mHealth Weight Management Lit Matrix-2

Running head: mHEALTH FOR WEIGHT MANAGEMENT 1 How mHealth Supports Weight Management Among Children and Adolescents Deepthi Tandra HINF-660-A Dr. Fanta A. Waterman Sacred Heart University April 12, 2023

mHEALTH FOR WEIGHT MANAGEMENT 2 Literature/Synthesis Matrix What is your research question? How can mHealth support weight management among obese and overweight children and adolescents in the United States? Step 1: Identify your Sources by First Author/Date. What are the main ideas of each source? (Make sure you have at least 2-3 per source) Source # Authors; Title; Journal; Year publication (APA) Key Findings 1 Arthurs, N., Tully, L., O’Malley, G., & Browne, S. (2022). Usability and engagement testing of mHealth Apps in paediatric obesity: a narrative review of current literature. International Journal of Environmental Research and Public Health , 19 (3), 1453. 1. Knowledge gaps still exist in determining the most suitable and efficacious features, long-term effects, and sustainability of eHealth interventions for pediatric overweight and obesity. 2. While some mHealth apps have shown promising effects on clinical outcomes, other studies report no significant differences in BMI, waist circumference, or percent body fat. 3. A combined approach of mHealth and usual care may achieve better clinical outcomes than standardised care alone, but longer study duration and further follow-up are required. 2 Langarizadeh, M., Sadeghi, M., As’habi, A., Rahmati, P., & Sheikhtaheri, A. (2021). Mobile apps for weight management in children and adolescents; An updated systematic review. Patient Education and Counseling , 104 (9), 2181-2188. 1. Nine studies were included in the review, with mixed results. 2. Five studies utilized a mobile app as an independent intervention, with two reporting a lower BMI and one reporting a decrease in body weight. 3. Only one study reported a significant improvement in physical activity through mobile app use. 4. The findings suggest that further research is needed on the use of mobile apps as an additional approach for combating childhood obesity. 3 Kouvari, M., Karipidou, M., Tsiampalis, T., Mamalaki, E., Poulimeneas, D., Bathrellou, E., ... & Yannakoulia, M. (2022). Digital health interventions for weight management in children and adolescents: systematic review and meta-analysis. Journal of medical Internet research , 24 (2), e30675. 1. Nine manuscripts from eight clinical trials of 582 children or adolescents were considered eligible for the study. 2. Pooled analysis revealed an overall significant decrease in BMI metrics in the intervention group, and the studies suggest technology-based approaches are functional and acceptable in enhancing weight loss in young populations. 4 Browne, S., Kechadi, M. T., O'Donnell, S., Dow, M., 1. A mobile health (mHealth) intervention was applied as an adjunct to

mHEALTH FOR WEIGHT MANAGEMENT 4 5. A higher number of consultations associated with greater weight loss, independent of age and degree of obesity at treatment initiation. 8 Lyzwinski, L. N., Caffery, L. J., Bambling, M., & Edirippulige, S. (2018). Consumer perspectives on mHealth for weight loss: a review of qualitative studies. Journal of telemedicine and telecare , 24 (4), 290-302. 1. Common high preference themes for mHealth interventions for weight loss include simple and attractive apps that allow for self-monitoring with feedback. 2. Key optimization themes for weight loss apps are personalization, simplicity with appeal, and engagement/entertainment. 3. Common identified benefits of mHealth for weight loss include self- monitoring, goal setting, feedback, ability to motivate, educate, and remind. 4. Common barriers users identified were related to technological and psychological issues as well as message overload/inappropriate timing of messages. 5. Critical factors in planning an mHealth weight loss intervention are the message tone, structure, frequency of message delivery, and personalization, and designing simple apps that engage the user while tailoring content to different target group demographic preferences. 9 Chew, C. S. E., Davis, C., Lim, J. K. E., Lim, C. M. M., Tan, Y. Z. H., Oh, J. Y., ... & Finkelstein, E. A. (2021). Use of a mobile lifestyle intervention app as an early intervention for adolescents with obesity: Single-cohort study. Journal of Medical Internet Research , 23 (9), e20520. 1. Engagement with the mHealth application was high, with 83% of participants completing at least 7 coaching sessions, and the majority of participants rated the app as good to excellent and stated that they would recommend it to others. 2. Although there was no significant change in BMI z-scores, the use of Kurbo as an early intervention could help to improve quality of life and reduce body fat percentage and total caloric intake. 10 San Giovanni, C. B., Dawley, E., Pope, C., Steffen, M., & Roberts, J. (2021). The doctor will “friend” you now: a qualitative study on adolescents’ preferences for weight management app features. Southern medical journal , 114 (7), 373. 1. Adolescents prefer weight management apps that include features related to nutritional education, physical activity tracking, and social connection. 2. Familiarity with similar apps and accessibility of apps on smartphones promoted app use. 3. Barriers to app use included the need for wireless internet, operating difficulties, and privacy concerns. 11 Stasinaki, A., Büchter, D., Shih, C. H., Heldt, K., 1. The PathMate2 mobile app intervention combined with standardized

mHEALTH FOR WEIGHT MANAGEMENT 5 Güsewell, S., Brogle, B., ... & Kowatsch, T. (2021). Effects of a novel mobile health intervention compared to a multi-component behaviour changing program on body mass index, physical capacities and stress parameters in adolescents with obesity: a randomized controlled trial. BMC pediatrics , 21 (1), 1-16. counseling was compared to a traditional behavior changing intervention (BCI) in youth with obesity in Switzerland. 2. Both groups showed significant improvements in physical capacities and body composition after 12 months, but only the control group showed significant reduction in BMI-SDS at T1. 3. The average daily usage rate of the PathMate2 app was high (71.5%), and no side effects were observed. 12 Vajravelu, M. E., & Arslanian, S. (2021). Mobile health and telehealth interventions to increase physical activity in adolescents with obesity: a promising approach to engaging a hard-to-reach population. Current Obesity Reports , 1-9. 1. Mobile health (mHealth) and telehealth-based physical activity interventions have the potential to increase physical activity among adolescents. 2. Wearable activity trackers, text messages or apps, and video visits with exercise specialists are common methods used in these interventions. 3. User engagement is often poor and methods of activity measurement vary across interventions. 13 Lopez, K. E., Salvy, S. J., Fink, C., Werner, J., Wee, C. P., Hegedus, E., ... & Vidmar, A. P. (2021). Executive functioning, depressive symptoms, and intervention engagement in a sample of adolescents enrolled in a weight management program. Childhood Obesity , 17 (4), 281-290. 1. The study examined factors that determine engagement with mHealth applications for obesity management among adolescents. 2. The intervention arm that required parental involvement resulted in the greatest engagement. 3. Hispanic ethnicity was predictive of higher engagement in the control arm. 4. Baseline self-reported depressive symptoms and deficits in executive functioning were not predictors of engagement. 14 Cueto, V., Wang, C. J., & Sanders, L. M. (2019). Impact of a mobile app–based health coaching and behavior change program on participant engagement and weight status of overweight and obese children: Retrospective cohort study. JMIR mHealth and uHealth , 7 (11), e14458. 1. Increased engagement in a mobile app-based weight management program was associated with longer voluntary commitment periods. 2. Participants who received more coaching sessions had a greater decrease in weight status. 3. Participants in the 4- and 12-week commitment groups received fewer coaching sessions compared to those in the 24-week group. 15 James, D. C., Harville II, C., McQueen, D. S., & Facey, J. A. (2022). “I Want a Program That Looks at My Whole Life.” A Focus Group Study on the Ideal Components for an mHealth Weight Management 1. African American women (AAW) expressed a desire for a culturally relevant mHealth weight management program that is cost-effective, accessible, and acceptable. 2. The ideal components of an mHealth weight management program for

mHEALTH FOR WEIGHT MANAGEMENT 7 additional strategies are needed to impact weight loss among overweight African American adolescents. 19 Reddy, P., Dukhi, N., Sewpaul, R., Ellahebokus, M. A. A., Kambaran, N. S., & Jobe, W. (2021). Mobile health interventions addressing childhood and adolescent obesity in Sub-Saharan Africa and Europe: current landscape and potential for future research. Frontiers in Public Health , 9 , 604439. 1. Seven studies reported from Europe, but no eligible studies from Sub- Saharan Africa 2. Need for an evidence base of mHealth interventions that are both relevant and appropriate to address the growing public health problem of child and adolescent overweight and obesity 3. Uptake of mHealth interventions is likely to be high, particularly in poor communities in Africa where there is high penetrance of mobile phone technology among adolescents. 20 Park, J., Park, M. J., & Seo, Y. G. (2021). Effectiveness of Information and Communication Technology on Obesity in Childhood and Adolescence: Systematic Review and Meta- analysis. Journal of Medical Internet Research , 23 (11), e29003. 1. Child-centered ICT interventions showed no significant effect on BMI, body weight, BMI z-score, waist circumference, and percentage body fat in the overall analysis. 2. Subgroup analyses showed that web intervention, lifestyle modification comparator, intervention involving both boys and girls, and intervention involving obesity only had statistically significant effects on BMI reduction. 3. Evidence from the meta-analysis suggests that internet technology is a useful tool for weight loss in children with obesity. 21 Bakırcı-Taylor, A. L., Reed, D. B., McCool, B., & Dawson, J. A. (2019). mHealth improved fruit and vegetable accessibility and intake in young children. Journal of Nutrition Education and Behavior , 51 (5), 556-566. 1. The study aimed to explore the potential of mHealth technologies to improve fruit and vegetable intake in children. 2. The intervention included a mobile website, Facebook posts, and text messages delivered over 10 weeks. 3. Significant improvements were observed in skin carotenoid levels in both children and parents in the intervention group compared to the control group. 22 Moorman, E. L., Koskela-Staples, N. C., Mathai, B. B., Fedele, D. A., & Janicke, D. M. (2021). Pediatric obesity treatment via telehealth: current evidence and future directions. Current Obesity Reports , 10 , 371- 384. 1. Pediatric telehealth weight management interventions are feasible and acceptable, with high retention and attendance rates and high satisfaction reported in the majority of reviewed studies. 2. Marginal reductions in BMI z-scores were observed in most studies, with only two studies showing larger reductions. 3. Improvement in reporting results and more rigorous research, including

mHEALTH FOR WEIGHT MANAGEMENT 8 randomized designs and larger sample sizes, is needed to determine clinical impact and magnitude of effects. 23 Bradley, L. E., Smith-Mason, C. E., Corsica, J. A., Kelly, M. C., & Hood, M. M. (2019). Remotely delivered interventions for obesity treatment. Current Obesity Reports , 8 , 354-362. 1. Remotely delivered interventions for obesity treatment are feasible and generally acceptable. 2. Weight loss outcomes from these interventions are mixed. 3. Engagement in these interventions, particularly in the long term, is a significant challenge. 4. Newer technologies enable tailored and adaptable interventions, but more research is needed in this area. 24 Hu, R., van Velthoven, M. H., & Meinert, E. (2020). Perspectives of people who are overweight and obese on using wearable technology for weight management: systematic review. JMIR mHealth and uHealth , 8 (1), e12651. 1. The study reviewed user perspectives on wearable technology for weight management in people who are overweight and obese. 2. 19 studies were included in the review, including randomized controlled trials, non-randomized studies, qualitative studies, and reviews. 3. Mixed perceptions existed for different constructs of wearable technologies, indicating that interventions were not often tailored to participants' motivations. 4. Very few wearable technology interventions included a thorough qualitative analysis of participants' views on important features of the intervention that made it successful. 25 Nezami, B. T., Ward, D. S., Lytle, L. A., Ennett, S. T., & Tate, D. F. (2018). A mHealth randomized controlled trial to reduce sugar‐sweetened beverage intake in preschool‐aged children. Pediatric obesity , 13 (11), 668-676. 1. A smartphone-delivered intervention was effective in reducing parent- provided sugar-sweetened beverage and juice (SSB/juice) consumption among children ages 3-5 and maternal weight. 2. Mothers in the Smart Moms group lost 2.4 kg at 6 months compared to a 0.9-kg gain in the control group. 3. Linear mixed models showed a greater reduction in child SSB/juice intake in the Smart Moms group compared to the control group at 6 months. 4. The study suggests that mHealth technologies can be a novel approach to family-based obesity prevention.

mHEALTH FOR WEIGHT MANAGEMENT 10 structure, frequency of message delivery, and personalization, and designing simple apps that engage the user while tailoring content to different target group demographic preferences. education, physical activity tracking, and social connection. Familiarity with similar apps and accessibility of apps on smartphones promoted app use. greater decrease in weight status. SYNTHESIS Source #: First Author: Vajravelu Date: 2021 Source #: First Author: San Giovanni Date: 2021 Source #: First Author: Lyzwinski Date: 2018 Theme 3: Challenges in mHealth adoption among adolescents and children User engagement is often poor and methods of activity measurement vary across interventions. Barriers to app use included the need for wireless internet, operating difficulties, and privacy concerns. Common barriers users identified were related to technological and psychological issues as well as message overload/inappropriate timing of messages. Step 4. What is your conclusion? This is the ‘why’ your topic is so key to healthcare (and is the preliminary answer to your research question.) The use of mHealth apps for weight management in adolescents and children with obesity is promising, although there are several barriers to their use, including poor user engagement and technical difficulties. Critical factors for planning an effective mHealth intervention include message tone, structure, and personalization, as well as designing simple apps that engage the user while tailoring content to different target groups. Adolescents prefer weight management apps that include features related to nutritional education, physical activity tracking, and social connection. Studies suggest that technology-based approaches are functional and acceptable in enhancing weight loss in young populations, and a 24-week mobile health intervention incorporating elements of addiction medicine was effective in reducing food addiction symptoms in adolescents with obesity. A mobile- based support system with personalized weight-loss targets and daily weight measurements also improved 1-year weight outcomes compared to standard care childhood obesity treatment.