PathMate2: The Impact of Health Information System Services on the Effects of Therapy in Overweight Teenagers (PM2)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Problem In Switzerland, 20% of children are overweight and novel methods are urgently needed to control the epidemic. Foundations of chronic diseases develop during childhood and track into adulthood obesity in more than 75% of patients, contributing to a significant increase in public health costs.
Multi-professional programs combining physical activity, nutritional and behavioral components have positive effects on therapy outcomes and co-morbidities, but these interventions induce high costs and are time-consuming for health providers, patients and families, in particular those living in rural regions. In fact, less than 0.2% of overweight children can participate in these programs. Thus, health information systems (HIS) have not only the potential to improve outcomes of obesity therapy but also to reduce health costs and increase access to health care in remote regions. Most HIS have indeed not been evaluated in this regard.
Preparation work In the PathMate project (SNF grant #135552), a mobile HIS has been developed for teenagers to support therapy and to prevent obesity in accordance with state-of-the-art multiprofessional programs and, in contrast to commercially available IT applications, with a high standard of data protection and safety. The IS effects of this HIS have been successfully evaluated in first longitudinal studies. In parallel, the impact of multi-professional therapies in Swiss children as well as potential confounders have been established in several longitudinal cohort studies with up to two-years follow-up.
Objectives
The overall goal of PathMate2 is to assess the impact of HIS services on the degree of obesity measured by the body mass index (BMI) incl. other health outcomes. Individual and shared understanding between patients and therapists are assessed as mediating factors. Specific goals are:
- to assess the effects of a child-friendly IT-mediated low-threshold intervention under the supervision of primary care providers and obesity experts, compared to expensive on-site consultations in highly specialized pediatric obesity centers
- to automatically capture and process obesity-related biosignals by smart sensors and use results for immediate feedback for the patients and medical providers based on permissions and communication patterns and
- to design evidence-based selfregulation interventions for teenager in their everyday life by coupling Neuro Information Systems (NeuroIS) services with Smart Health Sensors (SHS).
Methods HIS services are collaboratively developed by design-science research and evaluated by medical experts, patients, IS researcher and computer scientists. First, HIS services from PathMate are enhanced with SHS enabling real-time data analytics on mobile devices and results can be seen by both therapists and patients. Second, a randomized controlled trial (RCT) is conducted by a physician in a specialized pediatric obesity center in St. Gall with the goal to evaluate the effects of the re-designed and improved HIS services on adherence to therapy of the patient and his parents as well as on BMI and other health outcomes; a second RCT is conducted in parallel to assess the effects of these services in a community setting in the French-speaking part of Switzerland.
Importance and impact Building on the preliminary results of the PathMate project it is expected that the improved HIS services that are going to be designed and evaluated in PathMate2 have the potential for a significant impact on individual health and the quality of healthcare systems in general.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
Saint Gallen
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St. Gallen, Saint Gallen, Switzerland, 9006
- Ostschweizer Kinderspital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- obesity, BMI > P. 97 (Jenni et al., 2011) or overweight, BMI >P.90, plus risk factors or co-morbidity
- ability and parent's permission to use pre-configured study smartphones handed out to the children
- readiness to use the personal smartphone number and to spend the sum allocated exclusively for the study SMS during the 6 months of intervention
Exclusion Criteria:
- major somatic or psychiatric disease without adequate treatment,
- weight-relevant medication (antiepileptic drugs, methylphenhydate and similar medication),
- inability or lack of parent's or caregivers' permission to use a study smartphone with a mobile phone contract,
- lack of informed consent from children and parents and
- undue consumption of the amount allocated for study SMS for non-study purposes,
- overuse of smartphone e.g. without night beak for at least 8 hours.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Intervention SG
Therapy during 6 months with PathMate2 design.
6 therapy visits + PathMate2 over 6 months
|
To improve self-regulation of overweight adolescents and subsequently their weight status, we tested, whether a biofeedback relaxation exercise decreases stress and whether relaxation services as well as sensor data integration implemented in a novel Smartphone App supported intervention have effects on stress, physical activity and weight outcomes.
During the intensive phase of 6 months, patients of the intervention group (IG) are equipped with a smartphone and a specially designed chat App with game character, which encourages them through a virtual coach to achieve daily activity, healty lifestyle or relaxation challenges and earn virtual rewards, to increase adherance to the health information system.
Other Names:
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|
No Intervention: Control SG
Therapy during 6 months with usual care.
10 therapy visits over 6 months
|
|
|
Active Comparator: Intervention VD
Adapted sport session 1h/week + PathMate-S during 6 months
|
Overweight or obese adolescents of the treatment as-usual group (CG) have monthly visits on site during the intensive phase.
Counseling for physical activity, healthy eating and lifestyle as well as psychosocial wellbeing is provided by a pediatrician.
Other Names:
|
|
No Intervention: Control VD
Adapted sport session 1h/week during 6 months
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Body Mass Index
Time Frame: 12 months
|
Main outcome parameter is Body Mass Index, as BMI-SDS adjusted for gender & age.
Group size of 4*20 was based on an expected decrease by -0.23±0.02
(SDS, Mean±SD) after 1 year, from initially 2.88±0.7.
|
12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
fitness / physical capability
Time Frame: 12 months
|
Eurofit-test
|
12 months
|
|
fitness / physical activity
Time Frame: 12 months
|
accelerometry
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12 months
|
|
stress reduction, biological measure
Time Frame: 12 months
|
Cortisol levels in blood
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12 months
|
|
stress and arousal
Time Frame: 12 months
|
Self-Assessment Manikin (SAM) Scale
|
12 months
|
|
reduction of chronic stress
Time Frame: 12 months
|
Trierer Stress Inventar questionnaire (TICS)
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12 months
|
|
stress and arousal, biophysical measure
Time Frame: 12 months
|
skin conductance (Nexus 10)
|
12 months
|
|
well-being
Time Frame: 12 months
|
KIDSCREEN
|
12 months
|
|
waist circumference
Time Frame: 12 months
|
Waist-to-Height-ratio or SDS according to Fredricks 2005
|
12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Dagmar lAllemand, Prof. MD, Ostschweizer Kinderspital, St. Gallen, Switzerland
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2016-01965
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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