Digital health programs and childhood obesity

Text messaging programs and childhood obesity | Image Credit: © majivecka - © majivecka - stock.adobe.com.

A review article published in Frontiers aimed to summarize the impact that various digital interventions for children and adolescents affected by obesity, as rapid development of socioeconomic growth and modernization over the last 2 decades have dramatically contributed to obesity rates.¹

Since 1975, the World Health Organization (WHO) estimated that the obesity percentage has nearly tripled, with childhood obesity being defined as a global epidemic that can lead to several comorbidities in adult life like diabetes, hyperlipidaemia, hypertension or hepatic steatosis, with authors noting "that the situation is destined to get worse."¹

The COVID-19 pandemic has further contributed to the rise in obesity rates, necessitating innovative strategies for prevention and treatment. The study focused on mobile health (mhealth) tools, telemedicine, and other technological innovations that can aid in the treatment and prevention of obesity in children and adolescents.¹

In a recent interview with Contemporary Pediatrics on how digital therapeutics can impact mental health in children, Jason Kahn, PhD, researcher at Boston Children’s Hospital, instructor of psychiatry at Harvard Medical School, and chief scientific officer and founder of the Mightier digital therapeutic, said awareness of some of these technologies can make a difference too.²

"Where digital therapies can step into the void if they can provide tools so kids can build skills, competencies, and strengths that can help them succeed and thrive while they are potentially on a waiting list for more specialized providers, these skills can then transfer into their lives," Kahn said. "With these tools, we see kids having more success and getting help earlier when available.”²

Study authors each identified and reviewed the most appropriate published studies in order to collect a broad perspective on the use of new technological innovations to prevent and treat childhood obesity and associated characteristics and strengths. A comprehensive literature search was conducted using PubMed, Scopus, EMBASE, and Web of Science databases, focusing on studies published from 2013 to September 2023. Keywords related to childhood obesity, digital health, and technological interventions were used to identify relevant articles. The selected studies were reviewed and analyzed to assess the effectiveness and limitations of digital tools in childhood obesity management.¹

Telemedicine and text messages has been explored in managing children and adolescents with obesity, providing innovative access to health care. According to the investigators, data taken from randomized control trials (RCTs) and systematic reviews "have shown that telemedicine has been introduced into the management of obese [pediatric] patients through various technology-enhanced measures: telephone contact for obese children or other types of interventions, such as remote service delivery, video conferencing, short message service (SMS), and text messaging."¹

Review found that use of text messaging programs have been associated with changes in health behaviors such as fruit and vegetable consumption, low total caloric intake, physical activity, and screen time. Regarding telemedicine, good feasibility and fidelity characterize these interventions, with most studies having demonstrated high retention rates (e.g., 80%–100% among telemedicine groups) and high attendance at telemedicine appointments are the most commonly cited strengths of these tools.¹

The analysis revealed that digital health interventions, including mhealth applications, telemedicine, and digital therapeutics, show promise in supporting weight management and promoting healthy behaviors among children and adolescents. Telemedicine, in particular, has demonstrated high feasibility and patient satisfaction, although its long-term impact on BMI reduction remains unclear.¹

Authors concluded that digital technologies offer valuable tools for addressing childhood obesity, providing accessible and personalized interventions. However, the effectiveness of these tools is influenced by factors such as socioeconomic status, ethnicity, and the integration of in-person support. Future research should focus on optimizing these interventions to ensure they are effective across diverse populations and sustainable in the long term.¹

"Sustaining long-term engagement with mhealth technologies designed for health purposes remains a challenge. Strategies to maintain user's interest and motivation over extended periods of time are crucial for ensuring continued participation and benefit," the study authors noted.¹

References:

1. Porri D, Morabito LA, Cavallaro P, et al. Time to act on childhood obesity: the use of technology. Front Pediatr. 2024;12:1359484. doi:10.3389/fped.2024.1359484
2. Fitch, J. Digital therapeutics and what they can do for mental health. Contemporary Pediatrics. August 8, 2024. Accessed August 8, 2024. https://www.contemporarypediatrics.com/view/digital-therapeutics-and-what-they-can-do-for-mental-health