Text Message Behavioral Intervention for Teens on Eating, Physical Activity and Social Wellbeing (TEXTBITES): Protocol for a Randomized Controlled Trial.

Stephanie R Partridge,Katharine Steinbeck,Anna C Singleton,Alicia Grunseit,Julie Redfern,Clara Chow,Karice Hyun,Zoe Latham,Rebecca Raeside

doi:10.2196/16481

Abstract

BackgroundObesity is among the most significant health challenges facing today’s adolescents. Weight gain during adolescence is related to cardiovascular disease, type 2 diabetes, and some cancers in later life. Presently, adolescents living in Australia have limited access to age-appropriate obesity prevention services.ObjectiveThis study aims to investigate whether a two-way text message program, with optional telephone health counseling, improves body mass index (BMI) z score and lifestyle outcomes in adolescents who are overweight.MethodsThis study will be a single-blind randomized controlled trial (N=150) comparing a two-way text message intervention, with optional telephone health counseling, to usual care in adolescents (13-18 years old, inclusive) who are overweight (recruited from a pediatric weight management clinic and the broader community in Sydney, Australia). The intervention group will receive a six-month text message program, which consists of two-way, semipersonalized, lifestyle-focused text messages (four messages/week) in addition to usual care. The control group will be assigned to receive usual care. The study also includes a follow-up at 12-months. The primary outcome is a change in BMI z score at six months. Secondary outcomes are changes in waist-to-height ratio, diet, physical and sedentary activity levels, sleep quality, quality of life, self-esteem, self-efficacy, social support, and eating disorder and depression symptoms. Also, we will examine acceptability, utility, and engagement with the program through a study-specific process evaluation questionnaire, semi-structured telephone interviews, and an analysis of health counselor communication logs. The analyses will be performed by the intention-to-treat principle to assess differences between intervention and control groups.ResultsThe study opened for recruitment in December 2019. Data collection is expected to be completed by December 2021, and the results for the primary outcome are expected to be published in early 2022.ConclusionsThis study will test the effectiveness of an interactive two-way text message program compared to usual care in improving BMI z score and lifestyle outcomes in adolescents with overweight. This interactive, innovative, and scalable project also aims to inform future practice and community initiatives to promote obesity prevention behaviors for adolescents.Trial RegistrationAustralia New Zealand Clinical Trials Registry (ANZCTR) ACTRN12619000389101; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377158&isReview=trueInternational Registered Report Identifier (IRRID)DERR1-10.2196/16481

Highlights

The global prevalence of obese and overweight adolescents has significantly increased over the last five decades, with 18% of the global population of children and adolescents being overweight or obesity in 2016 [1]
This study will test the effectiveness of an interactive two-way text message program compared to usual care in improving body mass index (BMI) z score and lifestyle outcomes in adolescents with overweight
This study aims to determine if the text message program can improve lifestyle outcomes

Summary

Introduction

The global prevalence of obese and overweight adolescents has significantly increased over the last five decades, with 18% of the global population of children and adolescents being overweight or obesity in 2016 [1]. In 2017-2018, 25% of adolescents aged 12-17 years old and living in Australia, were overweight or obese [2]. In the United States of America, 20.6% of adolescents aged 12-19 years old had obesity in 2013-2014 [3]. Gaining excess weight during adolescence is likely to lead to being overweight and obese in adulthood [7]. Weight gain during adolescence is associated with higher risk and earlier onset of cardiovascular disease [8], type 2 diabetes [9], and some cancers [10]. Weight gain during adolescence is related to cardiovascular disease, type 2 diabetes, and some cancers in later life. Adolescents living in Australia have limited access to age-appropriate obesity prevention services

Methods

Results

Conclusion