Abstract
BackgroundThe incidence of obesity among adolescents is increasing. Text messages are a primary communication form for adolescents and potentially a scalable strategy for delivering population health interventions.ObjectiveThis study aimed to determine the effectiveness of text message interventions in reducing BMI in adolescents and describe characteristics that are common to effective interventions.MethodsThis systematic review included randomized controlled trials of text message lifestyle interventions involving adolescents aged 10 to 19 years with outcomes focused on obesity prevention or management. Primary outcome was objective or self-report change in BMI.ResultsIn total, 4362 records were identified, and 215 full-text articles were assessed for eligibility. A total of 8 unique studies were identified, including 767 participants, mean age 14.3 (SD 0.9) years, BMI 29.7 (SD 1.6) kg/m2 and 53.1% (407/767) female (31/101, 30.7%-172/172, 100.0%). All interventions were multicomponent. The median active intervention period was 4.5 months. During the active and extended intervention phases, text messages accounted for >50% (8 studies) and >85% (3 studies) of contact points, respectively. Text messages were heterogeneous, with a median of 1.5 text messages sent per week (range: 1-21). A total of 4 studies utilized two-way text message communication with health professionals Of the 8 studies, 7 demonstrated reductions in BMI or BMI z-score in the intervention group compared with the control at the end of the final follow-up. The effect was only statistically significant in 1 study at 6 months. Over 6 months, reductions in BMI (kg/m2) ranged from 1.3% to 4.5% and BMI z-score ranged from 4.2% to 28.1%. Overall quality of the studies was low.ConclusionsFurther research is required to elucidate the effectiveness and potential impact of text message interventions on weight and weight-related behaviors in adolescents.
Highlights
BackgroundThe prevalence of overweight and obesity among children and adolescents is estimated to be 18% globally, with the prevalence of overweight increasing by 47% over the last four decades [1]
randomized controlled trials (RCTs) were included as they provide the strongest evidence for the benefits of a health care intervention [29]; (2) participants were adolescents, defined by the World Health Organization as the second decade of life, 10 to 19 years [5], both girls and boys, not pregnant and free of acute illness or chronic disease, as some conditions may influence body weight outcomes or ability to change lifestyle behaviors; (3) only studies focused on obesity prevention or management were included; and (4) studies with interventions of any duration that involved the delivery of text messages via a mobile phone device, including multicomponent interventions that were delivered in part by text message
Significant time by group effects were observed in 3 studies [36,37,40]; 2 studies reported the effect of the intervention on both BMI and BMI z-score [37,40], 3 studies reported the effect of the intervention on BMI only [35,36,38], and 3 studies reported the effect of the http://mhealth.jmir.org/2020/5/e15849/
Summary
BackgroundThe prevalence of overweight and obesity among children and adolescents is estimated to be 18% globally, with the prevalence of overweight increasing by 47% over the last four decades [1]. More short-term adverse health outcomes associated with adolescent overweight and obesity include weight stigma [8] and reduced quality of life and self-esteem [9]. Text messages are a primary communication form for adolescents and potentially a scalable strategy for delivering population health interventions. Objective: This study aimed to determine the effectiveness of text message interventions in reducing BMI in adolescents and describe characteristics that are common to effective interventions. Methods: This systematic review included randomized controlled trials of text message lifestyle interventions involving adolescents aged 10 to 19 years with outcomes focused on obesity prevention or management. A total of 4 studies utilized two-way text message communication with health professionals Of the 8 studies, 7 demonstrated reductions in BMI or BMI z-score in the intervention group compared with the control at the end of the final follow-up. Conclusions: Further research is required to elucidate the effectiveness and potential impact of text message interventions on weight and weight-related behaviors in adolescents
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