Work

Evaluation of a behavioral intervention to support adolescents undergoing bariatric surgery using the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework

Year: 2026

Type: article

Abstract: Severe obesity among adolescents in the United States is a major public health concern. While metabolic and bariatric surgery (MBS) is safe and effective for adolescents with severe obesity, no standardized lifestyle interventions are available to support MBS outcomes. TeenLyft, a 6-month behavioral support intervention adapted from the Diabetes prevention program, was provided to teens for peri-operative MBS care beginning four weeks before surgery. This study evaluated TeenLyft’s efficacy on improving weight-related behaviors using the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. Adolescents aged 13–18 years were recruited from a single tertiary care center MBS program. Participants enrolled in TeenLyft received online educational videos. The five RE-AIM dimensions were assessed independently using a mixed-methods approach. Data sources included baseline (pre-surgery), 3- and 6-month post-MBS follow-up data on anthropometric measures and cardiometabolic biomarkers, interviews, and electronic health records. Quantitative data provided descriptive statistics, and paired t-tests assessed within-subject changes over time to evaluate effectiveness. Qualitative data were thematically analyzed. For Reach, 76 adolescents enrolled in TeenLyft, 47 of whom did not complete MBS, and 29 (38.1%) completed MBS, with participants indicating the program structure and suitability were reasons for enrollment. In terms of effectiveness ( N = 29), older age was significantly associated with greater excess weight loss (EWL > 50%: 16.8 ± 0.7 vs. 15.3 ± 1.1 years, p = 0.0083), as was female sex ( p = 0.0062). As expected, weight and body mass index significantly decreased from pre-surgery to six months post-MBS (136.1 kg to 95.7 kg, p = 0.0001; BMI 48.3 to 33.3 kg/m 2 , p = 0.0001). Adolescents reported that the program supported their physical and emotional health and wanted more mental health-related content. Adoption was influenced by clinical staff involvement in recruitment, content development, and content alignment with adolescent needs. Implementatio n followed the outlined protocols with some additional adaptations to boost engagement via additional social media platforms. Maintenance showed most adolescents attended follow-up clinic visits at 6- and 12-month (83% and 67% respectively). Adolescents emphasized that the program provided education and skills to support post-operative weight management. The RE-AIM framework suggested that TeenLyft was a successful approach for providing behavioral support pre-and post-MBS. Additional benefits could be bolstered with support for mental health management. Trial Registration: NCT05393570.

Source: Scientific Reports

DOI: 10.1038/s41598-026-50810-w