Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Aug 12, 2019
Date Accepted: Feb 10, 2020
Date Submitted to PubMed: Apr 29, 2020
Are interventions for weight management in adolescents delivered via text messages effective? A systematic review
ABSTRACT
Background:
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.
Objective:
To determine the effectiveness of text message interventions on body mass index (BMI) in adolescents and describe characteristics that are common to effective interventions.
Methods:
Systematic review including: (i) randomised controlled trials of text message lifestyle interventions; (ii) participants are adolescents 10-19 years; and (iii) outcomes focussed on obesity prevention or management. Primary outcome was objective or self-report change in BMI.
Results:
In total, 4362 records were identified, and 215 full-text articles were assessed for eligibility. Eight unique studies were identified, including 767 participants, mean age 14.3±0.9 years, BMI 29.7±1.6 kg/m-2 and 53% female (31-100%). All interventions were multi-component. The median active intervention period was 4.5 months. During 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). Four studies utilised two-way text message communication with health-professionals. Seven of the eight studies demonstrated reductions in BMI or BMI z-score in the intervention group compared to the control at the end of the final follow-up. The effect was only statistically significant in one study at 6-months. Over 6-months, reductions in BMI (kg/m-2) ranged from 0.6-4.5% and BMI z-score ranged from 4.2-28.1%. Overall quality of the studies was low.
Conclusions:
Further research is required to elucidate the effectiveness, and potential impact of text message interventions on weight and weight related-behaviours in adolescents. Clinical Trial: PROSPERO CRD42018109197
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