Kay Melissa C, Burroughs Jasmine, Askew Sandy, Bennett Gary G, Armstrong Sarah, Steinberg Dori M
Duke Global Digital Health Science Center, Duke Center for Childhood Obesity Research, Duke University, Durham, NC, United States.
Duke Global Digital Health Science Center, Duke University, Durham, NC, United States.
J Med Internet Res. 2018 Dec 20;20(12):e11093. doi: 10.2196/11093.
The prevalence of childhood obesity continues to increase, and clinic-based treatment options have failed to demonstrate effectiveness. One of the strongest predictors of child weight is parent weight. Parental treatment for weight loss may indirectly reduce obesity in the child. We have previously demonstrated the effectiveness among adults of a fully automated, evidence-based digital weight loss intervention (Track). However, it is unknown if it is feasible to deliver such a treatment directly to parents with obesity who bring their child with obesity to a weight management clinic for treatment.
The objective of our study was to evaluate the feasibility of and engagement with a digital weight loss intervention among parents of children receiving treatment for obesity.
We conducted a 6-month pre-post feasibility trial among parents or guardians and their children aged 4-16 years presenting for tertiary care obesity treatment. Along with the standard family-based treatment protocol, parents received a 6-month digital weight loss intervention, which included weekly monitoring of personalized behavior change goals via mobile technologies. We examined levels of engagement by tracking completed weeks of self-monitoring and feasibility by assessing change in weight.
Participants (N=48) were on average 39 years old, mostly female (35/42, 82% ), non-Hispanic Black individuals (21/41, 51%) with obesity (36/48, 75%). Over a quarter had a yearly household income of <US $25,000, and about a third had the equivalent of a high school education. Children were on average 10 years old and had a body mass index of 29.8 kg/m. The median percentage of weeks participants tracked their behaviors was 77% (18.5/24 total weeks; interquartile range [IQR] 6.3 to 100). The median number of attempts via phone or text message (short message service) required to complete one tracking week was 3.3 (IQR 2.6 to 4.9). Nearly half (23/48, 48%) had high levels of engagement, completing 80% (19/24) or more weeks of tracking. Of the 26 participants with weight measurements reported at 6 months, of which 81% (21/26) were self-reported, there was a median 2.44 kg (IQR -6.5 to 1.0) decrease in weight.
It is feasible to deliver an evidence-based digital weight loss intervention to parents or guardians whose children are enrolled in a weight management program. Given the feasibility of this approach, future studies should investigate the effectiveness of digital weight loss interventions for parents on child weight and health outcomes.
儿童肥胖的患病率持续上升，而基于诊所的治疗方案未能证明其有效性。儿童体重最强的预测因素之一是父母的体重。父母进行减肥治疗可能会间接降低孩子的肥胖率。我们之前已经证明了一种全自动、循证的数字减肥干预措施（Track）在成年人中的有效性。然而，对于将这种治疗直接提供给带着肥胖孩子到体重管理诊所接受治疗的肥胖父母是否可行尚不清楚。
我们研究的目的是评估在接受肥胖治疗的儿童的父母中进行数字减肥干预的可行性和参与度。
我们对前来接受三级肥胖治疗的4至16岁儿童的父母或监护人及其孩子进行了为期6个月的前后可行性试验。除了标准的基于家庭的治疗方案外，父母还接受了为期6个月的数字减肥干预，其中包括通过移动技术每周监测个性化行为改变目标。我们通过跟踪完成的自我监测周数来检查参与程度，并通过评估体重变化来检查可行性。
参与者（N = 48）平均年龄为39岁，大多数为女性（35/42，82%），非西班牙裔黑人个体（21/41，51%），患有肥胖症（36/48，75%）。超过四分之一的家庭年收入低于25,000美元，约三分之一的人相当于高中学历。儿童平均年龄为10岁，体重指数为29.8kg/m²。参与者跟踪其行为的周数中位数为77%（共24周中的18.5周；四分位间距[IQR]为6.3至100）。完成一周跟踪所需通过电话或短信（短消息服务）尝试的中位数为3.3次（IQR为2.6至4.9）。近一半（23/48，48%）的人参与度高，完成了80%（19/24）或更多周的跟踪。在6个月时有体重测量报告的26名参与者中，其中81%（21/26）是自我报告的，体重中位数下降了2.44kg（IQR为-6.5至1.0）。
为其孩子参加体重管理计划的父母或监护人提供循证数字减肥干预是可行的。鉴于这种方法的可行性，未来的研究应调查针对父母的数字减肥干预对孩子体重和健康结果的有效性。
