We continue looking at the role of digital technology in improving pediatric care. Two recent studies, both published in JAMA, found that adding a digital component to health counseling — even something as simple as a text message — may help reduce childhood obesity.
One study, funded by the Patient-Centered Outcomes Research Institute, used REDCap data tools hosted by Vanderbilt University Medical Center, with support from the National Institutes of Health. It was co-led by Dr. Eliana Perrin, a Bloomberg Distinguished Professor of Primary Care at Johns Hopkins University.
Text messages as a tool against obesity in infants
Dr. Perrin and her team developed the Greenlight Program, an initiative designed to educate parents about promoting healthy growth in infants. With most parents owning smartphones, this digital program is easily accessible.
The researchers recruited nearly 900 parent-infant pairs from hospitals and pediatric clinics at six different medical institutions. All participating infants were 21 days old or younger, born after 34 weeks of pregnancy, at a healthy weight, and without chronic conditions affecting weight gain.
Participants were divided into two groups. Both groups received Greenlight Program materials, which included counseling on nutrition and healthy habits, as well as age-appropriate booklets with goal-setting advice. However, only half of the group received interactive, personalized text messages from an automated system. These texts offered immediate feedback, tips for addressing challenges, and words of encouragement as they made progress.
The impact of text messages
The study tracked the outcomes of the text messages on childhood obesity until the children reached two years old. Researchers measured various health metrics, including weight and growth, to evaluate the program’s success. Through regular followups and digital monitoring, they could capture a comprehensive view of each child’s development.
Results showed a marked improvement in maintaining healthy growth patterns in children whose parents received the personalized texts. Between the two groups, children of parents who received digital support had healthier growth trajectories over their first two years compared to those who received only counseling.
The digital program led to a 45% relative reduction in obesity. Researchers found that the benefits of the digital intervention began as early as four months and continued over the two-year period, marking this study as one of the first large-scale efforts to prevent early childhood obesity.
Dr. Perrin said:
If we can prevent obesity in these children at the highest risk, we can also work toward greater health equity.
Implications for broader applications
The success of this study suggests that similar text-based interventions could be adapted to address other age groups or health issues. Digital technology offers a scalable way to deliver health education tailored to individual needs and support in real-time. The duration and size of this groundbreaking study adds confidence that the outcomes are not a coincidence.
Another study focuses on diversity
A recent study published in JAMA focused on infants coming from diverse racial and ethnic backgrounds. Called Greenlight Plus, the trial randomized 449 parent-child pairs to the digital intervention group and 451 to the counseling-only group. The study included 45% Hispanic children, 20.6% non-Hispanic White, 15.9% non-Hispanic Black, and 18.3% identifying as other or mixed races. Among parents, 65.2% preferred English and 34.8% preferred Spanish; 15.6% reported food insecurity, and 55.6% had limited health literacy.
Results showed a lower mean weight-for-length in the digital intervention group compared to the counseling-only group. Although the proportion of children classified as overweight was similar between groups, the digital intervention group had a significantly lower obesity rate (7.4% vs. 12.7%).
The authors noted that some population groups were not well represented in the study and that only English and Spanish speakers were included. Nonetheless, they highlighted the potential for a meaningful population-level impact if the intervention is scaled up, suggesting further studies on broader implementation.
Finally, a quick reminder about Dr. Pretlow’s app and an upcoming study geared at teens. The ability to rechannel displacement into less harmless activities rather than succumbing to urges is behind the behavior modification app, BrainWeighve, currently ramping up for a trial through the University of California Los Angeles (UCLA). The trial focuses on weight loss for obese teens using a self-directed, physician-supervised program withdrawing from one problem food at a time.
Your responses and feedback are welcome!
Source: “Digital Intervention Reduces Early Childhood Obesity Risk in Diverse Populations,” American Journal of Managed Care, 11/4/24
Source: “Simple text messages could help tackle childhood obesity,” Earth.com, 11/4/24
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