Short-Term Efficacy of an Innovative Mobile Phone Technology-Based Intervention for Weight Management for Overweight and Obese Adolescents: Pilot Study

Jyu-Lin Chen, Claudia M Guedes, Bruce A Cooper, Audrey E Lung, Jyu-Lin Chen, Claudia M Guedes, Bruce A Cooper, Audrey E Lung

Abstract

Background: In the United States, approximately one-third of adolescents are now overweight or obese, and one in six is obese. This financial cost and the larger nonfinancial costs of obesity make obesity prevention and management for adolescents imperative for the health of the nation. However, primary care visits are typically brief, and primary care providers may lack adequate resources to help overweight or obese adolescents to manage weight issues. To augment the efficacy of primary care visits for adolescent weight management, mobile phone technology can be used as an adjunct treatment that provides additional opportunities for encouraging improvement in lifestyle, attainment, and maintenance of healthy weight.

Objective: The purposes of this study were to (1) measure effects of an innovative mobile phone technology-based intervention for overweight and obese adolescents and to (2) examine the intervention's feasibility for use in primary care clinics.

Methods: The mobile phone-based intervention had three components: use of the Fitbit Flex, participation in an online educational program, and receipt of biweekly text messages during the maintenance phase. A randomized controlled study design was utilized. Data regarding anthropometrics (body mass index [BMI] and waist-to-hip ratio), blood pressure, levels of physical and sedentary activity, diet, and self-efficacy regarding physical activity and diet were collected at baseline and at 3 and 6 months after the baseline assessment.

Results: A total of 40 adolescents participated in the study. At the 6-month follow-up visit, compared to participants in the control group, the mobile phone-based intervention participants had significant improvement in BMI (z=-4.37, P=.001), diastolic blood pressure (z=-3.23, P=.001), physical activity days per week (z=2.58, P=.01), TV and computer time (z=-3.34, P=.001), servings of fruits and vegetables per day (z=2.74, P=.006), servings of soda and sweetened drinks (z=-3.19, P=.001), physical activity self-efficacy (z=2.75, P=.006), and dietary self-efficacy (z=5.05, P=.001). Medium to large effect sizes were found in these outcome variables.

Conclusions: The use of mobile technologies may offer a practical, reliable adjunct to weight management for overweight and obese adolescents in busy primary care clinics serving adolescents.

Trial registration: Clinicaltrials.gov Keywords: adolescent; mobile phone technology; obesity; randomized clinical trial; website.

Conflict of interest statement

Conflicts of Interest: None declared.

©Jyu-Lin Chen, Claudia M Guedes, Bruce A Cooper, Audrey E Lung. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 02.08.2017.

Figures

Figure 1
Figure 1
Pathway for Weight Management for Mobile phone-based intervention.
Figure 2
Figure 2
Study CONSORT flow diagram.

References

    1. Karnik S, Kanekar A. Childhood obesity: a global public health crisis. Int J Prev Med. 2012 Jan;3(1):1–7.
    1. Wilkosz ME, Chen J, Kennedy C, Rankin S. Gender and ethnic disparities contributing to overweight in California adolescents. Z Gesundh Wiss. 2010 Apr;18(2):131–144. doi: 10.1007/s10389-009-0300-7.
    1. Stevens J. Ethnic-specific revisions of body mass index cutoffs to define overweight and obesity in Asians are not warranted. Int J Obes Relat Metab Disord. 2003 Nov;27(11):1297–1299. doi: 10.1038/sj.ijo.0802417.
    1. Stevens J, Truesdale KP, Katz EG, Cai J. Impact of body mass index on incident hypertension and diabetes in Chinese Asians, American Whites, and American Blacks: the People's Republic of China Study and the Atherosclerosis Risk in Communities Study. Am J Epidemiol. 2008 Jun 01;167(11):1365–1374. doi: 10.1093/aje/kwn060.
    1. Lloyd L, Langley-Evans SC, McMullen S. Childhood obesity and adult cardiovascular disease risk: a systematic review. Int J Obes (Lond) 2010 Jan;34(1):18–28. doi: 10.1038/ijo.2009.61.
    1. Lloyd L, Langley-Evans SC, McMullen S. Childhood obesity and risk of the adult metabolic syndrome: a systematic review. Int J Obes (Lond) 2012 Jan;36(1):1–11. doi: 10.1038/ijo.2011.186.
    1. Rugg K. Childhood obesity: its incidence, consequences and prevention. Nurs Times. 2004;100(3):28–30.
    1. Griffiths L, Parsons TJ, Hill AJ. Self-esteem and quality of life in obese children and adolescents: a systematic review. Int J Pediatr Obes. 2010 Aug;5(4):282–304. doi: 10.3109/17477160903473697.
    1. Wang LY, Chyen D, Lee S, Lowry R. The association between body mass index in adolescence and obesity in adulthood. J Adolesc Health. 2008 May;42(5):512–518. doi: 10.1016/j.jadohealth.2007.10.010.
    1. Finkelstein EA, Graham WC, Malhotra R. Lifetime direct medical costs of childhood obesity. Pediatrics. 2014 May;133(5):854–862. doi: 10.1542/peds.2014-0063.
    1. Kitzmann K, Dalton WT, Stanley CM, Beech BM, Reeves TP, Buscemi J, Egli CJ, Gamble HL, Midgett EL. Lifestyle interventions for youth who are overweight: a meta-analytic review. Health Psychol. 2010 Jan;29(1):91–101. doi: 10.1037/a0017437.
    1. Whitlock E, O'Connor EA, Williams SB, Beil TL, Lutz KW. Effectiveness of weight management interventions in children: a targeted systematic review for the USPSTF. Pediatrics. 2010 Feb;125(2):e396–e418. doi: 10.1542/peds.2009-1955.
    1. Fukuoka Y, Komatsu J, Suarez L, Vittinghoff E, Haskell W, Noorishad T, Pham K. The mPED randomized controlled clinical trial: applying mobile persuasive technologies to increase physical activity in sedentary women protocol. BMC Public Health. 2011 Dec 14;11:933. doi: 10.1186/1471-2458-11-933.
    1. Shuger S, Barry VW, Sui X, McClain A, Hand GA, Wilcox S, Meriwether RA, Hardin JW, Blair SN. Electronic feedback in a diet- and physical activity-based lifestyle intervention for weight loss: a randomized controlled trial. Int J Behav Nutr Phys Act. 2011 May 18;8:41. doi: 10.1186/1479-5868-8-41.
    1. Greaves CJ, Sheppard KE, Abraham C, Hardeman W, Roden M, Evans PH, Schwarz P, IMAGE Study Group Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health. 2011 Feb 18;11:119. doi: 10.1186/1471-2458-11-119.
    1. Sim L, Lebow J, Wang Z, Koball A, Murad MH. Brief primary care obesity interventions: a meta-analysis. Pediatrics. 2016 Oct;138(4):1. doi: 10.1542/peds.2016-0149.
    1. Lenhart A. Pew Research Center. 2015. Apr 09, [2017-07-25]. Teens, social media & technology overview 2015
    1. Wickham CA, Carbone ET. Who's calling for weight loss? A systematic review of mobile phone weight loss programs for adolescents. Nutr Rev. 2015 Jun;73(6):386–398. doi: 10.1093/nutrit/nuu018.
    1. Chen J, Wilkosz ME. Efficacy of technology-based interventions for obesity prevention in adolescents: a systematic review. Adolesc Health Med Ther. 2014;5:159–170. doi: 10.2147/AHMT.S39969. doi: 10.2147/AHMT.S39969.
    1. Chaplais E, Naughton G, Thivel D, Courteix D, Greene D. Smartphone interventions for weight treatment and behavioral change in pediatric obesity: a systematic review. Telemed J E Health. 2015 Oct;21(10):822–830. doi: 10.1089/tmj.2014.0197.
    1. 5-2-1-0 Let's Go! 2015. [2017-07-25]. .
    1. Dolinsky DH, Armstrong SC, Kinra S. The clinical treatment of childhood obesity. Indian J Pediatr. 2013 Mar;80 Suppl 1:S48–S54. doi: 10.1007/s12098-012-0766-0.
    1. Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004 Apr;31(2):143–164. doi: 10.1177/1090198104263660.
    1. Bandura A. Human agency in social cognitive theory. Am Psychol. 1989 Sep;44(9):1175–1184.
    1. Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Upper Saddle River, NJ: Prentice Hall; 1986.
    1. Freedman D, Perry G. Body composition and health status among children and adolescents. Prev Med. 2000 Aug;31(2):S34–S53. doi: 10.1006/pmed.1998.0480. doi: 10.1006/pmed.1998.0480.
    1. McCarthy HD. Measuring growth and obesity across childhood and adolescence. Proc Nutr Soc. 2014 May;73(2):210–217. doi: 10.1017/S0029665113003868.
    1. Matheson DM, Killen JD, Wang Y, Varady A, Robinson TN. Children's food consumption during television viewing. Am J Clin Nutr. 2004 Jun;79(6):1088–1094.
    1. Edmundson E, Parcel GS, Feldman HA, Elder J, Perry CL, Johnson CC, Williston BJ, Stone EJ, Yang M, Lytle L, Webber L. The effects of the Child and Adolescent Trial for Cardiovascular Health upon psychosocial determinants of diet and physical activity behavior. Prev Med. 1996;25(4):442–454. doi: 10.1006/pmed.1996.0076.
    1. Lee EC, Whitehead AL, Jacques RM, Julious SA. The statistical interpretation of pilot trials: should significance thresholds be reconsidered? BMC Med Res Methodol. 2014 Mar 20;14:41. doi: 10.1186/1471-2288-14-41.
    1. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. New York: Psychology Press; 1988.
    1. Wu YP, Hommel KA. Using technology to assess and promote adherence to medical regimens in pediatric chronic illness. J Pediatr. 2014 Apr;164(4):922–927. doi: 10.1016/j.jpeds.2013.11.013.
    1. Majeed-Ariss R, Baildam E, Campbell M, Chieng A, Fallon D, Hall A, McDonagh JE, Stones SR, Thomson W, Swallow V. Apps and adolescents: a systematic review of adolescents' use of mobile phone and tablet apps that support personal management of their chronic or long-term physical conditions. J Med Internet Res. 2015 Dec 23;17(12):e287. doi: 10.2196/jmir.5043.
    1. Aldiss S, Taylor R, Soanes L, Maguire R, Sage M, Kearney N, Gibson F. Working in collaboration with young people and health professionals. A staged approach to the implementation of a randomised controlled trial. J Res Nurs. 2010 Sep 17;16(6):561–576. doi: 10.1177/1744987110380803. .
    1. Thompson D, Cullen KW, Boushey C, Konzelmann K. Design of a website on nutrition and physical activity for adolescents: results from formative research. J Med Internet Res. 2012 Apr 26;14(2):e59. doi: 10.2196/jmir.1889.

Source: PubMed

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