Mobile apps for pediatric obesity prevention and treatment, healthy eating, and physical activity promotion: just fun and games?

Abstract

Mobile applications (apps) offer a novel way to engage children in behavior change, but little is known about content of commercially available apps for this population. We analyzed the content of apps for iPhone/iPad for pediatric weight loss, healthy eating (HE), and physical activity (PA). Fifty-seven apps were downloaded and tested by two independent raters. Apps were coded for: inclusion of the Expert Committee for Pediatric Obesity Prevention's (ECPOP) eight recommended strategies (e.g., set goals) and seven behavioral targets (e.g., do ≥1 h of PA per day), utilization of gaming elements, and general characteristics. Most apps lacked any expert recommendations (n035, 61.4 %). The mean number of recommendations among apps that used recommendations was 3.6±2.7 out of 15, 56.1 % (n032) apps were classified as games, and mean price per app was $1.05±1.66. Most apps reviewed lacked expert recommendations and could be strengthened by addition of comprehensive information about health behavior change and opportunities for goal setting. KEYWORDSPediatric obesity, Childhood, Overweight, Mobile apps, Mobile health INTRODUCTION Recent reports show that 16.9 % of children in the United States are obese and almost 30 % of children are overweight or obese by age 5 years [1, 2], putting them at greater risk for health complications and future weight gain [3,4]. Among actions recommended by pediatric obesity experts are promotion of healthy eating (HE) and physical activity (PA) [5,6] as well including the whole family in treatment [7]. Mobile applications (apps) are an engaging way to involve children in health behavior changes, capitalizing on portability and affordability of delivering health information via mobile devices and opportunity to use gaming to make health information entertaining [8,9]. While most children do not own their own smartphone, parents are heavy app users, with 57 % of app-using

Smart-Phone Obesity Prevention Trial for Adolescent Boys in Low-Income Communities: The ATLAS RCT

“…To the authors' knowledge, no previous study has used smartphone technology in a school-based obesity prevention program 14 and few existing smartphone "apps" include evidence-based behavior change techniques. 19 Therefore, the primary aim of the present study was to evaluate the effects of the multicomponent, school-based obesity prevention intervention incorporating smartphone technology, known as ATLAS (Active Teen Leaders Avoiding Screen-time). This article reports the 8-month (immediate postprogram) intervention effects.…”

How behavioral science can advance digital health

“…Both show that the use of evidence-based behavioral strategies in apps is very low relative to the strategies typically employed in traditionally delivered interventions. Schoffman and colleagues found that 61 % of mobile apps targeting childhood obesity did not include any evidence-based behavioral strategies [6]. Breland and colleagues found that 14 % of diabetes mobile apps did not include any evidencebased behavioral strategies and 33 % included only one of six possible strategies [7].…”

Is a Picture Worth a Thousand Words? Few Evidence-Based Features of Dietary Interventions Included in Photo Diet Tracking Mobile Apps for Weight Loss

“…These findings are similar to findings from other reviews suggesting that few evidence-based techniques are included in the most popular weight loss apps for adults 11,[13][14][15] and in HE and PA apps for children. 12 Findings from this and other studies highlight the continued need for inclusion of more evidence-based techniques promoting HE behavior, including self-regulation, in an effort to better ensure the efficacy of these types of mobile apps for weight loss and reduction of chronic disease.…”

“…9 While mobile apps for weight loss are prevalent, most do not include evidencebased strategies and there is poor integration of these apps in weight loss interventions. [10][11][12][13][14][15] Adherence to diet self-monitoring is a key component of weight loss. 16,17 Previous studies have demonstrated that frequency of self-monitoring is significantly associated with weight loss 6,16 and that frequency of and adherence to self-monitoring is more important for weight loss than accuracy of nutritional data tracked.…”