Feasibility and efficacy of a web-based family telehealth nutrition intervention to improve child weight status and dietary intake: A pilot randomised controlled trial

Abstract

Introduction Innovative eHealth solutions that improve access to child weight management interventions are crucial to address the rising prevalence of childhood obesity globally. The study aimed to evaluate the feasibility and preliminary efficacy of a 12-week online telehealth nutrition intervention to improve child weight and dietary outcomes, and the impact of additional text messages (SMS) targeted to mothers and fathers. Methods Families with children aged 4 to 11 were randomised across three groups: Telehealth, Telehealth+SMS, or Waitlist control. Telehealth and Telehealth+SMS groups received two telehealth consultations delivered by a dietitian, 12 weeks access to a nutrition website and a private Facebook group. The Telehealth+SMS group received additional SMS. Feasibility was assessed through recruitment, retention, and intervention utilisation. Efficacy was assessed through changes in measured child body mass index (BMI), waist circumference and diet. Results Forty-four (96%) and 36 (78%) families attended initial and second telehealth consultations, respectively. Thirty-six families (78%) completed week 12 assessments. Child BMI and waist circumference changes from baseline to week 12 were not statistically different within or between groups. Children in Telehealth+SMS had significantly reduced percentage energy from energy-dense nutrient-poor food (95% CI −21.99 to −0.03%E; p = .038) and increased percentage energy from healthy core food (95% CI −0.21 to 21.89%E; p = .045) compared to Waitlist control. Discussion A family-focused online telehealth nutrition intervention is feasible. While the modest sample size reduced power to detect between-group changes in weight status, some improvements in child dietary intakes were identified in those receiving telehealth and SMS.

Accuracy of Parent-Reported Child Height and Weight and Calculated Body Mass Index Compared With Objectively Measured Anthropometrics: Secondary Analysis of a Randomized Controlled Trial

“…Parent-reported and researcher-measured child height and weight data were available from 42 families at baseline and 35 families (83%) at week 12. Baseline characteristics of children and parents who were lost to follow-up, defined as not responding after 3 reminders to complete assessments, were not significantly different from the baseline characteristics of those who completed the follow-up at week 12 [14].…”

“…This was a secondary analysis of data from a pilot randomized controlled trial that aimed to investigate the feasibility of a 12-week Web-based family lifestyle intervention to support parents in improving their child’s weight status and eating habit [14]. The intervention group received 2 semistructured telehealth consultations (online video consultations, attended by at least one parent and the index child) with Accredited Practising Dietitian, access to the Back2basics Family program website [15], a Facebook group, and additional evidence-based short message service (SMS) text messaging targeted to the parents.…”

Effectiveness of Individual Real-Time Video Counseling on Smoking, Nutrition, Alcohol, Physical Activity, and Obesity Health Risks: Systematic Review

“…Of these, 7894 records were excluded at the title and abstract screening stage, and 97 full text records were assessed for eligibility ( Figure 1 ). A total of 84 of the 97 full text records were excluded for the following reasons: 26 did not measure smoking, nutrition, alcohol consumption, physical activity, and obesity outcomes; 23 did not use any form of video counseling intervention; 19 involved group video counseling and not individual video counseling [ 37 - 54 ]; 3 were protocol papers [ 55 - 57 ]; 8 were not randomized studies [ 58 - 65 ]; 2 studies were ongoing [ 32 , 66 ]; 1 was a conference abstract [ 67 ]; and 2 studies described a multicomponent intervention, and it was not possible to isolate the effect of real-time video counseling [ 68 , 69 ]. The remaining 13 eligible studies were included in the review.…”

Dietary intake in health and disease, challenges in measuring and reporting diet‐disease relationships

“…In this issue, Chai et al detailed the three‐stage development of a bank of text messages targeted to parents of primary school‐aged children, designed to support improvement in child eating behaviours . After evaluation by health experts and parents based on clarity, usefulness and relevance, a bank of 48 text messages were retained for use as a component of a future family‐based nutrition intervention . Lombard et al previously reported in this journal the protocol for the Communicating Health (CH) study, which focused on using social media for health communication in young adults.…”

“…21 After evaluation by health experts and parents based on clarity, usefulness and relevance, a bank of 48 text messages were retained for use as a component of a future family-based nutrition intervention. 22 Lombard et al 23 previously reported in this journal the protocol for the Communicating Health (CH) study, which focused on using social media for health communication in young adults. CH was a four phase, iterative study aimed at understanding young adults use of social media for obtaining dietary health information, co-creating healthy eating messages and communication strategies, evaluating the messages, and developing tools and resources for use by stakeholders and researchers in this field.…”