Accepted for/Published in: JMIR Formative Research
Date Submitted: Dec 21, 2023
Date Accepted: Apr 4, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Impact of Behavior Change Counseling Delivered Via a Digital Health Tool versus Routine Care among Adolescents with Obesity: A Randomized Pilot Feasibility Study
ABSTRACT
Background:
Youth overweight and obesity is a public health crisis, and increases risk of poor cardiovascular health (CVH) and chronic disease. Healthcare providers play a key role in weight management; yet few tools exist to support providers in delivering tailored evidence-based behavior change interventions to patients.
Objective:
The goal of this pilot feasibility study was to determine the feasibility of implementing PREVENT in clinical settings, to generate implementation data to inform scale up, and to gather preliminary effectiveness data.
Methods:
A randomized pilot clinical trial was conducted to examine the feasibility, implementation, and preliminary impact of PREVENT on patient knowledge, motivation, behaviors and CVH outcomes. The study took place in a multi-disciplinary obesity management clinic at a children's hospital within an academic medical center. Patients aged 12-18 (N=36) were randomized to use PREVENT during their routine visit (n=18) or usual care control (n=18). PREVENT is a digital health tool designed for use by providers to engage patients in behavior change education and goal setting, and provides resources to support change. Patient EHR and self-report behavior data were collected at baseline and 3 months post-intervention. Implementation data were collected via PREVENT, direct observation, surveys, and interviews. We conducted quantitative, qualitative, and mixed methods analyses to evaluate pre-post patient changes and implementation data.
Results:
PREVENT was feasible, acceptable, easy to understand, and helpful to patients. Although not statistically significant, only PREVENT patients increased their motivation to change their behaviors, and knowledge of ways to improve heart health and of resources. Compared to the control group, PREVENT patients significantly improved their overall CVH and blood pressure (p-values <.05).
Conclusions:
Digital tools can support the delivery of behavior change counseling in clinical settings to increase knowledge and motivate patients to change their behaviors. An appropriately-powered trial is necessary to determine the impact of PREVENT on CVH behaviors and outcomes. Clinical Trial: NCT06121193
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