Table 2.

Cognitive adaptations in the ACHIEVE intervention

Self-monitoring	-Tracker: participants mark fruits/vegetables, sugar drinks, junk food, smart portions, smart snacks and exercise. Detailed food and calorie log not required so complexity of recording is simplified. -Weigh-in one time per week during the intensive phase, and once per month during the maintenance phase. Frequent weigh-ins provide opportunity for reinforcement and repetition.
Group weight-management sessions	-Highly structured, emphasis on behavioral rehearsal. -Material taught in small content units. Frequent meetings (1 session per week during the intensive phase, 1 session per month during the maintenance phase) allow repetition of concepts. -Program materials are written at 5th-8th grade reading level. -Hands-on activities emphasized. Taste testing, label reading, portion measuring. - Role-playing emphasized. Practicing saying no to junk food, or choosing smarter portions at a birthday party. Increases self-efficacy to adhere to healthier eating habits. -Worksheets review topic of the week.
Individual sessions	-Allow for individualized cognitive tailoring as needed. -Opportunity to emphasize an individualized high impact behavior based upon the concepts learned in groups.
Physical activity classes	-Provide opportunity for modeling and building physical activity skills in supportive setting to increase cardiovascular fitness and exercise self efficacy
Environmental prompts	-Refrigerator magnets, preprinted grocery lists, watches, water bottle, measuring cups, lunch bag as reminders to be used at home.
Reinforcements	-Participation is rewarded with varying levels of gifts relative to the number of classes attended.