Aim2Be 干预在改变超重和肥胖青少年生活方式行为方面的效果：随机对照试验。

Efficacy of the Aim2Be Intervention in Changing Lifestyle Behaviors Among Adolescents With Overweight and Obesity: Randomized Controlled Trial.

机构信息

School of Nutrition Sciences, Faculty of Health Sciences, The University of Ottawa, Ottawa, ON, Canada.

School of Population and Public Health, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada.

出版信息

J Med Internet Res. 2023 Apr 25;25:e38545. doi: 10.2196/38545.

DOI:10.2196/38545

PMID:37097726

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10170359/

Abstract

BACKGROUND

Aim2Be is a gamified lifestyle app designed to promote lifestyle behavior changes among Canadian adolescents and their families.

OBJECTIVE

The primary aim was to test the efficacy of the Aim2Be app with support from a live coach to reduce weight outcomes (BMI Z score [zBMI]) and improve lifestyle behaviors among adolescents with overweight and obesity and their parents versus a waitlist control group over 3 months. The secondary aim was to compare health trajectories among waitlist control participants over 6 months (before and after receiving access to the app), assess whether support from a live coach enhanced intervention impact, and evaluate whether the app use influenced changes among intervention participants.

METHODS

A 2-arm parallel randomized controlled trial was conducted from November 2018 to June 2020. Adolescents aged 10 to 17 years with overweight or obesity and their parents were randomized into an intervention group (Aim2Be with a live coach for 6 months) or a waitlist control group (Aim2Be with no live coach; accessed after 3 months). Adolescents' assessments at baseline and at 3 and 6 months included measured height and weight, 24-hour dietary recalls, and daily step counts measured with a Fitbit. Data on self-reported physical activity, screen time, fruit and vegetable intake, and sugary beverage intake of adolescents and parents were also collected.

RESULTS

A total of 214 parent-child participants were randomized. In our primary analyses, there were no significant differences in zBMI or any of the health behaviors between the intervention and control groups at 3 months. In our secondary analyses, among waitlist control participants, zBMI (P=.02), discretionary calories (P=.03), and physical activity outside of school (P=.001) declined, whereas daily screen time increased (P<.001) after receiving access to the app compared with before receiving app access. Adolescents randomized to Aim2Be with live coaching reported more time being active outside of school compared with adolescents who used Aim2Be with no coaching over 3 months (P=.001). App use did not modify any changes in outcomes among adolescents in the intervention group.

CONCLUSIONS

The Aim2Be intervention did not improve zBMI and lifestyle behaviors in adolescents with overweight and obesity compared with the waitlist control group over 3 months. Future studies should explore the potential mediators of changes in zBMI and lifestyle behaviors as well as predictors of engagement.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03651284; https://clinicaltrials.gov/ct2/show/study/NCT03651284.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-020-4080-2.

摘要

背景

Aim2Be 是一款游戏化的生活方式应用程序，旨在促进加拿大青少年及其家庭改变生活方式行为。

目的

主要目的是在有现场教练支持的情况下测试 Aim2Be 应用程序的功效，以减少超重和肥胖青少年及其父母的体重结果（BMI Z 分数[zBMI]）并改善生活方式行为，与等待名单对照组相比，在 3 个月内。次要目的是比较等待名单对照组参与者在 6 个月内（在获得应用程序访问权限之前和之后）的健康轨迹，评估现场教练的支持是否增强了干预效果，并评估应用程序的使用是否影响了干预参与者的变化。

方法

这是一项从 2018 年 11 月至 2020 年 6 月进行的 2 臂平行随机对照试验。年龄在 10 至 17 岁之间的超重或肥胖青少年及其父母被随机分配到干预组（6 个月内使用 Aim2Be 和现场教练）或等待名单对照组（3 个月后使用 Aim2Be，无现场教练）。在基线和 3 个月和 6 个月时，对青少年进行了包括身高和体重测量、24 小时膳食回顾和使用 Fitbit 测量的每日步数在内的评估。还收集了青少年及其父母的自我报告体育活动、屏幕时间、水果和蔬菜摄入量以及含糖饮料摄入量的数据。

结果

共有 214 对父母-子女参与者被随机分配。在我们的主要分析中，在 3 个月时，干预组和对照组之间的 zBMI 或任何健康行为均无显着差异。在我们的次要分析中，在等待名单对照组中，zBMI（P=.02）、可自由支配的卡路里（P=.03）和校外体育活动（P=.001）下降，而每天的屏幕时间（P<.001）在获得应用程序访问权限后与获得应用程序访问权限前相比有所增加。与使用无现场教练的 Aim2Be 的青少年相比，在 3 个月的时间内，随机分配到使用 Aim2Be 和现场教练的青少年在校外的活跃时间更多（P=.001）。在干预组中，使用 Aim2Be 进行现场辅导的青少年比使用 Aim2Be 没有辅导的青少年在校外的活动时间更多（P=.001）。应用程序的使用并没有改变干预组青少年的任何结果变化。