Nicole L Nollen1, Matthew S Mayo2, Susan E Carlson3, Michael A Rapoff4, Kathy J Goggin5, Edward F Ellerbeck6. 1. Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, Kansas. Electronic address: nnollen@kumc.edu. 2. Department of Biostatistics, University of Kansas School of Medicine, Kansas City, Kansas. 3. Department of Dietetics and Nutrition, University of Kansas School of Medicine, Kansas City, Kansas. 4. Department of Pediatrics, University of Kansas School of Medicine, Kansas City, Kansas. 5. Health Services and Outcomes Research, Children's Mercy School of Pharmacy, University of Missouri-Kansas City, Kansas City, Missouri. 6. Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, Kansas.
Abstract
BACKGROUND: Mobile technologies have wide-scale reach and disseminability, but no known studies have examined mobile technologies as a stand-alone tool to improve obesity-related behaviors of at-risk youth. PURPOSE: To test a 12-week mobile technology intervention for use and estimate effect sizes for a fully powered trial. METHODS:Fifty-one low-income, racial/ethnic-minority girls aged 9-14 years were randomized to a mobile technology (n=26) or control (n=25) condition. Both conditions lasted 12 weeks and targeted fruits/vegetables (FVs; Weeks 1-4); sugar-sweetened beverages (SSBs; Weeks 5-8), and screen time (Weeks 9-12). The mobile intervention prompted real-time goal setting and self-monitoring and provided tips, feedback, and positive reinforcement related to the target behaviors. Controls received the same content in a written manual but no prompting. Outcomes included device utilization and effect size estimates of FVs, SSBs, screen time, and BMI. Data were collected and analyzed in 2011-2012. RESULTS:Mobile technology girls used the program on 63% of days and exhibited trends toward increased FVs (+0.88, p=0.08) and decreased SSBs (-0.33, p=0.09). The adjusted difference between groups of 1.0 servings of FVs (p=0.13) and 0.35 servings of SSBs (p=0.25) indicated small to moderate effects of the intervention (Cohen's d=0.44 and -0.34, respectively). No differences were observed for screen time or BMI. CONCLUSIONS: A stand-alone mobile app may produce small to moderate effects for FVs and SSBs. Given the extensive reach of mobile devices, this pilot study demonstrates the need for larger-scale testing of similar programs to address obesity-related behaviors in high-risk youth.
RCT Entities:
BACKGROUND: Mobile technologies have wide-scale reach and disseminability, but no known studies have examined mobile technologies as a stand-alone tool to improve obesity-related behaviors of at-risk youth. PURPOSE: To test a 12-week mobile technology intervention for use and estimate effect sizes for a fully powered trial. METHODS: Fifty-one low-income, racial/ethnic-minority girls aged 9-14 years were randomized to a mobile technology (n=26) or control (n=25) condition. Both conditions lasted 12 weeks and targeted fruits/vegetables (FVs; Weeks 1-4); sugar-sweetened beverages (SSBs; Weeks 5-8), and screen time (Weeks 9-12). The mobile intervention prompted real-time goal setting and self-monitoring and provided tips, feedback, and positive reinforcement related to the target behaviors. Controls received the same content in a written manual but no prompting. Outcomes included device utilization and effect size estimates of FVs, SSBs, screen time, and BMI. Data were collected and analyzed in 2011-2012. RESULTS: Mobile technology girls used the program on 63% of days and exhibited trends toward increased FVs (+0.88, p=0.08) and decreased SSBs (-0.33, p=0.09). The adjusted difference between groups of 1.0 servings of FVs (p=0.13) and 0.35 servings of SSBs (p=0.25) indicated small to moderate effects of the intervention (Cohen's d=0.44 and -0.34, respectively). No differences were observed for screen time or BMI. CONCLUSIONS: A stand-alone mobile app may produce small to moderate effects for FVs and SSBs. Given the extensive reach of mobile devices, this pilot study demonstrates the need for larger-scale testing of similar programs to address obesity-related behaviors in high-risk youth.
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