Digital Tools to Support Family-Based Weight Management for Children: Mixed Methods Pilot and Feasibility Study

Abstract

Background Family-based behavioral therapy is an efficacious approach to deliver weight management counseling to children and their parents. However, most families do not have access to in-person, evidence-based treatment. We previously developed and tested DRIVE (Developing Relationships that Include Values of Eating and Exercise), a home-based parent training program to maintain body weight among children at risk for obesity, with the intent to eventually disseminate it nationally alongside SafeCare, a parent support program that focuses on parent-child interactions. Currently the DRIVE program has only been tested independently of SafeCare. This study created the “mHealth DRIVE” program by further adapting DRIVE to incorporate digital and mobile health tools, including remotely delivered sessions, a wireless scale that enabled a child-tailored weight graph, and a pedometer. Telehealth delivery via mHealth platforms and other digital tools can improve program cost-effectiveness, deliver long-term care, and directly support both families and care providers. Objective The objective of this study was to examine preliminary acceptability and effectiveness of the mHealth DRIVE program among children and parents who received it and among SafeCare providers who potentially could deliver it. Methods Study 1 was a 13-week pilot study of a remotely delivered mHealth family-based weight management program. Satisfaction surveys were administered, and height and weight were measured pre- and post-study. Study 2 was a feasibility/acceptability survey administered to SafeCare providers. Results Parental and child satisfaction (mean of 4.9/6.0 and 3.8/5.0, respectively) were high, and children’s (N=10) BMI z-scores significantly decreased (mean –0.14, SD 0.17; P=.025). Over 90% of SafeCare providers (N=74) indicated that SafeCare families would benefit from learning how to eat healthily and be more active, and 80% of providers reported that they and the families would benefit from digital tools to support child weight management. Conclusions Pediatric mHealth weight management interventions show promise for effectiveness and acceptability by families and providers. Trial Registration Clinicaltrials.gov NCT03297541, https://clinicaltrials.gov/ct2/show/NCT03297541.

Significant effects of childhood obesity treatment with a web‐based component in a randomised controlled study (Web‐COP)

“…This randomised controlled, multicomponent and multicentre study of children aged 5–12 years with obesity showed a significant decrease in BMI‐SDS over a 6 months' period for those receiving the intervention compared to standard care. This finding is consistent with previous research that evaluated web‐based treatment as a part of a multicomponent intervention targeting childhood obesity 25 . Staiano et al.…”

“…25 Staiano et al suggested that digital tools could serve as an opportunity for supporting in-person care with digitally delivered care, with the advantage of bridging the gap between counselling sessions with tools to encourage progress to a healthier lifestyle. 25 Further, Smogeli Holter recently suggested that digital interventions should be integrated in clinical practice, but that more research is needed on implementation. 26 This study showed that engaging parents and children in group sessions and a web-based intervention targeting childhood obesity treatment improved BMI-SDS.…”

“…It has previously been shown that personalised coaching is likely to have an impact on both traditional and mHealth weight loss interventions. 25,34 It was not possible to state how much the personal coaching contributed to the study result.…”

Validation of remote assessment of preschool children's anthropometrics and motor skills

“…One result of this study demonstrated discrepancy between in-person and remote height measurements. Reliable height measurements have presented a challenge within pediatric telemedicine research ( 27 , 28 ), as height for research studies and clinical purposes are typically measured by trained assessors in-person ( 29 ). Advances in automated height measurements via cellphones or tablet-based techniques may be incorporated to decrease errors in measurement ( 28 ).…”

Firearm screening and secure storage counseling among home visiting providers: a cross-sectional study of SafeCare® providers in the U.S.

“…The survey was open for 2 weeks total, and a reminder email was sent after 1 week. Survey topics included child nutrition ( 21 ), firearm safety, and recreational marijuana use among caregivers. The current study presents results related to the firearm section.…”