Digital Health Interventions for Weight Management in Children and Adolescents: Systematic Review and Meta-analysis

Matina Kouvari, Melina Karipidou, Thomas Tsiampalis, Eirini Mamalaki, Dimitrios Poulimeneas, Eirini Bathrellou, Demosthenes Panagiotakos, Mary Yannakoulia, Matina Kouvari, Melina Karipidou, Thomas Tsiampalis, Eirini Mamalaki, Dimitrios Poulimeneas, Eirini Bathrellou, Demosthenes Panagiotakos, Mary Yannakoulia

Abstract

Background: Recent meta-analyses suggest the use of technology-based interventions as a treatment option for obesity in adulthood. Similar meta-analytic approaches for children are scarce.

Objective: The aim of this meta-analysis is to examine the effect of technology-based interventions on overweight and obesity treatment in children and adolescents.

Methods: A systematic literature search was performed using MEDLINE (PubMed), Scopus, and Cochrane Library for randomized clinical trials to identify interventional studies published between January 2000 and February 2021.

Results: In total, 9 manuscripts from 8 clinical trials of 582 children or adolescents were considered eligible. BMI, BMI z-score, and other BMI-related baseline metrics during and after intervention were considered as primary outcomes. In 7 of 8 studies, a technology-based intervention was applied in addition to conventional care. Of the 8 studies, 6 studies were conducted in the United States, 1 in Australia, and 1 in northwestern Europe. In total, 5 studies included adolescents, whereas the rest addressed children aged 9 to 12 years. Intervention duration ranged from 3 to 24 months. Significant differences between groups in BMI metric changes were reported by 5 of the 8 studies. Pooled analysis revealed an overall significant decrease in BMI metrics in the intervention group (standardized mean difference -0.61, 95% CI -1.10 to -0.13; P=.01). Subgroup analysis revealed that significance was lost in case of no parental involvement (standardized mean difference -0.36, 95% CI -0.83 to 0.11; P=.14). The small number of clinical trials found, the varying study quality, and the study heterogeneity are some limitations of this review.

Conclusions: The studies reported herein describe functional and acceptable technology-based approaches, in addition to conventional treatments, to enhance weight loss in young populations.

Keywords: childhood obesity; digital health; eHealth; mHealth; mobile phone; youth.

Conflict of interest statement

Conflicts of Interest: None declared.

©Matina Kouvari, Melina Karipidou, Thomas Tsiampalis, Eirini Mamalaki, Dimitrios Poulimeneas, Eirini Bathrellou, Demosthenes Panagiotakos, Mary Yannakoulia. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 14.02.2022.

Figures

Figure 1
Figure 1
Flow diagram describing the literature review process.
Figure 2
Figure 2
Results from the random effects meta-analysis concerning the effect of the technology-based interventions on BMI-related metrics according to the study follow-ups. In case of studies with multiple follow-ups, only the last follow-up time was considered for the estimation of the overall effect size.
Figure 3
Figure 3
Results from the subgroup analysis according to the parental involvement of the technology-based intervention concerning its effect on BMI-related metrics. In case of studies with multiple follow-ups, only the last follow-up time was considered for the estimation of the overall effect size.
Figure 4
Figure 4
Results from the subgroup analysis according to the type of the intervention concerning its effect on BMI-related metrics. In case of studies with multiple follow-ups, only the last follow-up time was considered for the estimation of the overall effect size.

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