Obesity is one of the most common health conditions among autistic young people and its prevalence rises at faster rates for autistic-relative to non-autistic-individuals. This places them at heightened risk for cardiovascular disease (CVD) and mortality before they enter adulthood. Studies have identified three key contributing factors to CVD outcomes in autistic individuals: unhealthy lifestyle behaviors, Adverse Childhood Experiences (ACEs), and chronic stress. This study will explore the effectiveness of two CVD-focused primary care interventions for autistic individuals (ages 9-26): (1) lifestyle medicine consultations tailored towards supporting health-promoting behaviors; and (2) a Cognitive Behavioral Therapy (CBT) intervention tailored towards addressing chronic stress that contributes to excess weight and maladaptive eating behaviors and results in obesity and CVD. Participants and their caregivers will be randomly placed into either the Lifestyle Medicine Group, CBT Group, or combined Lifestyle Medicine with CBT Group. Participants will respond to questionnaires and surveys measuring lifestyle habits, stress, and psychological risk factors at their first visit, 6-month visit, and 3 months post-intervention visit. Over the course of 6 months, participants will attend virtual sessions (up to three times a month) in accordance with their intervention group.
Autistic individuals experience almost three times the mortality rate relative to non-autistic populations, and are disproportionately likely to experience obesity-with increasing rates beginning in childhood and adolescence-relative to both the general population and those with other developmental conditions. Obesity is one of the most common health conditions among autistic young people and its prevalence rises at faster rates for autistic-relative to non-autistic-individuals. This places them at heightened risk for cardiovascular disease (CVD) and mortality before they enter adulthood. Studies have identified three key contributing factors to CVD outcomes in autistic individuals: unhealthy lifestyle behaviors, Adverse Childhood Experiences (ACEs), and chronic stress. Taken together, this study addresses a critical gap in the field: lack of appropriate and effective healthcare/lifestyle interventions for autistic individuals with CVD and/or experiences of chronic stress that lead to obesity and poor cardiovascular health. These efforts require dedicated interventions selected for their impact on two key mechanisms underlying obesity and CVD: lifestyle and ACEs/chronic stress. This study will explore the effectiveness of two CVD-focused primary care interventions for autistic individuals (ages 9-26): (1) lifestyle medicine consultations tailored towards supporting health-promoting behaviors; and (2) a Cognitive Behavioral Therapy (CBT) intervention tailored towards addressing chronic stress that contributes to excess weight and maladaptive eating behaviors and results in obesity and CVD. Participants and their caregivers will be randomly placed into either the Lifestyle Medicine Group, CBT Group, or combined Lifestyle Medicine with CBT Group. Participants will respond to questionnaires and surveys measuring lifestyle habits, stress, and psychological risk factors at their first visit, 6-month visit, and 3 months post-intervention visit. Over the course of 6 months, participants will attend virtual sessions (up to three times a month) in accordance with their intervention group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
130
The intervention is a series of lifestyle medicine consultations.
The intervention is a series of CBT sessions.
Receives both Lifestyle Medicine and CBT interventions
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Los Angeles, California, United States
Behavior Assessment System for Children: Third Edition (BASC-3)
A series of instruments designed to help aid in the diagnosis and treatment of children, adolescents, and young adults between the ages of 2 and 25 - captures self- and/or caregiver reported psychological distress.
Time frame: Administered at Baseline, at final intervention visit (6-month mark), and 3-Months post-intervention.
American College of Lifestyle Medicine (ACLM) Nutrition in Action Diet Screener
Self- and/or caregiver reported diet, physical activity, sleep, stress, and motivation to change.
Time frame: Administered at Baseline, at final intervention visit (6-month mark), and 3-Months post-intervention.
Adverse Childhood Experiences Screener (PEARLS/ACEs)
Captures adverse childhood experiences.
Time frame: Administered at Baseline
General Nutrition Knowledge Questionnaire (GNKQ)
Captures general knowledge of nutrition and food groups.
Time frame: Administered at Baseline, at final intervention visit (6-month mark), and 3-Months post-intervention.
Project EAT-IV Survey
Self- and/or caregiver reported diet, physical activity, sleep, and stress.
Time frame: Administered at Baseline
Participant and Caregiver Survey
Addresses participant and caregiver experience in the study - captures acceptability and feasibility of intervention.
Time frame: Administered at final intervention visit (6-month mark).
Childhood Autism Rating Scale: Second Edition (CARS-2)
Identifies autism spectrum disorder (ASD) in children and the severity of their symptoms.
Time frame: Administered at Baseline
ASD DSM-5 Checklist
Captures diagnostic criterion from clinicians when used to diagnose Autism Spectrum Disorder.
Time frame: Administered at Baseline
Vineland Adaptive Behavioral Scales: Third Edition (Vineland-III)
Used to measure adaptive behaviors and aid in the diagnosis of intellectual and developmental disabilities.
Time frame: Administered at Baseline
Cardiovascular disease (CVD) indicators
Height (cm)
Time frame: Collected at Baseline, at final intervention visit (6-month mark), and 3-Months post-intervention.
Cardiovascular disease (CVD) indicators
Weight (kg)
Time frame: Collected at Baseline, at final intervention visit (6-month mark), and 3-Months post-intervention.
Cardiovascular disease (CVD) indicators
Waist circumference (cm)
Time frame: Collected at Baseline, at final intervention visit (6-month mark), and 3-Months post-intervention.
Cardiovascular disease (CVD) indicators
Blood pressure (mmHg)
Time frame: Collected at Baseline, at final intervention visit (6-month mark), and 3-Months post-intervention.
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