- In a clinical trial hosted by MassGeneral Hospital for Children and Harvard Vanguard, mHealth interventions were found to improve weight management in children.
The Connect 4 Health trial took place from June 2014 to March 2016 at Harvard Vanguard pediatric facilities, and enrolled 721 children ages 2 through 12 with BMIs in the overweight or obese range. Participants were then placed in either an enhanced primary care intervention or an enhanced primary care plus mHealth coaching intervention.
Parents of the children in both groups received educational materials focusing on key goals such as decreasing screen time and consumption of sugar-sweetened beverages, improving diet quality, increasing moderate or vigorous physical activity, improving sleep quality, and promoting social and emotional wellness.
Also included were monthly text messages to parents with links to publicly available resources to support behavioral change, and a Neighborhood Resource Guide listing support facilities in their communities.
In addition to these activities, the coaching group were contacted by health coaches every other month by phone, videoconference, or in person. This group also received additional educational materials after each individualized coaching session such as twice-weekly text messages or emails.
Both intervention groups noticed improvements in BMI, but the coaching plus group saw higher improvement, indicating that more comprehensive mHealth interventions are more effective in promoting positive health changes.
"Combatting obesity is an enormous challenge in pediatrics and identifying tools that are proven to make a difference in the health and well-being of our patients is essential," says co-author Daniel H. Slater, MD, chairman of Pediatrics at Atrius Health.
"Improvements which include the electronic health record flagging of children with an unhealthy BMI, clinical decision support tools to help clinicians provide high quality care, and educational materials for parents to support self-guided behavior change have all laid the groundwork for the two interventions tested in this study,” he said.
Parents also noted that increased mHealth interventions promoted high levels of satisfaction and assurance with the weight management programs. Overall, 63 percent of parents in the enhanced primary care plus coaching group, compared to 48 percent of those in the control group, felt participation in these intervention programs added satisfaction with their child’s health services
The next step for the research team involves the development of preventative intervention, and heightening successful intervention methods from the study, to address the most severe cases of childhood obesity.
“Our findings are pretty conclusive that there are three aspects of interventions for childhood obesity that work: improving clinical practices for obesity management; engaging and supporting families in behavior change; and linking families to community resources for further support,” said Elsie Taveras, MD, MPH, chief of General Pediatrics at MassGeneral Hospital for Children.
“We're now testing a family-based intervention that starts working with mothers in pregnancy and their children ages 2 and under to support prevention and developing more aggressive weight management approaches for children with the most severe obesity, for whom the interventions in this study were not successful,” she said.