The use of smartphones to influence lifestyle changes in overweight and obese youth with congenital heart disease: a single-arm study: Pilot and feasibility study protocol: Smart Heart Trial

Meghan Rombeek, Stefanie De Jesus, Luis Altamirano-Diaz, Eva Welisch, Harry Prapavessis, Jamie A Seabrook, Kambiz Norozi, Meghan Rombeek, Stefanie De Jesus, Luis Altamirano-Diaz, Eva Welisch, Harry Prapavessis, Jamie A Seabrook, Kambiz Norozi

Abstract

Background: Both obesity and congenital heart disease (CHD) are risk factors for the long-term cardiovascular health of children and adolescents. The addition of smart mobile technology to conventional lifestyle counseling for weight management offers great potential to appeal to technologically literate youth and can address a large geographical area with minimal burden to participants. This pilot study seeks to examine the influence of a 1-year lifestyle intervention on nutrition and physical activity-related health outcomes in overweight or obese children and adolescents with CHD.

Methods: This is a pilot and feasibility study which utilizes a single-arm, prospective design with a goal to recruit 40 overweight and obese patients. The feasibility metrics will evaluate the integrity of the study protocol, data collection and questionnaires, recruitment and consent, and acceptability of the intervention protocol and primary outcome measures. The primary clinical outcome metrics are anthropometry, body composition, and cardiorespiratory exercise capacity. The secondary clinical metrics include quality of life, nutrition and physical activity behavior, lung and muscle function, and cardio-metabolic risk factors. Outcomes are assessed at baseline, 6 months, and 1 year. To date, a total of 36 children and youth (11 girls), aged 7-17 years (mean = 14.4 years), have commenced the intervention. Recruitment for the study was initiated in June 2012 and is currently ongoing.

Discussion: The information provided in this paper is intended to help researchers and health professionals with the development and evaluation of similar lifestyle intervention programs. Since the application of smartphones to pediatric cardiac health and obesity management is a novel approach, and continued research in this area is warranted, this paper may serve as a foundation for further exploration of this health frontier and inform the development of a broader strategy for obesity management in pediatric cardiology.

Trial registration: This pilot study was retrospectively registered at the www.ClinicalTrials.gov registry as NCT02980393 in November 2016, with the study commencing in May 2012. Study protocol version 15OCT2014.

Keywords: Adolescents; Children; Congenital heart disease; Lifestyle counseling; Nutrition; Physical activity; Smart mobile technology.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Health Science Research Ethics Board (REB#18843) at the University of Western Ontario. Participants who are 16 years of age or older are asked to sign the consent form prior to any study procedures being performed. For participants younger than 16 years of age, the parent or guardian are asked to provide consent. This study was retrospectively registered by Consent for publication

Participants gave informed consent to share anonymized data.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Schedule of enrolment, interventions, and assessments. The Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) diagram for the Smart Heart pilot study
Fig. 2
Fig. 2
Outline of the pilot study procedure from baseline to 12-month measures. The Smart Heart Trial included three assessments and spanned 12 months. The physical, metabolic, cardiovascular, and body composition outcome measures were taken for each subject upon study entry at baseline and at follow-up after 6 and 12 months. Nutrition and fitness counseling was performed by mobile phone once per week, with the nutrition and fitness counseling support alternating weeks (i.e., 25 counseling sessions for each for a total of 50 sessions)
Fig. 3
Fig. 3
Eight-year-old boy performing a two-leg jump on the Leonardo Mechanograph® platform

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