disease

Change in physical activity as assessed by the Actigraph GT9X accelerometers

Moderate-vigorous physical activity counts during the 7-day period will be calculated by summing moderate and vigorous activity counts and then applying a logarithmic transformation to address skew.

Time frame: Baseline, 6 months after enrollment

Change in physical activity as assessed by the International Physical Activity Questionnaire

This is a 27-item self-reported measure of physical activity. The result is reported categorically in one of three categories as follows: Low/inactive - do not meet the criteria for moderate or high activity levels, Moderate - meet 1 of the following: A) 3 or more days with at least 30 minutes of moderate-intensity activity or walking; B) 5 or more days with at least 30 minutes of moderate-intensity activity or walking; C) 5 or more days of any combination of walking, moderate-intensity, or vigorous intensity activities with at least 600 metabolic equivalent of task (MET)-minutes per week. \[One MET is energy expenditure when at rest. For instance, 2 METs is twice the energy expended while at rest.\] and high - meet 1 of the following: A: 3 or more days of vigorous-intensity activity and at least 1500 MET-minutes per week; B) 7 days of any combination of walking, moderate-intensity or vigorous intensity activities with at least 3000 MET-minutes per week.

Time frame: Baseline, 6 months after enrollment

Change in diet as assessed by the School Physical Activity & Nutrition (SPAN) survey - Healthy foods index

The School Physical Activity and Nutrition (SPAN) questionnaire is a brief self-administered measure of dietary intake. The healthy foods index will be reported, and total score ranges from 0-50, with a higher score indicating more frequent intake of healthy foods.

Time frame: Baseline, 6 months after enrollment

Change in diet as assessed by the School Physical Activity & Nutrition (SPAN) survey - Unhealthy foods index

The School Physical Activity and Nutrition (SPAN) questionnaire is a brief self-administered measure of dietary intake. The unhealthy foods index will be reported, and total score ranges from 0-45, with a higher score indicating more frequent intake of unhealthy foods.

Time frame: Baseline, 6 months after enrollment

Change in alcohol use as assessed by the alcohol use disorders identification test (AUDITC)

alcohol use disorders identification test (AUDITC) is a 3 item measure and will give a general idea of how often participants are drinking alcohol and in what quantities

Time frame: Baseline, 6 months after enrollment

Change in social support for physical activity as assessed by the Social Support for Exercise scales

This scale has 13 items, each is scored from 1(none)-5(very often) and 8(does not apply), higher number indicating better social support

Time frame: Baseline, 6 months after enrollment

Change in social support for diet as assessed by the Social Support for Diet scales

This scale has 10 items each is scored from 1(none)-5(very often) and 8(does not apply)

Time frame: Baseline, 6 months after enrollment

Change in participant illness perception as assessed by the brief Illness Perception Questionnaire

This is a 9 item questionnaire. The first 8 questions are scored from 0-10 and the 9th question will ask the subject to list in rank-order the three most important factors that they believe caused their illness.

Time frame: Baseline, 6 months after enrollment

Change in perceived severity

Perceived severity will be measured with 2 adapted items that assess to what extent they believe fatty liver disease is a severe health problem and to what extent do they consider complications for fatty liver to be severe health problems. Participants respond on a scale of 1-5, with a higher number indicating a perception that NAFLD is extremely severe.

Time frame: Baseline, 6 months after enrollment

Change in Perceived treatment efficacy

Perceived treatment efficacy will be assessed with 8 items, also adapted from Glasgow et al.that assess the importance of four protective factors (weight loss, eating healthy, avoiding sweets, and physical activity) and the likeliness of those factors to prevent future complications from fatty liver disease. Participants respond on a scale of 1-5, with a higher number indicating higher confidence in NAFLD treatment .

Time frame: Baseline, 6 months after enrollment

Change in Stress as assessed by the 4 items Perceived Stress Scale

Each of the 4 items is scored form (never)-4(very often) with a highest score of 16,indicating more stress

Time frame: Baseline, 6 months after enrollment

Change in Depression as assessed by the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10)

This scale consists of 10 questions each one is scored form rarely or none of the time to all of the time.The total score is calculated by finding the sum of 10 items. Any score equal to or above 10 is considered depressed.

Time frame: Baseline, 6 months after enrollment

Change in Anxiety as assessed by the 7-item Generalized Anxiety Disorder (GAD-7) questionnaire.

This scale consists of 7 questions and each is scored form 0(not at all) to 3(nearly every day) for a maximum score of 21, a higher score indicating more anxiety

Time frame: Baseline, 6 months after enrollment