Originally published by 2 Minute Medicine^® (view original article). Reused on AccessMedicine with permission.

1. Smartphone-based app effectively helped reduce obesity in school-aged children.

2. Family involvement is an important component of effectively reducing obesity using this smartphone-based app.

Evidence Rating Level: 1 (Excellent)

Childhood obesity is a growing health problem and multifaceted approaches that involve both children and their families are likely required to mitigate this growing epidemic. However, the effectiveness of smartphone-based interventions targeting students and their families in obesity prevention has not been tested, especially in middle-income countries like China.

This randomized control trial aimed to determine the effectiveness of a novel smartphone-based app that engaged students and families in preventing obesity in primary school children. This study followed 1362 children (51.5% boys), aged 8-10, from three socioeconomically distinct regions in China for one school year from September 11, 2018, to June 30, 2019. Twenty-four schools were included in the study with twelve schools randomized to intervention and twelve schools randomized to control. Boarding schools and schools for children with talents or minority ethnic groups were excluded. Intervention included a comprehensive smartphone-based app, ten classroom sessions on healthy habits, and frequent monitoring of physical activity and weight. The primary outcome was change in body mass index (BMI) and secondary outcomes included changes in adiposity, blood pressure, physical activity, and dietary behaviors.

The difference in BMI between intervention and control group after one year was -0.46kg/m². Furthermore, the prevalence of obesity decreased by 27% in the intervention group compared to 5.6% in control group. However, this study was limited in that obesity-related behavior was reported by the students or their parents, which may be susceptible to a social desirability bias. Nonetheless, this study suggested that a comprehensive program that collectively engages children, teachers, and parents can be highly successful in reducing childhood obesity. Interestingly, previous studies targeting just children were less successful, suggesting the importance of involving parents. However, this study did not directly compare effectiveness of intervention targeting student alone versus student and parents, which may be a direction for future studies.

Click to read the study in JAMA Pediatrics

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