JMIR Publications

ABSTRACT

Background:

Childhood overweight or obesity has become one of the world's most concerning health problems. Tele-intervention could be a non-pharmacological way to controlling pediatric body weight.

Objective:

To systematically evaluate the reported effects of tele-intervention versus usual care in controlling weight in children who are overweight or obese.

Methods:

We systematically searched four databases (Cochrane Library (including CENTRAL), Embase, PubMed, and Web of Science) for potential studies using tele-intervention for weight control amongst children with overweight or obesity. Studies without randomization for comparing tele-intervention and non-tele-intervention were excluded. Two independent reviewers extracted and double-checked data on study design, baseline characteristics, and outcomes. Qualitative information was tabulated, and quantitative data were pooled using random-effects model. Pooled point estimate was presented with 95% confidence interval (CI). Outcomes related to weight control in this synthesis were body mass index (BMI), BMI z-score, body fat, and waist circumference. Because BMI and BMI z-score were measured similarly across the included trials, their pooled measurement was mean difference (MD). Nevertheless, measuring units of body fat and waist circumference varied in trials, and they were pooled using standardized mean difference (SMD).

Results:

A total of 26 randomized controlled trials (RCTs) with 2,866 overweight or obese children met eligibility criteria. Most RCTs contributing to meta-analysis were low risk of bias, three RCTs were with some concerns in risk of bias, and only one trial was with high risk of bias. The pooled result showed that tele-intervention significantly reduced BMI z-score within six months (MD -0.15; 95% CI -0.23 to -0.08) and over six months (MD -0.19; 95% CI -0.34 to -0.03). A similar trend can be observed in the outcome of BMI in six months (MD -2.48; 95% CI -4.15 to -0.82), but non-significant over a six-month period.

Conclusions:

Tele-intervention may be a viable option for controlling childhood obesity, especially when family members are involved and professional interaction is designed into the tele-intervention. Long-term impacts, on the other hand, remains uncertain and warrant further investigation in the future.