Text, web-based health intervention improves weight trajectories for children up to age 2
Click Here to Manage Email Alerts
Key takeaways:
- Children in the intervention group had a lower mean weight-for-length trajectory vs. children in the clinic-only group.
- Fewer children in the intervention vs. clinic-only group had obesity at age 24 months.
SAN ANTONIO — At 24 months, children who received a health literacy-informed digital text and web-based intervention had better weight trajectories vs. those who did not, according to Greenlight Plus Trial results presented at ObesityWeek.
“Childhood obesity rates continue to increase and disparities start early. We know that most children with obesity do not outgrow it,” Eliana Perrin, MD, MPH, Bloomberg Distinguished Professor of primary care in the department of pediatrics in the School of Medicine and Nursing at Johns Hopkins University, said during a presentation. “Early intervention strategies can prevent obesity with long-term implications for cardiometabolic health and health equity, but most prevention interventions don't work. Digital interventions may be well-suited for reducing health disparities, because cell phones are nearly ubiquitous, and this approach could be quickly scalable.”
Perrin and colleagues conducted the Greenlight Plus Trial, a multicenter, individually randomized, parallel-group trial with 900 healthy children aged 21 days old or younger born after 34 weeks’ gestation at six U.S. medical centers between October 2019 and January 2022. All children were randomly assigned to either the clinic-based health behavior counseling group (n = 451) with health behavior counseling from pediatric clinicians, or the clinic plus digital intervention group (n = 449) where families received health literacy-informed, individually tailored responsive text messages supporting health behavior goals and a web-based dashboard in addition to health behavior counseling.
The primary outcome was child weight-for-length trajectory at 24 months. Secondary outcomes, all at 24 months, included weight-for-length z-score, BMI z-score and the percentage of children with overweight or obesity.
Overall, at 24 months, 85.7% of participants in the intervention group and 86.9% of those in the clinic-only group had weight-for-length trajectory data.
Mean weight-for-length at 24 months was 14.8 kg/m for the clinic plus digital intervention group and 15.1 kg/m for the clinic-only group. Compared with the clinic-only group, children in the clinic plus digital intervention group had a lower mean weight-for-length trajectory, with an estimated reduction of 0.33 kg/m (95% CI, 0.57 to 0.09; P < .001), according to the researchers.
Researchers observed an adjusted mean difference of –0.19 for both weight-for-length (95% CI, –0.37 to –0.02) and BMI (95% CI, –0.36 to –0.01) z-scores at 24 months.
Based on WHO criteria, at 24 months, fewer children in the clinic plus digital intervention group had overweight (12.4% vs. 16%; adjusted RR = 0.68; 95% CI, 0.48-0.93) or obesity (2.6% vs. 5.7%; aRR = 0.46; 95% CI, 0.24-0.89) compared with the clinic-only group, according to the researchers.
Also at 24 months, fewer children in the clinic plus digital intervention had obesity based on CDC criteria of BMI 95th percentile compared with the clinic-only group (7.4% vs. 12.7%; aRR = 0.56; 95% CI, 0.36-0.88), the researchers found.
According to Perrin, these results translate into a number needed to treat of 19 patients to prevent one case of childhood obesity.
“This Greenlight Plus intervention is one of only a couple of known, effective interventions that prevents childhood overweight and obesity, and this study advances the field by including a large, diverse patient population from several sites across the U.S., compared to other studies that are time- and resource-intensive. The digital components of this intervention have the potential to be quickly scaled up and implemented,” Perrin said. “The substantial reduction in the risk of childhood obesity observed in the study could have a significant population-level impact of scale and may have a profound impact on later obesity, cardiometabolic outcomes and health equity, but broader implementation studies are warranted.”
Reference:
Collapse
Heerman WJ. O-020. Presented at: ObesityWeek; Nov. 3-6, 2024; San Antonio.
Read more about
Click Here to Manage Email Alerts