Methods/design
This is a 2x5 repeated-measures, RCT design. Families are randomly assigned to either PAC or PWL. All adolescents participate in the 4-month TEENS+ protocol. This trial is modeled after our pilot and designed to test its efficacy in a fully powered trial over 1-year follow-up. Assessments are conducted at 0, 2, 4, 8 and 12 months. The primary dependent variable of interest is adolescent ΔBMI at 12 months (ΔBMISPIRIT schedule of enrolment, intervention, and assessments for the TEENS+ randomized clinical trial