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Dakin M, Omorou AY, Guillemin F. Effectiveness of interventions to reduce social inequalities of weight status in adolescents: A systematic review and meta-analysis. Obes Rev 2024; 25:e13752. [PMID: 38644206 DOI: 10.1111/obr.13752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/29/2024] [Accepted: 03/19/2024] [Indexed: 04/23/2024]
Abstract
Many interventions are implemented in the public health context to overcome social inequalities of weight status in adolescents, but their effectiveness is challenged. This study aimed to examine the effectiveness of these interventions with a systematic review and meta-analysis. We systematically searched for reports of randomized control trials and quasi-experimental studies aiming to reduce social inequalities of weight status in adolescents in five electronic databases. The primary outcomes were social inequalities in weight-related outcomes (body mass index [BMI], BMI z score, waist circumference, percent body fat, prevalence of overweight/obesity). Interventions were effective when they reduced social inequalities in at least one weight-related outcome. Meta-analyses involved using random-effects models. The review included 38 publications (33 studies) with interventions mostly targeting disadvantaged adolescents (n = 29 studies), showing effectiveness in half of the studies (n = 19/33, 57.6%). The meta-analysis (27 studies) revealed that targeted interventions significantly reduced BMI z score (β = -0.04 [95% CI -0.08, -0.01]), BMI (β = -0.32 [-0.47, -0.18]), and waist circumference (β = -0.84 [-1.48, -0.21]) but not percent body fat (β = -0.27 [-0.71, 0.17]) or prevalence of overweight/obesity (odds ratio = 1.06 [0.85, 1.31]). This review shows moderate effectiveness of interventions targeting disadvantaged adolescents to reduce social inequalities of weight status. High-quality research with better implementation to reach their full potential is required to strengthen their effectiveness.
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Affiliation(s)
- Mohamed Dakin
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
| | - Abdou Yacoubou Omorou
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
- Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy, France
| | - Francis Guillemin
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
- Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy, France
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Nguyen A, Yu F, Park LG, Fukuoka Y, Wong C, Gildengorin G, Nguyen TT, Tsoh JY, Jih J. An App-Based Physical Activity Intervention in Community-Dwelling Chinese-, Tagalog-, and Vietnamese-Speaking Americans: Single-Arm Intervention Study. JMIR Form Res 2024; 8:e56373. [PMID: 38857065 PMCID: PMC11196906 DOI: 10.2196/56373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/08/2024] [Accepted: 04/04/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Physical inactivity is associated with adverse health outcomes among Asian Americans, who exhibit the least adherence to physical activity guidelines compared with other racial and ethnic groups. Mobile app-based interventions are a promising approach to promote healthy behaviors. However, there is a lack of app-based interventions focused on improving physical activity among Asian Americans whose primary language is not English. OBJECTIVE This pilot study aimed to assess the feasibility and acceptability of a 5-week intervention using a culturally and linguistically adapted, evidence-based mobile phone app with an accelerometer program, to promote physical activity among Chinese-, Tagalog-, or Vietnamese-speaking Americans. METHODS Participants were recruited through collaborations with community-based organizations. The intervention was adapted from a 12-month physical activity randomized controlled trial involving the app and accelerometer for English-speaking adults. Sociodemographic characteristics, lifestyle factors, and physical measurements were collected at the baseline visit. A 7-day run-in period was conducted to screen for the participants who could wear a Fitbit One (Fitbit LLC) accelerometer and complete the app's daily step diary. During the 4-week intervention period, participants wore the accelerometer and reported their daily steps in the app. Participants also received daily messages to reinforce key contents taught during an in-person educational session, remind them to input steps, and provide tailored feedback. Feasibility measures were the percentage of eligible participants completing the run-in period and the percentage of participants who used the app diary for at least 5 out of 7 days during the intervention period. We conducted poststudy participant interviews to explore overall intervention acceptability. RESULTS A total of 19 participants were enrolled at the beginning of the study with a mean age of 47 (SD 13.3; range 29-70) years, and 58% (n=11) of them were female. Of the participants, 26% (n=5) were Chinese, 32% (n=6) were Vietnamese, and 42% (n=8) were Filipino. All participants met the run-in criteria to proceed with the intervention. Adherence to the app diary ranged from 74% (n=14) in week 2 to 95% (n=18) in week 4. The daily average steps per week from accelerometers increased each week from 8451 (SD 3378) steps during the run-in period to 10,930 (SD 4213) steps in week 4. Participants reported positive experiences including an increased motivation to walk and the enjoyment of being able to monitor their physical activity. CONCLUSIONS This is the first pilot study of a multicomponent intervention and evidence-based mobile phone app to promote physical activity among Asian Americans who use apps in traditional Chinese, Tagalog, or Vietnamese, which demonstrated high feasibility and acceptability. Future work focused on multilingual mobile apps to address disparities in physical inactivity among Asian Americans should be considered.
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Affiliation(s)
- Antony Nguyen
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
- Asian American Research Center on Health, San Francisco, CA, United States
| | - Filmer Yu
- Asian American Research Center on Health, San Francisco, CA, United States
| | - Linda G Park
- Department of Community Health Systems, University of California San Francisco, San Francisco, CA, United States
| | - Yoshimi Fukuoka
- Asian American Research Center on Health, San Francisco, CA, United States
- Department of Physiological Nursing, University of California San Francisco, San Francisco, CA, United States
| | - Ching Wong
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Ginny Gildengorin
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Tung T Nguyen
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, United States
- Asian American Research Center on Health, San Francisco, CA, United States
- Multiethnic Health Equity Research Center, University of California San Francisco, San Francsico, CA, United States
| | - Janice Y Tsoh
- Asian American Research Center on Health, San Francisco, CA, United States
- Multiethnic Health Equity Research Center, University of California San Francisco, San Francsico, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Jane Jih
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, United States
- Asian American Research Center on Health, San Francisco, CA, United States
- Multiethnic Health Equity Research Center, University of California San Francisco, San Francsico, CA, United States
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Alkhatib A, Obita G. Childhood Obesity and Its Comorbidities in High-Risk Minority Populations: Prevalence, Prevention and Lifestyle Intervention Guidelines. Nutrients 2024; 16:1730. [PMID: 38892662 PMCID: PMC11175158 DOI: 10.3390/nu16111730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
The prevalence of childhood obesity and its associated comorbidities is a growing global health problem that disproportionately affects populations in low- and middle-income countries (LMICs) and minority ethnicities in high-income countries (HICs). The increased childhood obesity disparities among populations reflect two concerns: one is HICs' ineffective intervention approaches in terms of lifestyle, nutrition and physical activity in minority populations, and the second is the virtually non-existent lifestyle obesity interventions in LMICs. This article provides guidelines on childhood obesity and its comorbidities in high-risk minority populations based on understanding the prevalence and effectiveness of preventative lifestyle interventions. First, we highlight how inadequate obesity screening by body mass index (BMI) can be resolved by using objective adiposity fat percentage measurements alongside anthropometric and physiological components, including lean tissue and bone density. National healthcare childhood obesity prevention initiatives should embed obesity cut-off points for minority ethnicities, especially Asian and South Asian ethnicities within UK and USA populations, whose obesity-related metabolic risks are often underestimated. Secondly, lifestyle interventions are underutilised in children and adolescents with obesity and its comorbidities, especially in minority ethnicity population groups. The overwhelming evidence on lifestyle interventions involving children with obesity comorbidities from ethnic minority populations shows that personalised physical activity and nutrition interventions are successful in reversing obesity and its secondary cardiometabolic disease risks, including those related to cardiorespiratory capacity, blood pressure and glucose/insulin levels. Interventions combining cultural contextualisation and better engagement with families are the most effective in high-risk paediatric minority populations but are non-uniform amongst different minority communities. A sustained preventative health impact can be achieved through the involvement of the community, with stakeholders comprising healthcare professionals, nutritionists, exercise science specialists and policy makers. Our guidelines for obesity assessment and primary and secondary prevention of childhood obesity and associated comorbidities in minority populations are fundamental to reducing global and local health disparities and improving quality of life.
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Affiliation(s)
- Ahmad Alkhatib
- College of Life Sciences, Birmingham City University, City South Campus, Edgbaston, Birmingham B15 3TN, UK
- School of Health and Life Sciences, Teesside University, Tees Valley, Middlesbrough TS1 3BX, UK;
| | - George Obita
- School of Health and Life Sciences, Teesside University, Tees Valley, Middlesbrough TS1 3BX, UK;
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Wang JW, Zhu Z, Shuling Z, Fan J, Jin Y, Gao ZL, Chen WD, Li X. Effectiveness of mHealth App-Based Interventions for Increasing Physical Activity and Improving Physical Fitness in Children and Adolescents: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth 2024; 12:e51478. [PMID: 38687568 PMCID: PMC11094610 DOI: 10.2196/51478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 02/11/2024] [Accepted: 03/14/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly reduced physical activity (PA) levels and increased sedentary behavior (SB), which can lead to worsening physical fitness (PF). Children and adolescents may benefit from mobile health (mHealth) apps to increase PA and improve PF. However, the effectiveness of mHealth app-based interventions and potential moderators in this population are not yet fully understood. OBJECTIVE This study aims to review and analyze the effectiveness of mHealth app-based interventions in promoting PA and improving PF and identify potential moderators of the efficacy of mHealth app-based interventions in children and adolescents. METHODS We searched for randomized controlled trials (RCTs) published in the PubMed, Web of Science, EBSCO, and Cochrane Library databases until December 25, 2023, to conduct this meta-analysis. We included articles with intervention groups that investigated the effects of mHealth-based apps on PA and PF among children and adolescents. Due to high heterogeneity, a meta-analysis was conducted using a random effects model. The Cochrane Risk of Bias Assessment Tool was used to evaluate the risk of bias. Subgroup analysis and meta-regression analyses were performed to identify potential influences impacting effect sizes. RESULTS We included 28 RCTs with a total of 5643 participants. In general, the risk of bias of included studies was low. Our findings showed that mHealth app-based interventions significantly increased total PA (TPA; standardized mean difference [SMD] 0.29, 95% CI 0.13-0.45; P<.001), reduced SB (SMD -0.97, 95% CI -1.67 to -0.28; P=.006) and BMI (weighted mean difference -0.31 kg/m2, 95% CI -0.60 to -0.01 kg/m2; P=.12), and improved muscle strength (SMD 1.97, 95% CI 0.09-3.86; P=.04) and agility (SMD -0.35, 95% CI -0.61 to -0.10; P=.006). However, mHealth app-based interventions insignificantly affected moderate to vigorous PA (MVPA; SMD 0.11, 95% CI -0.04 to 0.25; P<.001), waist circumference (weighted mean difference 0.38 cm, 95% CI -1.28 to 2.04 cm; P=.65), muscular power (SMD 0.01, 95% CI -0.08 to 0.10; P=.81), cardiorespiratory fitness (SMD -0.20, 95% CI -0.45 to 0.05; P=.11), muscular endurance (SMD 0.47, 95% CI -0.08 to 1.02; P=.10), and flexibility (SMD 0.09, 95% CI -0.23 to 0.41; P=.58). Subgroup analyses and meta-regression showed that intervention duration was associated with TPA and MVPA, and age and types of intervention was associated with BMI. CONCLUSIONS Our meta-analysis suggests that mHealth app-based interventions may yield small-to-large beneficial effects on TPA, SB, BMI, agility, and muscle strength in children and adolescents. Furthermore, age and intervention duration may correlate with the higher effectiveness of mHealth app-based interventions. However, due to the limited number and quality of included studies, the aforementioned conclusions require validation through additional high-quality research. TRIAL REGISTRATION PROSPERO CRD42023426532; https://tinyurl.com/25jm4kmf.
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Affiliation(s)
- Jun-Wei Wang
- School of Sport Medicine and Health, Chengdu Sport University, Chengdu, China
- School of Sports Science, Beijing Sport University, Beijing, China
| | - Zhicheng Zhu
- Physical education institute, Xinyu University, Xinyu, China
| | - Zhang Shuling
- School of Sport Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Jia Fan
- School of Sport Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Yu Jin
- School of Sport Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Zhan-Le Gao
- School of Sport Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Wan-Di Chen
- Academic Administration, Chengdu Sport University, Chengdu, China
| | - Xue Li
- School of Sport Medicine and Health, Chengdu Sport University, Chengdu, China
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Pushpa BS, Abdul Latif SN, Sharbini S, Murang ZR, Ahmad SR. Nutrition education and its relationship to body image and food intake in Asian young and adolescents: a systematic review. Front Nutr 2024; 11:1287237. [PMID: 38585614 PMCID: PMC10995287 DOI: 10.3389/fnut.2024.1287237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/21/2024] [Indexed: 04/09/2024] Open
Abstract
Background The literature brings to light the unhealthy nutritional habits prevalent among Asian adolescents and their high level of body image dissatisfaction. This study aims to conduct a systematic review of the literature on the effect of nutritional education interventions on their nutritional knowledge and food intake behavior, attitude, practice, and body image. Methods We searched relevant published studies in PubMed, Web of Science, Scopus, Science Direct, and Springer using the PICO framework and performed a quality assessment using the 10-point checklist adapted from the National Institutes for Health tool. Results The majority of the nutritional education interventions improve unhealthy food intake and body image misperception, particularly on nutritional knowledge/self-efficacy, healthy dietary habits, physical activities, and fruit and vegetable intake. We also found a negative association with excess weight gain, obesity, and unethical weight reduction practices, leading to dissatisfaction with body image. Conclusion These interventions can help address dietary problems and body image perception and support the development of future interventions.
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Affiliation(s)
| | | | - Sharimawati Sharbini
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei
| | | | - Siti Rohaiza Ahmad
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei
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Metzendorf MI, Wieland LS, Richter B. Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity. Cochrane Database Syst Rev 2024; 2:CD013591. [PMID: 38375882 PMCID: PMC10877670 DOI: 10.1002/14651858.cd013591.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
BACKGROUND Obesity is considered to be a risk factor for various diseases, and its incidence has tripled worldwide since 1975. In addition to potentially being at risk for adverse health outcomes, people with overweight or obesity are often stigmatised. Behaviour change interventions are increasingly delivered as mobile health (m-health) interventions, using smartphone apps and wearables. They are believed to support healthy behaviours at the individual level in a low-threshold manner. OBJECTIVES To assess the effects of integrated smartphone applications for adolescents and adults with overweight or obesity. SEARCH METHODS We searched CENTRAL, MEDLINE, PsycINFO, CINAHL, and LILACS, as well as the trials registers ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform on 2 October 2023 (date of last search for all databases). We placed no restrictions on the language of publication. SELECTION CRITERIA Participants were adolescents and adults with overweight or obesity. Eligible interventions were integrated smartphone apps using at least two behaviour change techniques. The intervention could target physical activity, cardiorespiratory fitness, weight loss, healthy diet, or self-efficacy. Comparators included no or minimal intervention (NMI), a different smartphone app, personal coaching, or usual care. Eligible studies were randomised controlled trials of any duration with a follow-up of at least three months. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodology and the RoB 2 tool. Important outcomes were physical activity, body mass index (BMI) and weight, health-related quality of life, self-efficacy, well-being, change in dietary behaviour, and adverse events. We focused on presenting studies with medium- (6 to < 12 months) and long-term (≥ 12 months) outcomes in our summary of findings table, following recommendations in the core outcome set for behavioural weight management interventions. MAIN RESULTS We included 18 studies with 2703 participants. Interventions lasted from 2 to 24 months. The mean BMI in adults ranged from 27 to 50, and the median BMI z-score in adolescents ranged from 2.2 to 2.5. Smartphone app versus no or minimal intervention Thirteen studies compared a smartphone app versus NMI in adults; no studies were available for adolescents. The comparator comprised minimal health advice, handouts, food diaries, smartphone apps unrelated to weight loss, and waiting list. Measures of physical activity: at 12 months' follow-up, a smartphone app compared to NMI probably reduces moderate to vigorous physical activity (MVPA) slightly (mean difference (MD) -28.9 min/week (95% confidence interval (CI) -85.9 to 28; 1 study, 650 participants; moderate-certainty evidence)). We are very uncertain about the results of estimated energy expenditure and cardiorespiratory fitness at eight months' follow-up. A smartphone app compared with NMI probably results in little to no difference in changes in total activity time at 12 months' follow-up and leisure time physical activity at 24 months' follow-up. Anthropometric measures: a smartphone app compared with NMI may reduce BMI (MD of BMI change -2.6 kg/m2, 95% CI -6 to 0.8; 2 studies, 146 participants; very low-certainty evidence) at six to eight months' follow-up, but the evidence is very uncertain. At 12 months' follow-up, a smartphone app probably resulted in little to no difference in BMI change (MD -0.1 kg/m2, 95% CI -0.4 to 0.3; 1 study; 650 participants; moderate-certainty evidence). A smartphone app compared with NMI may result in little to no difference in body weight change (MD -2.5 kg, 95% CI -6.8 to 1.7; 3 studies, 1044 participants; low-certainty evidence) at 12 months' follow-up. At 24 months' follow-up, a smartphone app probably resulted in little to no difference in body weight change (MD 0.7 kg, 95% CI -1.2 to 2.6; 1 study, 245 participants; moderate-certainty evidence). A smartphone app compared with NMI may result in little to no difference in self-efficacy for a physical activity score at eight months' follow-up, but the results are very uncertain. A smartphone app probably results in little to no difference in quality of life and well-being at 12 months (moderate-certainty evidence) and in little to no difference in various measures used to inform dietary behaviour at 12 and 24 months' follow-up. We are very uncertain about adverse events, which were only reported narratively in two studies (very low-certainty evidence). Smartphone app versus another smartphone app Two studies compared different versions of the same app in adults, showing no or minimal differences in outcomes. One study in adults compared two different apps (calorie counting versus ketogenic diet) and suggested a slight reduction in body weight at six months in favour of the ketogenic diet app. No studies were available for adolescents. Smartphone app versus personal coaching Only one study compared a smartphone app with personal coaching in adults, presenting data at three months. Two studies compared these interventions in adolescents. A smartphone app resulted in little to no difference in BMI z-score compared to personal coaching at six months' follow-up (MD 0, 95% CI -0.2 to 0.2; 1 study; 107 participants). Smartphone app versus usual care Only one study compared an app with usual care in adults but only reported data at three months on participant satisfaction. No studies were available for adolescents. We identified 34 ongoing studies. AUTHORS' CONCLUSIONS The available evidence is limited and does not demonstrate a clear benefit of smartphone applications as interventions for adolescents or adults with overweight or obesity. While the number of studies is growing, the evidence remains incomplete due to the high variability of the apps' features, content and components, which complicates direct comparisons and assessment of their effectiveness. Comparisons with either no or minimal intervention or personal coaching show minor effects, which are mostly not clinically significant. Minimal data for adolescents also warrants further research. Evidence is also scarce for low- and middle-income countries as well as for people with different socio-economic and cultural backgrounds. The 34 ongoing studies suggest sustained interest in the topic, with new evidence expected to emerge within the next two years. In practice, clinicians and healthcare practitioners should carefully consider the potential benefits, limitations, and evolving research when recommending smartphone apps to adolescents and adults with overweight or obesity.
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Affiliation(s)
- Maria-Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Bernd Richter
- Institute of General Practice, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Gangachin SE, Bayrami R, Rahimi B, Masudi S. Smartphone-based educational and counseling interventions for women with high body mass index at Urmia's health centers. BMC Womens Health 2024; 24:8. [PMID: 38166804 PMCID: PMC10763417 DOI: 10.1186/s12905-023-02807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 11/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND AND PURPOSE Overweight and obesity in women of reproductive age not only contribute to chronic diseases but also lead to fertility issues, adverse pregnancy outcomes, and psychological challenges. Among the detrimental behaviors associated with obesity, the consumption of fast foods and sedentary lifestyles have the most significant impact on weight gain and require effective interventions. This study aims to examine the effectiveness of an educational and counseling smartphone intervention in raising awareness and modifying behaviors related to sedentary behavior and fast food consumption in women with high body mass index. MATERIALS AND METHODS This randomized controlled trial was conducted with two parallel groups comprising 106 women of reproductive age who sought assistance at Urmia health centers in 2022. Participants with diverse social and economic backgrounds were included. They were randomly assigned to either a control group or an intervention group. Valid and reliable questionnaires were administered to assess awareness regarding sedentary behaviors and fast foods consumption, as well as engagement in sedentary behaviors and consumption of fast foods. In addition to standard care, the intervention group received educational and counseling sessions through a dedicated smartphone application. Data analysis was performed using SPSS 20 software at a significance level of P < 0.05. FINDINGS The results of a statistical t-test indicated a noteworthy disparity between the control and intervention groups concerning the average awareness scores related to fast foods consumption (P < 0.001) and sedentary behaviors (P < 0.001) before and 3 months after the intervention. Additionally, a substantial statistical difference was observed in the mean consumption of fast foods (P < 0.001) and hours of sedentary behaviors (P < 0.001) before and 3 months after the intervention when comparing the two groups. CONCLUSION Educational and counseling programs, when applied effectively, can serve the dual purpose of enhancing awareness concerning sedentary behaviors and fast foods consumption while concurrently fostering a reduction in the prevalence of these behaviors. The study was registered in the Iranian Registry of Clinical Trials (IRCT Id: IRCT20210722051953N1) at 04/08/2021.
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Affiliation(s)
- Sayeh Ebrahimi Gangachin
- Graduate, Department of Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Roghieh Bayrami
- Reproductive Health Research Center, Clinical Research Institute, Department of Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
| | - Bahlol Rahimi
- Department of Health Information Technology, School of Allied Medical Sciences, Urmia University of Medical Sciences, Urmia, Iran
| | - Sima Masudi
- Department of Epidemiology and Biostatistics, School of Medicine, Urmia University of Medical Science, Urmia, Iran
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Ezike C, Da Silva K. Technology-Based Interventions to Reduce Sugar-Sweetened Beverages among Adolescents: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7101. [PMID: 38063531 PMCID: PMC10706072 DOI: 10.3390/ijerph20237101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023]
Abstract
This scoping review investigates the effectiveness of technology-based interventions in reducing sugar-sweetened beverage (SSB) consumption among adolescents. The rise in SSB consumption among young individuals has become a global public health concern due to its association with obesity, diabetes, and various other health problems. The purpose of this scoping review is to map out and examine the various technology-based interventions used in reducing sugar-sweetened beverages among children and adolescents. A systematic search of three databases using the PRISMA guideline was followed, and 474 articles were retrieved. Seven articles met the inclusion criteria and the critical appraisal using the critical appraisal skill program (CASP). The seven articles underwent both descriptive and thematic analysis. Four technology-based interventions were identified from the selected articles, which include smartphone apps, online or web-based tools, text messages, and social marketing strategies. Our findings suggest that these interventions hold promise in improving adolescents' eating patterns and health outcomes associated with SSB intake, highlighting their potential as useful strategies in resolving this urgent public health concern.
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Affiliation(s)
- Chidinma Ezike
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Keith Da Silva
- College of Dentistry, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada;
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Obita G, Alkhatib A. Effectiveness of Lifestyle Nutrition and Physical Activity Interventions for Childhood Obesity and Associated Comorbidities among Children from Minority Ethnic Groups: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:nu15112524. [PMID: 37299488 DOI: 10.3390/nu15112524] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
Lifestyle physical activity (PA) and nutrition are known to be effective interventions in preventing and managing obesity-related comorbidities among adult populations but less so among children and adolescents. We examined the effectiveness of lifestyle interventions in children from minority ethnic populations in Western high-income countries (HICs). Our systematic review included 53 studies, involving 26,045 children from minority ethnic populations who followed lifestyle intervention programmes lasting between 8 weeks and 5 years with the aim of preventing and/or managing childhood obesity and associated comorbidities, including adiposity and cardiometabolic risks. The studies were heterogenous in terms of lifestyle intervention components (nutrition, PA, behavioural counselling) and settings (community vs. schools and after-school settings). Our meta-analysis included 31 eligible studies and showed no significant effects of lifestyle interventions when they focused on body mass index (BMI) outcomes (pooled BMI mean change = -0.09 (95% CI = -0.19, 0.01); p = 0.09). This was irrespective of the intervention programme duration (<6 months vs. ≥6 months), type (PA vs. nutrition/combined intervention) and weight status (overweight or obese vs. normal weight) as all showed nonsignificant effects in the sensitivity analysis. Nonetheless, 19 of the 53 studies reported reductions in BMI, BMI z-score and body fat percentage. However, the majority of lifestyle interventions adopting a quasi-design with combined primary and secondary obesity measures (11 out of 15 studies) were effective in reducing the obesity comorbidities of cardiometabolic risks, including metabolic syndrome, insulin sensitivity and blood pressure, in overweight and obese children. Preventing childhood obesity in high-risk ethnic minority groups is best achieved using combined PA and nutrition intervention approaches, which jointly target preventing obesity and its comorbidities, especially the outcomes of diabetes, hypertension and cardiovascular disease. Therefore, public health stakeholders should integrate cultural and lifestyle factors and contextualise obesity prevention strategies among minority ethnic groups in Western HICs.
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Affiliation(s)
- George Obita
- School of Health and Life Sciences, Teesside University, Tees Valley, Middlesbrough TS1 3BX, UK
| | - Ahmad Alkhatib
- School of Health and Life Sciences, Teesside University, Tees Valley, Middlesbrough TS1 3BX, UK
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10
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Chee W, Kim S, Jang M, Im EO. Lessons from a Customer Discovery Study: a Technology-Based Cancer Support Program for Asian American Breast Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:248-254. [PMID: 34704170 PMCID: PMC9205581 DOI: 10.1007/s13187-021-02107-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE A culturally tailored technology-based cancer support program was recently developed and tested among Asian American breast cancer survivors. To explore future opportunities to sustain the program, the research team participated in the SPeeding Research-tested INTervention (SPRINT) program sponsored by the National Cancer Institute. The purpose of this discussion paper is to share the lessons that the research team gained from a customer discovery study through the SPRINT program. METHODS During the SPRINT program, a total of 73 stakeholders were recruited through a snowball sampling across the globe. Semi-structured interviews were conducted for customer discovery through WebEX, phone calls, and in-person visits (50 in-person interviews, 4 phone interviews, and 19 WebEx interviews). All the interviews were recorded using audio-taping or writing memos. Also, the research team wrote memos on the issues/concerns related to the project during the interview process. Then, the transcripts and memos were analyzed using a content analysis to provide evidence for the lessons. RESULTS The themes reflecting the lessons from the customer discovery study included (a) "who are the stakeholders"; (b) "depending on stakeholders"; (c) "what works or not"; (d) "personal versus family responsibilities"; and (e) "depending on countries' situations." CONCLUSION These lessons could provide directions for future development and implementation of technology-based cancer support programs for Asian American breast cancer survivors.
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Affiliation(s)
- Wonshik Chee
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
| | - Sangmi Kim
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
| | - Mia Jang
- Health & Wellness Innovations, Inc, Ann Arbor, USA
| | - Eun-Ok Im
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA.
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11
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Jiang Q, Ma L, Yue M. Animation Narrative on Stress Relief and Psychological Cognitive Development in Adolescents. Occup Ther Int 2022; 2022:1111488. [PMID: 36101670 PMCID: PMC9463020 DOI: 10.1155/2022/1111488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 11/18/2022] Open
Abstract
As the atmosphere of domestic animation is getting stronger and stronger in recent years, its proportion in the process of public aesthetics, entertainment, and consumption is increasing; thus, the relationship between the audience and works has become an important academic focus. The theatrical animation in the animation industry has become the category that needs to be focused on and changed in the development process of domestic animation because of its characteristics of receiving attention from all-age audiences. Because of the diversified audience levels faced by theatrical animation, it is particularly difficult to coordinate the needs of each audience level, coupled with the long-term influence of Japanese and American animation; the trend of pop culture led by network culture; the inheritance, excavation, and reconstruction of national culture; and other cultural environment and creative thinking intertwined, making the construction of the independence of domestic animation appear more and more difficult. The purpose of this paper is to analyze the theoretical study of the healing elements of Natsume Yojimbo and to analyze the creation of Chinese traditional ink and wash in the creation of our own works. It is concluded that the thematic choices are based on two categories: emotions and dreams, which focus on personal life experience and universal concern for human life. The character construction is divided into three aspects: self-resistance and self-reflection, self-vision and self-actualization, and traumatic experience and self-rescue to explain the complexity and diversity of the characters' growth connotation. The narrative perspective constitutes the perspective from which the issues are viewed. The omniscient perspective allows for the coexistence of complex character relationships and a clear storyline, while the limited perspective reveals certain emotional tendencies. The narrative mode presents the moral of the text with cause-and-effect narrative, embellished group narrative, and dreamlike polyphony narrative. Finally, the article discusses the realistic dilemma of the growth narrative of domestic online animation and tries to put forward feasible development suggestions in response to the problems at this stage.
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Affiliation(s)
- Qian Jiang
- Art Institute of Xiangtan University, Xiangtan, Hunan 411105, China
| | - Li Ma
- Art Institute of Xiangtan University, Xiangtan, Hunan 411105, China
| | - Min Yue
- The First People's Hospital of Xiangtan City, Xiangtan, Hunan 411100, China
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12
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Dobbie LJ, Tahrani A, Alam U, James J, Wilding J, Cuthbertson DJ. Exercise in Obesity-the Role of Technology in Health Services: Can This Approach Work? Curr Obes Rep 2022; 11:93-106. [PMID: 34791611 PMCID: PMC8597870 DOI: 10.1007/s13679-021-00461-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Physical activity (PA) is an important strategy to prevent and treat obesity. Electronic health (eHealth) interventions, such as wearable activity monitors and smartphone apps, may promote adherence to regular PA and successful weight loss. This review highlights the evidence for eHealth interventions in promoting PA and reducing weight. RECENT FINDINGS Wearables can increase PA and are associated with moderate weight loss in middle/older-aged individuals, with less convincing effects long-term (> 1 year) and in younger people. Data for interventions such as mobile phone applications, SMS, and exergaming are less robust. Investigations of all eHealth interventions are often limited by complex, multi-modality study designs, involving concomitant dietary modification, making the independent contribution of each eHealth intervention on body weight challenging to assess. eHealth interventions may promote PA, thereby contributing to weight loss/weight maintenance; however, further evaluation is required for this approach to be adopted into routine clinical practice.
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Affiliation(s)
- Laurence J. Dobbie
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Abd Tahrani
- Institute of Metabolism and Systems, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
- Department of Diabetes and Endocrinology, Birmingham Heartlands Hospital, Birmingham, UK
| | - Uazman Alam
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Jennifer James
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - John Wilding
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Daniel J. Cuthbertson
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
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13
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Baumann H, Fiedler J, Wunsch K, Woll A, Wollesen B. mHealth Interventions to Reduce Physical Inactivity and Sedentary Behavior in Children and Adolescents: Systematic Review and Meta-analysis of Randomized Controlled Trials. JMIR Mhealth Uhealth 2022; 10:e35920. [PMID: 35544294 PMCID: PMC9133983 DOI: 10.2196/35920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/15/2022] [Accepted: 03/23/2022] [Indexed: 12/29/2022] Open
Abstract
Background
Children and adolescents increasingly do not meet physical activity (PA) recommendations. Hence, insufficient PA (IPA) and sedentary behavior (SB) among children and adolescents are relevant behavior change domains for using individualized mobile health (mHealth) interventions.
Objective
This review and meta-analysis investigated the effectiveness of mHealth interventions on IPA and SB, with a special focus on the age and level of individualization.
Methods
PubMed, Scopus, Web of Science, SPORTDiscus, and Cochrane Library were searched for randomized controlled trials published between January 2000 and March 2021. mHealth interventions for primary prevention in children and adolescents addressing behavior change related to IPA and SB were included. Included studies were compared for content characteristics and methodological quality and summarized narratively. In addition, a meta-analysis with a subsequent exploratory meta-regression examining the moderating effects of age and individualization on overall effectiveness was performed.
Results
On the basis of the inclusion criteria, 1.3% (11/828) of the preliminary identified studies were included in the qualitative synthesis, and 1.2% (10/828) were included in the meta-analysis. Trials included a total of 1515 participants (mean age (11.69, SD 0.788 years; 65% male and 35% female) self-reported (3/11, 27%) or device-measured (8/11, 73%) health data on the duration of SB and IPA for an average of 9.3 (SD 5.6) weeks. Studies with high levels of individualization significantly decreased insufficient PA levels (Cohen d=0.33; 95% CI 0.08-0.58; Z=2.55; P=.01), whereas those with low levels of individualization (Cohen d=−0.06; 95% CI −0.32 to 0.20; Z=0.48; P=.63) or targeting SB (Cohen d=−0.11; 95% CI −0.01 to 0.23; Z=1.73; P=.08) indicated no overall significant effect. The heterogeneity of the studies was moderate to low, and significant subgroup differences were found between trials with high and low levels of individualization (χ21=4.0; P=.04; I2=75.2%). Age as a moderator variable showed a small effect; however, the results were not significant, which might have been because of being underpowered.
Conclusions
Evidence suggests that mHealth interventions for children and adolescents can foster moderate reductions in IPA but not SB. Moreover, individualized mHealth interventions to reduce IPA seem to be more effective for adolescents than for children. Although, to date, only a few mHealth studies have addressed inactive and sedentary young people, and their quality of evidence is moderate, these findings indicate the relevance of individualization on the one hand and the difficulties in reducing SB using mHealth interventions on the other.
Trial Registration
PROSPERO CRD42020209417; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209417
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Affiliation(s)
- Hannes Baumann
- Department of Human Movement, Faculty of Psychology and Human Movement Science, University of Hamburg, Hamburg, Germany
- Department of Biological Psychology and Neuroergonomics, Institute for Psychology and Occupational Science, Technical University Berlin, Berlin, Germany
- Department of Performance, Neuroscience, Therapy and Health, Faculty of Health Sciences, Medical School Hamburg, Hamburg, Germany
| | - Janis Fiedler
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Kathrin Wunsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Bettina Wollesen
- Department of Human Movement, Faculty of Psychology and Human Movement Science, University of Hamburg, Hamburg, Germany
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14
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Alotaibi M, Alnajjar F, Cappuccio M, Khalid S, Alhmiedat T, Mubin O. Efficacy of Emerging Technologies to Manage Childhood Obesity. Diabetes Metab Syndr Obes 2022; 15:1227-1244. [PMID: 35480851 PMCID: PMC9037732 DOI: 10.2147/dmso.s357176] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/13/2022] [Indexed: 11/23/2022] Open
Abstract
Childhood obesity is a widespread medical condition and presents a formidable challenge for public health. Long-term treatment strategies and early prevention strategies are required because obese children are more likely to carry this condition into adulthood, increasing their risk of developing other major health disorders. The present review analyses various technological interventions available for childhood obesity prevention and treatment. It also examines whether machine learning and technological interventions can play vital roles in its management. Twenty-six studies were shortlisted for the review using various technological strategies and analysed regarding their efficacy. While most of the selected studies showed positive outcomes, there was a lack of studies using robots and artificial intelligence to manage obesity in children. The use of machine learning was observed in various studies, and the integration of social robots and other efficacious strategies may be effective for treating childhood obesity in the future.
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Affiliation(s)
- Mohammad Alotaibi
- Faculty of Computers and Information Technology, University of Tabuk, Tabuk, Saudi Arabia
| | - Fady Alnajjar
- College of Information Technology, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Massimiliano Cappuccio
- School of Engineering and IT, University of New South Wales Canberra, Canberra, Australia
| | - Sumaya Khalid
- College of Information Technology, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Tareq Alhmiedat
- Faculty of Computers and Information Technology, University of Tabuk, Tabuk, Saudi Arabia
- Industrial Innovation & Robotics Center, University of Tabuk, Tabuk, Saudi Arabia
| | - Omar Mubin
- School of Computer, Data and Mathematical Sciences, Western Sydney University, Sydney, Australia
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15
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Pawellek S, Ziegeldorf A, Wulff H. [Strategies and effects of digital interventions in overweight and obesity treatments in children and adolescents-a systematic review]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:624-634. [PMID: 35320378 PMCID: PMC9064867 DOI: 10.1007/s00103-022-03512-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/18/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Rising obesity prevalence in childhood and adolescence are characterized by unhealthy lifestyles such as low physical activity due to high media use. Recent studies use the accessibility of this target group through digital media, whereby technologies represent new approaches in the intervention design of weight reduction. However, the question arises as to which digital combinations and methodological program concepts condition effective body mass index (BMI) changes. AIM To gain insights into effective program design and media use; digital intervention strategies for BMI reduction in overweight and obese children and adolescents will be analyzed and evaluated. METHODS A systematic review was conducted in the databases MEDLINE via PubMed, Science Direct, and Web of Science to analyze studies from 2016 to 2021 on changes in BMI and BMI z‑score of overweight and obese 6‑ to 18-year-olds. Methodological study quality was assessed according to the Cochrane Risk of Bias guidelines. RESULTS From 3974 studies, seven articles describing the use of fitness wristbands, smartphones, and computer-based programs were identified. All media achieved BMI reductions, with smartphone interventions via calls and messages causing the most significant changes. DISCUSSION Smartphones as providers of digital programs (e.g., apps) offer effective approaches to obesity reduction. Based on the data, the selection and combination of several media as well as the relevance of family involvement and the methodological foundation of the measures are confirmed. Due to the young age of the participants, media interventions must be made accessible to the target group.
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Affiliation(s)
- Sabine Pawellek
- Institut für Gesundheitssport und Public Health, Universität Leipzig, Jahnallee 59, 04109, Leipzig, Deutschland.
| | - Alexandra Ziegeldorf
- Institut für Gesundheitssport und Public Health, Universität Leipzig, Jahnallee 59, 04109, Leipzig, Deutschland
| | - Hagen Wulff
- Gesundheitserziehung/Gesundheitsbildung, Universität Potsdam, Potsdam, Deutschland
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16
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Karataş N, Kaya A, İşler Dalgıç A. The effectiveness of user-focused mobile health applications in paediatric chronic disease management: A systematic review. J Pediatr Nurs 2022; 63:e149-e156. [PMID: 34598848 DOI: 10.1016/j.pedn.2021.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 11/19/2022]
Abstract
PROBLEM This systematic review aims to evaluate the effectiveness of user-focused mobile health (mHealth) applications in paediatric chronic disease management. ELIGIBILITY CRITERIA Articles were included under the Population Intervention Comparator Outcome Study (PICOS) design framework for (P) children with a chronic disease, (I) mHealth user-focused apps, (C) usual care/control groups, (O) health outcomes related to chronic diseases, and (S) randomised controlled trials. This study followed the guidelines provided by Cochrane, Preferred Reporting Items for Systematic Reviews and Meta-Analysis, and Mobile Health Evidence Reporting and Assessment. SAMPLE A comprehensive literature search screening was conducted via CINAHL, PubMed, CENTRAL, ELSEVIER, SAGE, Science Direct, Scopus, Taylor Francis, WoS, and IEEE XPLORE from inception to November 15, 2020. RESULTS The review included seven articles, which combined provided data for a total of 755 children. The effects of the mHealth applications on the investigated 31 unique outcomes of five chronic paediatric diseases were mixed, ranging from effective to no effect. The risk of bias in the included studies was mostly either high or concerning according to Risk of Bias tool 2.0. The mobile apps that were evaluated were not standalone apps but were designed to interact with and provide data to healthcare providers. CONCLUSION Some mHealth interventions in this systematic review produced clinically meaningful and statistically relevant reductions in health outcomes related to chronic disease management. However, based on the available data, it is not possible to make definitive conclusions concerning the preferred target population of the interventions. IMPLICATION mHealth apps may be beneficial in improving selected patient outcomes in chronic disease management. Our results may assist the digital health services of hospitals, paediatric nurses who are interested in mHealth, and children who have a chronic disease.
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Affiliation(s)
- Nimet Karataş
- Pediatric Nursing Department, Faculty of Nursing, Akdeniz University Antalya, Turkey.
| | - Ayla Kaya
- Pediatric Nursing Department, Faculty of Nursing, Akdeniz University Antalya, Turkey.
| | - Ayşegül İşler Dalgıç
- Pediatric Nursing Department, Faculty of Nursing, Akdeniz University Antalya, Turkey.
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17
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Kouvari M, Karipidou M, Tsiampalis T, Mamalaki E, Poulimeneas D, Bathrellou E, Panagiotakos D, Yannakoulia M. Digital Health Interventions for Weight Management in Children and Adolescents: Systematic Review and Meta-analysis. J Med Internet Res 2022; 24:e30675. [PMID: 35156934 PMCID: PMC8887634 DOI: 10.2196/30675] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/10/2021] [Accepted: 09/22/2021] [Indexed: 12/15/2022] Open
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.
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Affiliation(s)
- Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.,Faculty of Health, University of Canberra, Canberra, Australia
| | - Melina Karipidou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Thomas Tsiampalis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Dimitrios Poulimeneas
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Eirini Bathrellou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.,Faculty of Health, University of Canberra, Canberra, Australia
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
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18
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Okoniewski W, Sundaram M, Chaves-Gnecco D, McAnany K, Cowden JD, Ragavan M. Culturally Sensitive Interventions in Pediatric Primary Care Settings: A Systematic Review. Pediatrics 2022; 149:184573. [PMID: 35098300 PMCID: PMC9645707 DOI: 10.1542/peds.2021-052162] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 02/03/2023] Open
Abstract
CONTEXT Culturally sensitive interventions in the pediatric primary care setting may help reduce health disparities. Less is known on the development of these interventions, their target groups, and their feasibility, acceptability, and impact on health outcomes. OBJECTIVE We conducted a systematic review to describe culturally sensitive interventions developed for the pediatric primary care setting. DATA SOURCES PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo (January 2000 to July 2020). STUDY SELECTION Studies were eligible for inclusion if they were (1) original research on an intervention with an evaluation, (2) within a pediatric primary care setting, (3) not limited to education for providers, (4) not limited to interpreter use, and (5) based in the United States. DATA EXTRACTION The following were extracted: study topic, study design, intervention, cultural sensitivity strategies and terminology, setting, target group, sample size, feasibility, acceptability, and health outcomes. RESULTS Twenty-five studies described 23 interventions targeting a variety of health topics. Multiple cultural sensitivity strategies were used, most commonly sociocultural (83%). Most interventions (57%) were focused on Hispanic/Latino families. Interventions were generally reported as being feasible and acceptable; some also changed health outcomes. LIMITATIONS Small samples and heterogenous methods subject to bias were used. Relevant articles may have been missed because of the variety of terms used to describe cultural sensitivity. CONCLUSIONS The included articles provide preliminary evidence that culturally sensitive interventions can be feasible and effective and may help eliminate disparities for patients from communities with barriers to equitable care.
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Affiliation(s)
- William Okoniewski
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania,Lehigh Valley Reilly Children’s Hospital, Allentown, Pennsylvania,Address correspondence to William Okoniewski, MD, Lehigh Valley Reilly Children’s Hospital, 1200 S Cedar Crest Blvd, Allentown, PA 18105. E-mail:
| | | | | | - Katie McAnany
- Division of General Academic Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri
| | - John D. Cowden
- Division of General Academic Pediatrics,Division of General Academic Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri
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19
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Azevedo LB, Stephenson J, Ells L, Adu-Ntiamoah S, DeSmet A, Giles EL, Haste A, O'Malley C, Jones D, Chai LK, Burrows T, Collins CE, van Grieken A, Hudson M. The effectiveness of e-health interventions for the treatment of overweight or obesity in children and adolescents: A systematic review and meta-analysis. Obes Rev 2022; 23:e13373. [PMID: 34747118 DOI: 10.1111/obr.13373] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/20/2021] [Accepted: 09/17/2021] [Indexed: 12/13/2022]
Abstract
The aim of this systematic review and meta-analysis was to examine the effectiveness of e-health interventions for the treatment of children and adolescents with overweight or obesity. Databases were searched up to November 2020. Studies were randomized controlled trials where interventions were delivered via e-health (e.g., computers, tablets, and smartphones, but not phone calls). Studies should target the treatment of overweight or obesity in children or their agent of changes and report body mass index (BMI) or BMI z-score. A meta-analysis using a random-effects model was conducted. Nineteen studies met the inclusion criteria, and 60% were of high quality. The narrative review revealed variation in behavior change strategies and modes of delivery. The pooled mean reduction in BMI or BMI z-score showed evidence for a nonzero effect (standardized mean difference = -0.31, 95% confidence interval -0.49 to -0.13), with moderately high heterogeneity between studies (I2 = 74%, p < 0.001). Subgroup analysis revealed high heterogeneity in studies with a high or unclear risk of bias. E-health interventions can be effective in treating children and adolescents with overweight and obesity and should be considered by practitioners and policymakers. However, an understanding of the most effective and acceptable intervention components, long-term benefits, and sustainability should be further studied.
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Affiliation(s)
- Liane B Azevedo
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - John Stephenson
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Louisa Ells
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK
| | | | - Ann DeSmet
- Faculty of Psychological and Educational Sciences, Université libre de Bruxelles, Brussels, Belgium.,Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Emma L Giles
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Anna Haste
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Claire O'Malley
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Daniel Jones
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Li Kheng Chai
- Health and Wellbeing Queensland, Queensland Government, Brisbane, Queensland, Australia.,School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, NSW, Australia.,Hunter Medical Research Institute, Rankin Park, New South Wales, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, NSW, Australia.,Hunter Medical Research Institute, Rankin Park, New South Wales, Australia
| | - Amy van Grieken
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Michelle Hudson
- Middlesbrough 0-19 Service (Healthier Together), Harrogate and District NHS Foundation Trust, Harrogate, UK
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20
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Li B, Gao S, Bao W, Li M. Effectiveness of lifestyle interventions for treatment of overweight/obesity among children in China: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2022; 13:972954. [PMID: 36387871 PMCID: PMC9659900 DOI: 10.3389/fendo.2022.972954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 10/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pediatric obesity has become a global public health problem. China has the largest population of obese children in the world. It is important to develop effective interventions to control child obesity. This systematic review summarizes proof from randomized controlled trials to assess the efficacy of lifestyle intervention to reduce BMI and metabolic risk factors for overweight/obese Chinese children. METHODS We searched studies from five databases (PubMed, MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and CNKI). Research that meets the following requirements was included: randomized controlled trials, participants are overweight/obese Chinese children aged <18 years old, and the effectiveness of lifestyle interventions is evaluated. RESULTS Eight randomized controlled trials were included. A significant difference was found between the intervention group and the control group for the BMI changes (mean difference = -1.49; 95% CI: -2.20 to -0.77; p < 0.001). Subgroup analyses consistently demonstrated that effects of lifestyle interventions on BMI change including multiple-component interventions (mean difference = -2.03 kg/m2; 95% CI: -3.62 to -0.43; p < 0.001) were stronger than those only with physical activities or health education; effects of lifestyle interventions on BMI change were also strengthened if duration of intervention last for more than 1 year (mean difference = -3.03 kg/m2; 95% CI: -4.00 to -2.06; p = 0.01) or with age during 12-18 years old (mean difference = -1.90 kg/m2; 95% CI: -3.37 to -0.43; p < 0.001). CONCLUSIONS Lifestyle interventions are effective in reducing BMI in Chinese children with overweight/obesity, and the effectiveness is more profound when the lifestyle intervention includes multiple components, lasts longer than one year, and/or is conducted among teens. These findings provide an important evidence base for developing and implementing potentially effective lifestyle interventions for the treatment of overweight/obesity among Chinese children.
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Affiliation(s)
- Bo Li
- Department of Endocrinology, National Health Commission (NHC) Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Shan Gao
- Department of Endocrinology, Xuanwu Hospital, Capital Medical University, Beijing, China
- *Correspondence: Ming Li, ; Shan Gao,
| | - Wei Bao
- Institute of Public Health, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Ming Li
- Department of Endocrinology, National Health Commission (NHC) Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Ming Li, ; Shan Gao,
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Qiu LT, Sun GX, Li L, Zhang JD, Wang D, Fan BY. Effectiveness of multiple eHealth-delivered lifestyle strategies for preventing or intervening overweight/obesity among children and adolescents: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2022; 13:999702. [PMID: 36157474 PMCID: PMC9491112 DOI: 10.3389/fendo.2022.999702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the effect of multiple eHealth-delivered lifestyle interventions on obesity-related anthropometric outcomes in children and adolescents. METHODS The Medline (via PubMed), Embase, Cochrane Library, Web of Science, CBM, VIP, CNKI, and Wanfang electronic databases were systematically searched from their inception to March 18, 2022, for randomized controlled trials (RCTs). Meta-analyses were performed to investigate the effect of multiple eHealth-delivered lifestyle interventions on obesity-related anthropometric outcomes (body mass index [BMI], BMI Z-score, waist circumference, body weight, and body fat%). Two independent investigators reviewed the studies for accuracy and completeness. All included studies were evaluated using the Cochrane Risk-of-Bias (ROB) Tool. RESULTS Forty trials comprising 6,403 patients were selected for the meta-analysis. The eligible trials were published from 2006 to 2022. Compared with the control group, the eHealth-intervention group was more effective in reducing BMI (weighted mean difference [WMD] = -0.32, 95% confidence interval [CI]: -0.50 to -0.13, I2 = 85.9%), BMI Z-score (WMD = -0.08, 95% CI: -0.14 to -0.03, I2 = 89.1%), waist circumference (WMD = -0.87, 95% CI: -1.70 to -0.04, I2 = 43.3%), body weight (WMD = -0.96, 95% CI: -1.55 to -0.37, I2 = 0.0%), and body fat% (WMD = -0.59, 95% CI: -1.08 to -0.10, I2 = 0.0%). The subgroup analysis showed that parental or school involvement (WMD = -0.66, 95% CI: -0.98 to -0.34), eHealth-intervention duration of >12 weeks (WMD = -0.67, 95% CI: -0.96 to -0.38), and mobile-based interventions (WMD = -0.78, 95% CI: -1.13 to -0.43) had a significantly greater intervention effect size on BMI. CONCLUSIONS This review recommends that multiple eHealth-delivered lifestyle strategies may be useful for preventing or treating overweight and obesity among children and adolescents. However, our results should be cautiously interpreted due to certain limitations in our study.
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Affiliation(s)
- Li-Ting Qiu
- The College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Gui-Xiang Sun
- The College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China
- Provincial Key Laboratory of Traditional Chinese Medicine (TCM) Diagnostics, Hunan University of Chinese Medicine, Changsha, China
- Institute of Chinese Medicine Diagnosis, Hunan University of Chinese Medicine, Changsha, China
- *Correspondence: Gui-Xiang Sun, ; Ling Li,
| | - Ling Li
- The College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China
- *Correspondence: Gui-Xiang Sun, ; Ling Li,
| | - Ji-Dong Zhang
- The College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Dan Wang
- School of Physical Education and Health, Hunan University of Technology and Business, Changsha, China
| | - Bo-Yan Fan
- The College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China
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Jones A, Armstrong B, Weaver RG, Parker H, von Klinggraeff L, Beets MW. Identifying effective intervention strategies to reduce children's screen time: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2021; 18:126. [PMID: 34530867 PMCID: PMC8447784 DOI: 10.1186/s12966-021-01189-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/12/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Excessive screen time ([Formula: see text] 2 h per day) is associated with childhood overweight and obesity, physical inactivity, increased sedentary time, unfavorable dietary behaviors, and disrupted sleep. Previous reviews suggest intervening on screen time is associated with reductions in screen time and improvements in other obesogenic behaviors. However, it is unclear what study characteristics and behavior change techniques are potential mechanisms underlying the effectiveness of behavioral interventions. The purpose of this meta-analysis was to identify the behavior change techniques and study characteristics associated with effectiveness in behavioral interventions to reduce children's (0-18 years) screen time. METHODS A literature search of four databases (Ebscohost, Web of Science, EMBASE, and PubMed) was executed between January and February 2020 and updated during July 2021. Behavioral interventions targeting reductions in children's (0-18 years) screen time were included. Information on study characteristics (e.g., sample size, duration) and behavior change techniques (e.g., information, goal-setting) were extracted. Data on randomization, allocation concealment, and blinding was extracted and used to assess risk of bias. Meta-regressions were used to explore whether intervention effectiveness was associated with the presence of behavior change techniques and study characteristics. RESULTS The search identified 15,529 articles, of which 10,714 were screened for relevancy and 680 were retained for full-text screening. Of these, 204 studies provided quantitative data in the meta-analysis. The overall summary of random effects showed a small, beneficial impact of screen time interventions compared to controls (SDM = 0.116, 95CI 0.08 to 0.15). Inclusion of the Goals, Feedback, and Planning behavioral techniques were associated with a positive impact on intervention effectiveness (SDM = 0.145, 95CI 0.11 to 0.18). Interventions with smaller sample sizes (n < 95) delivered over short durations (< 52 weeks) were associated with larger effects compared to studies with larger sample sizes delivered over longer durations. In the presence of the Goals, Feedback, and Planning behavioral techniques, intervention effectiveness diminished as sample size increased. CONCLUSIONS Both intervention content and context are important to consider when designing interventions to reduce children's screen time. As interventions are scaled, determining the active ingredients to optimize interventions along the translational continuum will be crucial to maximize reductions in children's screen time.
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Affiliation(s)
- Alexis Jones
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - R. Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Hannah Parker
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Lauren von Klinggraeff
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - M. W. Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
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23
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Yien JM, Wang HH, Wang RH, Chou FH, Chen KH, Tsai FS. Effect of Mobile Health Technology on Weight Control in Adolescents and Preteens: A Systematic Review and Meta-Analysis. Front Public Health 2021; 9:708321. [PMID: 34336779 PMCID: PMC8319399 DOI: 10.3389/fpubh.2021.708321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/21/2021] [Indexed: 11/13/2022] Open
Abstract
Childhood obesity is a crucial public health concern. In recent years, numerous studies have employed mobile health technology applications for weight control in children but obtaining varying effects. We conducted a meta-analysis to discuss the effectiveness of mobile health technology in reducing the body mass index (BMI) of obese children. The standardized mean difference (SMD) in BMI between the intervention and control groups was employed to measure the effect of mobile health technology intervention on weight control. The Comprehensive Meta-Analysis Version 3 software was employed for meta-analysis, and the results are presented in a forest plot. This study included nine randomized control trials, which featured a total of 1,202 participants. The meta-analysis revealed that mobile health technology intervention did not have a significant weight loss effect on subjects with obesity. However, by using ethnicity as a moderating variable for subgroup analysis, we discovered that the BMI of ethnic Chinese groups who received mobile health technology intervention was significantly lower than that of the control group. This effect was not significant in the non-ethnic Chinese subgroup. Therefore, the use of mobile health technology intervention for weight control in ethnic Chinese children resulted in significantly lower BMI in these children; however, the use of mobile health technology intervention for weight control is unsuitable for non-ethnic Chinese children.
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Affiliation(s)
- Jui-Mei Yien
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Health Care Management, University of Kang Ning, Tainan City, Taiwan
| | - Hsiu-Hung Wang
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ruey-Hsia Wang
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Fan-Hao Chou
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuo-Hsiung Chen
- Department of Business Administration, Cheng Shiu University, Kaohsiung, Taiwan
| | - Fu-Sheng Tsai
- Department of Business Administration, Cheng Shiu University, Kaohsiung, Taiwan.,Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung, Taiwan.,Super Micro Mass Research and Technology Center, Cheng Shiu University, Kaohsiung, Taiwan
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24
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Yen HY, Huang HY. Comparisons of physical activity and sedentary behavior between owners and non-owners of commercial wearable devices. Perspect Public Health 2021; 141:89-96. [PMID: 33733947 DOI: 10.1177/1757913921989389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS Wearable devices are a new strategy for promoting physical activity in a free-living condition that utilizes self-monitoring, self-awareness, and self-determination. The main purpose of this study was to explore health benefits of commercial wearable devices by comparing physical activity, sedentary time, sleep quality, and other health outcomes between individuals who used and those that did not use commercial wearable devices. METHODS The research design was a cross-sectional study using an Internet survey in Taiwan. Self-administered questionnaires included the International Physical Activity Questionnaire-Short Form, Pittsburgh Sleep Quality Index, Health-Promoting Lifestyle Profile, and World Health Organization Quality-of-Life Scale. RESULTS In total, 781 participants were recruited, including 50% who were users of wearable devices and 50% non-users in the most recent 3 months. Primary outcomes revealed that wearable device users had significantly higher self-reported walking, moderate physical activity, and total physical activity, and significantly lower sedentary time than non-users. Wearable device users had significantly better sleep quality than non-users. CONCLUSION Wearable devices inspire users' motivation, engagement, and interest in physical activity through habit formation. Wearable devices are recommended to increase physical activity and decrease sedentary behavior for promoting good health.
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Affiliation(s)
- Hsin-Yen Yen
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, 250 Wuxing St., Taipei 11031, Taiwan
| | - Hao-Yun Huang
- Gold Coast University Hospital, Southport, QLD, Australia
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25
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McDonough DJ, Su X, Gao Z. Health wearable devices for weight and BMI reduction in individuals with overweight/obesity and chronic comorbidities: systematic review and network meta-analysis. Br J Sports Med 2021; 55:917-925. [PMID: 33731385 PMCID: PMC10116995 DOI: 10.1136/bjsports-2020-103594] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To analyse the comparative effectiveness of different health wearable-based physical activity (PA) promotion intervention strategies against each other and control for reducing body weight and body mass index (BMI) in individuals with overweight/obesity and chronic comorbidities. DESIGN Systematic review and network meta-analysis (PROSPERO identifier: CRD42020158191). DATA SOURCES We performed two independent searches from December 2019 to September 2020 in PubMed, MEDLINE, Scopus, Web of Science, Central Register of Controlled Trials, EMBASE and PsycINFO databases for articles published in English between 2007 and 2020. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Inclusion criteria were based on the PICOS framework. We included randomised controlled trials of health wearable-based interventions using two or more PA intervention arms/strategies and compared their effects on participants' body weight (kg) and BMI (kg/m2) with a control group. Data were analysed using a Bayesian network meta-analysis to directly and indirectly compare the effects of the six different intervention strategies (comparators). The six comparators were: (1) control group (ie, usual care, waitlist); (2) comparison group (ie, traditional, non-health wearable PA interventions); (3) commercial health wearable-only intervention (eg, Fitbit, Polar M400); (4) research grade health wearable-only intervention (ie, accelerometers or pedometers); (5) multicomponent commercial health wearable intervention (eg, Fitbit + nutrition counselling); and (6) multicomponent research grade health wearable intervention. The results were reported as standardised mean differences (SMDs) with associated 95% credible intervals (CrIs). RESULTS From 641 screened records, 31 studies were included. For body weight reduction in individuals with overweight/obesity and chronic comorbidities, accelerometer/pedometer-only (SMD -4.44, 95% CrI -8.94 to 0.07) and commercial health wearable-only (SMD -2.76, 95% CrI -4.80 to -0.81) intervention strategies were the most effective compared with the three other treatments and control. For BMI reduction, multicomponent accelerometer/pedometer (SMD -3.43, 95% CrI -4.94 to -2.09) and commercial health wearable-only (SMD -1.99, 95% CrI -4.95 to 0.96) intervention strategies were the most effective compared with the other four conditions. CONCLUSION Health wearable devices are effective intervention tools/strategies for reducing body weight and BMI in individuals with overweight/obesity and chronic comorbidities.
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Affiliation(s)
- Daniel J McDonough
- School of Kinesiology, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Xiwen Su
- School of Kinesiology, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Zan Gao
- School of Kinesiology, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
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Tissot H, Pfarrwaller E, Haller DM. Primary care prevention of cardiovascular risk behaviors in adolescents: A systematic review. Prev Med 2021; 142:106346. [PMID: 33275966 DOI: 10.1016/j.ypmed.2020.106346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/28/2020] [Accepted: 11/24/2020] [Indexed: 11/15/2022]
Abstract
Adolescence is associated with behavioral changes offering opportunities for prevention of cardiovascular risk behaviors. Primary care physicians are ideally placed to deliver preventive interventions to adolescents. The objective was to systematically review the evidence about effectiveness of primary care-led interventions addressing the main cardiovascular risk behaviors in adolescents: physical activity, sedentary behaviors, diet and smoking. PubMed, Embase, PsycINFO, CINAHL, Cochrane, ClinicalTrials.gov, and ISRCTN registry were searched from January 1990 to April 2020. Randomized controlled trials of interventions in primary care contexts on at least one of the cardiovascular behaviors were included, targeting 10-19-year old adolescents, according to the World Health Organization's definition. Two authors independently assessed risk of bias. Twenty-two papers were included in the narrative synthesis, reporting on 18 different studies. Interventions targeting smoking uptake seemed more effective than interventions targeting established smoking or the three other risk behaviors. Intervention components or intensity were not clearly associated with effectiveness. Risk of bias was mostly unclear for most studies. There is little evidence for specific interventions on adolescents' cardiovascular risk behaviors in primary care, mainly due to studies' methodological limitations. Further research should investigate the effectiveness of opportunistic primary care-based interventions as compared to more complex interventions, and address the methodological shortcomings identified in this review.
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Affiliation(s)
- Hervé Tissot
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Eva Pfarrwaller
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Dagmar M Haller
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of General Practice, The University of Melbourne, Melbourne, Australia.
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The drivers, trends and dietary impacts of non-nutritive sweeteners in the food supply: a narrative review. Nutr Res Rev 2020; 34:185-208. [PMID: 33148371 DOI: 10.1017/s0954422420000268] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Poor diets, including excess added sugar consumption, contribute to the global burden of disease. Subsequently, many nutrition policies have been implemented to reduce added sugar intake and improve population health, including taxes, education, labelling and environmental interventions. A potential consequence of these policy actions is the substitution of added sugars with non-nutritive sweeteners (NNS) in a variety of foods and beverages. NNS are used to reduce the energy and sugar content of foods and beverages while maintaining their palatability. Evidence of the toxicological risks of NNS is inconsistent, though concerns have been raised over the potential substitution effects of ultra-processed foods containing NNS for whole foods. This review aimed to provide an overview of current NNS food supply and consumption patterns, assess added sugar-reduction policies and their impact on NNS, and determine the impact of NNS on food choice, energy intake and diet quality. NNS are widely available in a variety of products, though most commonly in carbonated beverages, dairy products, confectionery, table-top sweeteners and fruit drinks. However, the longitudinal trends of different product categories, and differences between geographies and economy-income levels, require further study. Few studies have examined NNS consumption trends globally, though an increase in NNS consumption in beverages has been observed in some regions. Research examining how the increased availability of low-sugar, NNS-containing products affects global dietary patterns is limited, particularly in terms of their potential substitution effects.
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Kahsay A, Gebregziabher H, Hadush Z, Yemane D, Hailemariam A, Mulugeta A. Exploration of Barriers to the Uptake of Nutritional Services Among Adolescent Girls from the Rural Communities of Tigray Region, Northern Ethiopia: A Qualitative Study. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2020; 11:157-171. [PMID: 33117032 PMCID: PMC7588270 DOI: 10.2147/ahmt.s276459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/16/2020] [Indexed: 11/23/2022]
Abstract
Background Adolescence is a time of tremendous physical growth and mental development, with high nutrient requirements. Ethiopia is among the countries with a high prevalence of nutritional deficiencies among the women of reproductive age group, whilst adolescent girls from rural areas suffered disproportionately. However, there is a dearth of evidence regarding the barriers that hinder adolescent girls to utilize the available nutritional services. Purpose The current study aimed to qualitatively explore the range of barriers for the uptake of nutritional interventions among adolescent girls in rural communities of Tigray, Northern Ethiopia. Methods and Participants We employed an explorative qualitative study among purposively selected adolescent girls and school teachers from rural districts of Tigray region. We conducted 11 focused group discussions with adolescent girls, 17 in-depth interviews (seven with teachers, seven with in-school adolescent girls, and three with out-of-school adolescent girls) using a semi-structured guide. Data was audio-taped, transcribed verbatim in local language, translated into English, and imported into ATLAS.ti version 7.5 qualitative data analysis software for analysis. Results Adolescents perceived that stunting, anemia, and thinness are among the main nutritional problems in their community. Food insecurity, limited nutrition awareness in the community, limited access to a water source, high workload, service provider's little attention for adolescents' nutrition, and food taboo have emerged as barriers for the uptake of adolescent girls' nutritional interventions. Though limited in reach, available nutritional interventions include awareness creation, nutritional supplementation, and disease prevention. Conclusion Food insecurity poses a strong challenge to adolescent girls' nutrition. As access to safe drinking water continues to be a considerable bottleneck for nutritional interventions, a multi-sectoral response to integrate water, sanitation, and hygiene (WASH) services is required. Bounded by food taboo, high burden of workload among the adolescent girls, women empowerment and nutritional status seem to be the unfinished agenda in resource limited settings such as the rural areas of Tigray region.
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Affiliation(s)
- Amaha Kahsay
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Hadush Gebregziabher
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Znabu Hadush
- Department of Environmental Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Dejen Yemane
- Department of Environmental Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | | | - Afework Mulugeta
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Yen HY. Smart wearable devices as a psychological intervention for healthy lifestyle and quality of life: a randomized controlled trial. Qual Life Res 2020; 30:791-802. [PMID: 33104939 DOI: 10.1007/s11136-020-02680-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Creating a healthy lifestyle is important across different life stages. Commercial smart wearable devices are an innovative and interesting approach as an early psychological intervention for modifying health-related behaviors. Therefore, the purpose of this study was to explore the effects of smart wearable devices on health-promoting lifestyles and quality of life. METHODS The study design was a three-parallel randomized controlled trial with a 3-month intervention. Two commercial smart wearable devices (smartwatches and smart bracelets) with different levels of complicated functions were applied as a psychological intervention in comparison with a smartphone app as the control group. Participants were healthy young adults with a median age of 26 years. Outcome measurements were conducted by self-administered questionnaires. Chi-square tests and ANOVA were performed for testing the difference of participants at baseline, and generalized estimating equations were performed for testing the effect of the intervention. RESULTS At the beginning, 81 participants were recruited and 73 participants completed the study. Results of a healthy lifestyle demonstrated significant group effects of exercise and a significant effect of the interaction for self-actualization and stress management in the experimental group with a smartwatch (Self-actualization: MD = 0.35[- 0.10,0.80]; Exercise: MD = 0.21[- 0.33 0.75]; Stress management: MD = 0.36[- 0.04,0.76]) by comparing with only using mobile app (Self-actualization: MD = - 0.03[- 0.25,0.18]; Exercise: MD = - 0.12[- 0.38,0.14]; Stress management, MD = - 0.28[- 0.55,0.00]). The significant effect of group-by-time interaction for self-actualization was found in the experimental group with a smart bracelet (MD = 0.05[- 0.30,0.20]) by comparing with the control group. The GEE-adjusted model indicated significant effects of the interaction on the comprehensive, physical, and mental quality of life in the experimental group with the smartwatch (Comprehensive: MD = 0.24[- 0.04,0.52]; Physical: MD = 0.67[0.26,1.09]; Mental: MD = 0.72[0.29,1.16]) by comparing with the control group (Comprehensive: MD = - 1.57[- 2.55, - 0.59]; Physical: MD = 0.25[0.00,0.50]; Mental: MD = 0.08[- 0.11,0.27]). CONCLUSION From a psychological perspective, smart wearable devices have potential benefits of shaping a healthy lifestyle and improving the quality of life. Enhancing the utility of commercial well-designed smart wearable devices is an innovative and effective strategy for promoting public health.
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Affiliation(s)
- Hsin-Yen Yen
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, 250 Wuxing St., Taipei, 11031, Taiwan.
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30
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Di Figlia-Peck S, Feinstein R, Fisher M. Treatment of children and adolescents who are overweight or obese. Curr Probl Pediatr Adolesc Health Care 2020; 50:100871. [PMID: 33097417 PMCID: PMC7576185 DOI: 10.1016/j.cppeds.2020.100871] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Stephanie Di Figlia-Peck
- Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, NY 11042, United States; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.
| | - Ronald Feinstein
- Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, NY 11042, United States; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Martin Fisher
- Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, NY 11042, United States; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
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Beasley JM, Wagnild JM, Pollard TM, Roberts TR, Ahkter N. Effectiveness of diet and physical activity interventions among Chinese-origin populations living in high income countries: a systematic review. BMC Public Health 2020; 20:1019. [PMID: 32600296 PMCID: PMC7322842 DOI: 10.1186/s12889-020-08805-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/29/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This review examines the effectiveness of diet and physical activity interventions to reduce cardiometabolic risk among Chinese immigrants and their descendants living in high income countries. The objective of this review is to provide information to help build future interventions aimed at improving diet and increasing physical activity levels among Chinese immigrants. METHODS Outcomes included BMI, weight, waist circumference (WC), waist-hip ratio (WHR), cholesterol (LDL, HDL), systolic and diastolic blood pressure (SBP, DBP), hemoglobin A1c (HgbA1c), fasting blood glucose (FBG), and HOMA-IR. Six databases were systematically searched from database inception to date of search (February 2020). Meta-analyses used random effect models to estimate pooled effects of outcomes with 95% confidence intervals. The outcomes assessed were changes in mean outcomes (post-intervention versus baseline) among the intervention group versus control groups. RESULTS Twenty-one articles were included for synthesis, and eight of these were included in the meta-analysis. Among children/adolescents, there were no significant effects of intervention for any of the outcomes having sufficient data for meta-analysis (BMI, WHR, SBP, and DBP). Among adults, the pooled effect including three studies showed significant changes in BMI (effect size = - 1.14 kg/m2; (95% CI: - 2.06, - 0.21), I2 = 31%). There were also significant effects of intervention among adults in terms of changes in SBP and DBP, as the pooled effect across three studies was - 6.08 mmHg (95% CI - 9.42, - 2.73), I2 = 0% and - 3.81 mmHg (95% CI: - 6.34, - 1.28), I2 = 0%, respectively. Among adults there were no other significant effects among the meta-analyses conducted (weight, WC, LDL, HgbA1c, and FBG). CONCLUSIONS This review is the first to summarize the effectiveness of diet and physical activity interventions specifically designed for Chinese immigrants living in high income countries. There were clinically meaningful changes in BMI and blood pressure among adults, but evidence was weak for other cardiometabolic outcomes (weight, WC, LDL, HgbA1c, and FBG), and among children, there was no evidence of effect for any cardiometabolic outcomes. Given our mixed findings, more work is needed to support the design of successful interventions, particularly those targeting children and their families. TRIAL REGISTRATION The systematic review protocol was registered in PROSPERO on December 17, 2018, the international prospective register of systematic reviews (registration number: CRD42018117842 ).
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Affiliation(s)
- Jeannette M. Beasley
- Department of Medicine, NYU Grossman School of Medicine, 462 First Avenue CD 673, New York, NY 10016 USA
| | - Janelle M. Wagnild
- Department of Anthropology, Durham University, South Road, Durham, DH1 3LE UK
| | - Tessa M. Pollard
- Department of Anthropology, Durham University, South Road, Durham, DH1 3LE UK
| | - Timothy R. Roberts
- NYU Health Sciences Library, NYU Grossman School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Nasima Ahkter
- Department of Anthropology, Durham University, South Road, Durham, DH1 3LE UK
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Tully L, Burls A, Sorensen J, El-Moslemany R, O'Malley G. Mobile Health for Pediatric Weight Management: Systematic Scoping Review. JMIR Mhealth Uhealth 2020; 8:e16214. [PMID: 32490849 PMCID: PMC7301268 DOI: 10.2196/16214] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/13/2020] [Accepted: 01/23/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The prevalence and consequences of obesity among children and adolescents remain a leading global public health concern, and evidence-based, multidisciplinary lifestyle interventions are the cornerstone of treatment. Mobile electronic devices are widely used across socioeconomic categories and may provide a means of extending the reach and efficiency of health care interventions. OBJECTIVE We aimed to synthesize the evidence regarding mobile health (mHealth) for the treatment of childhood overweight and obesity to map the breadth and nature of the literature in this field and describe the characteristics of published studies. METHODS We conducted a systematic scoping review in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews, by searching nine academic databases in addition to gray literature for studies describing acceptability, usability, feasibility, effectiveness, adherence, or cost-effectiveness of interventions assessing mHealth for childhood obesity treatment. We also hand searched the reference lists of relevant articles. Studies aimed at the prevention of overweight or obesity were excluded, as were studies in which mHealth was not the primary mode of treatment delivery for at least one study arm or was not independently assessed. A random portion of all abstracts and full texts was double screened by a second reviewer to ensure consistency. Data were charted according to study characteristics, including design, participants, intervention content, behavior change theory (BCT) underpinning the study, mode of delivery, and outcomes measured. RESULTS We identified 42 eligible studies assessing acceptability (n=7), usability (n=2), feasibility or pilot studies (n=15), treatment effect (n=17), and fidelity (n=1). Change in BMI z-scores or percentiles was most commonly measured, among a variety of dietary, physical activity, psychological, and usability or acceptability measures. SMS, mobile apps, and wearable devices made up the majority of mobile interventions, and 69% (29/42) of the studies specified a BCT used. CONCLUSIONS Pediatric weight management using mHealth is an emerging field, with most work to date aimed at developing and piloting such interventions. Few large trials are published, and these are heterogeneous in nature and rarely reported according to the Consolidated Standards of Reporting Trials for eHealth guidelines. There is an evidence gap in the cost-effectiveness analyses of such studies.
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Affiliation(s)
- Louise Tully
- School of Physiotherapy, Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Amanda Burls
- School of Health Sciences, Division of Health Services Research and Management, City University of London, London, United Kingdom
| | - Jan Sorensen
- Healthcare Outcomes Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Riyad El-Moslemany
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Grace O'Malley
- School of Physiotherapy, Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- W82GO Child and Adolescent Weight Management Service, Children's Health Ireland at Temple Street, Dublin, Ireland
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Partridge SR, Raeside R, Singleton A, Hyun K, Redfern J. Effectiveness of Text Message Interventions for Weight Management in Adolescents: Systematic Review. JMIR Mhealth Uhealth 2020; 8:e15849. [PMID: 32348264 PMCID: PMC7284408 DOI: 10.2196/15849] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/19/2019] [Accepted: 02/10/2020] [Indexed: 12/27/2022] Open
Abstract
Background The incidence of obesity among adolescents is increasing. Text messages are a primary communication form for adolescents and potentially a scalable strategy for delivering population health interventions. Objective This study aimed to determine the effectiveness of text message interventions in reducing BMI in adolescents and describe characteristics that are common to effective interventions. Methods This systematic review included randomized controlled trials of text message lifestyle interventions involving adolescents aged 10 to 19 years with outcomes focused on obesity prevention or management. Primary outcome was objective or self-report change in BMI. Results In total, 4362 records were identified, and 215 full-text articles were assessed for eligibility. A total of 8 unique studies were identified, including 767 participants, mean age 14.3 (SD 0.9) years, BMI 29.7 (SD 1.6) kg/m2 and 53.1% (407/767) female (31/101, 30.7%-172/172, 100.0%). All interventions were multicomponent. The median active intervention period was 4.5 months. During the active and extended intervention phases, text messages accounted for >50% (8 studies) and >85% (3 studies) of contact points, respectively. Text messages were heterogeneous, with a median of 1.5 text messages sent per week (range: 1-21). A total of 4 studies utilized two-way text message communication with health professionals Of the 8 studies, 7 demonstrated reductions in BMI or BMI z-score in the intervention group compared with the control at the end of the final follow-up. The effect was only statistically significant in 1 study at 6 months. Over 6 months, reductions in BMI (kg/m2) ranged from 1.3% to 4.5% and BMI z-score ranged from 4.2% to 28.1%. Overall quality of the studies was low. Conclusions Further research is required to elucidate the effectiveness and potential impact of text message interventions on weight and weight-related behaviors in adolescents.
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Affiliation(s)
- Stephanie Ruth Partridge
- The University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health, Sydney, Australia.,The University of Sydney, Prevention Research Collaboration, Charles Perkins Centre, Sydney School Public Health, Sydney, Australia
| | - Rebecca Raeside
- The University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health, Sydney, Australia
| | - Anna Singleton
- The University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health, Sydney, Australia
| | - Karice Hyun
- The University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health, Sydney, Australia
| | - Julie Redfern
- The University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health, Sydney, Australia.,The George Institute for Global Health, Sydney, Australia
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Jacobson MS, Kohn M. Smart Management of a Persistently Puzzling Problem-Adolescent Obesity. J Adolesc Health 2019; 64:421-422. [PMID: 30904088 DOI: 10.1016/j.jadohealth.2019.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 01/25/2019] [Indexed: 11/17/2022]
Affiliation(s)
| | - Michael Kohn
- Department of Adolescent and Young Adult Medicine, University of Sydney, Sydney, New South Wales, Australia; CRASH (Centre for Research into AdolescentS' Health), Westmead Hospital, Sydney, New South Wales, Australia
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