Background In an integrated care model, involving primary care providers (PCPs) and obesity specialists, telehealth may be useful for overcoming barriers to treating childhood obesity. Objective To conduct a pilot study comparing BMI changes between two arms: 1) PCP in-person clinic visits plus obesity specialist tele-visits (PCP visits + Specialist tele-visits) and 2) PCP in-person clinic visits only (PCP visits only), with ongoing tele-consultation between PCPs and obesity specialists for both arms. Methods Patients (N=40, 10–17 years, BMI ≥95th percentile) were randomized to Group 1 or 2. Both groups had PCP visits every 3 months for 12 months. Using a cross-over protocol, Group 1 had PCP visits + Specialist tele-visits during the first 6 months and PCP visits only during the second 6 months, and Group 2 followed the opposite sequence. Each of 12 tele-visits was conducted by a dietitian or psychologist with a patient and parent. Results Retention rates were 90% at 6 months and 80% at 12 months. BMI (z-score) decreased more for Group 1 (started with PCP visits + Specialist tele-visits) vs. Group 2 (started with PCP visits only) at 3 months (−0.11 vs. −0.05, P=0.049), following frequent tele-visits. At 6 months (primary outcome), BMI was lower than baseline within Group 1 (−0.11, P=0.0006) but not Group 2 (−0.06, P=0.08); however, decrease in BMI at 6 months did not differ between groups. After cross-over, BMI remained lower than baseline for Group 1 and dropped below baseline for Group 2. Conclusion An integrated care model utilizing telehealth holds promise for treating children with obesity.

Purpose Adolescent overweight and obesity is a significant problem for health care with associated quality of life and financial concerns. This systematic review investigated text messaging as an intervention to treat or prevent obesity in adolescent populations. Data sources The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement was used as a guideline for the literature search and interpretation of findings. CINAHL, Medline, Cochrane Database of Systematic Reviews, PsycINFO, and SocINDEX were searched using a combination of search terms. The initial 95 articles that met the search criteria were narrowed to seven that fit the focus. Conclusions Text messaging is acceptable to adolescents as an obesity treatment but data about content and timing of messages vary. The effects of text messaging on body mass index (BMI) were difficult to determine because messaging was often part of a multicomponent intervention. Text messaging as an intervention for adolescent obesity was used in various settings. There were no included studies from primary care settings. Implications for practice Further research is needed to determine the effect of messages on BMI and the most helpful content, timing, and frequency. This information may provide advanced practice nurses with effective, affordable tools to manage adolescent obesity in different settings.

Background and purpose: Rates of overweight and obesity in emerging adults are rapidly increasing and associated with many chronic illnesses, quality of life concerns, and increased health care spending. Effective weight management interventions are needed for this population. The purpose of this study was to examine effects of a text-messaging weight loss intervention on motivation, stage of change for weight loss, and BMI. Methods: Overweight and obese emerging adults were enrolled (n = 188) and randomized to control or intervention groups. Weight loss information was delivered via a website to both groups. The intervention group also received daily weight loss–related text messages. Motivation, stage of change, and BMI were assessed online, via self-report at baseline, 4, and 8 weeks. Conclusions: Ninety-five participants were included in the final data analysis. There was a significant increase in motivation and stage of change and decrease in BMI over the study duration, with no significant differences between groups. Implications for practice: Nurse practitioners are well positioned to provide innovative weight loss interventions in a variety of settings. These results provide important insights for the design of effective weight loss treatment for emerging adults and support the use of web-based and text message–based interventions.

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