Obesity Prevention and Control: Digital Health Interventions for Adolescents with Overweight or Obesity
Findings and Recommendations
The Community Preventive Services Task Force (CPSTF) recommends digital health interventions to assist adolescents with overweight or obesity with weight management.
Evidence shows these interventions lead to small but meaningful weight reductions in adolescents with overweight or obesity.
The full CPSTF Finding and Rationale Statement and supporting documents for Obesity Prevention and Control: Digital Health Interventions for Adolescents with Overweight or Obesity are available in The Community Guide Collection on CDC Stacks.
Intervention
Interventions combine self-monitoring and goal setting with digital health to help with weight management among adolescents aged 12-18 years who have overweight or obesity.
Trained moderators, with oversight from healthcare providers, work to increase adolescents’ awareness of healthy dietary or physical activity behaviors that help with weight management and teach them how to use the program’s website, mobile app, or wearable devices. Over a period of at least two months, adolescents record their weight and dietary or physical activity behaviors and track their progress toward set goals.
About The Systematic Review
The CPSTF recommendation is based on evidence from a systematic review published in 2018 (Ho et al., 8 studies [10 study arms], search period through December 2017) combined with more recent evidence (3 studies, search period December 2017 through March 2019).
Study Characteristics
- Included studies were conducted in urban and suburban areas of the United States (6 studies), other high-income countries (4 studies), and one upper middle income country (1 study).
- Adolescents in the included studies were 12-16 years of age, and represented African American, Hispanic, Asian American, and white populations.
Summary of Results
The systematic review included 11 studies (13 study arms).
- Body Mass Index (BMI) z-score decreased by a median of 0.10 (6 studies, 8 study arms)
- Percent body fat decreased by 0.49 percentage points (3 studies)
- BMI decreased by 0.39 kg/m² and 0.27 kg/m² (2 studies)
Summary of Economic Evidence
A systematic review of economic evidence has not been conducted.
Applicability
The CPSTF finding should be applicable to adolescents recruited from healthcare settings, schools, or other community organizations, regardless of sex, income level, race, or ethnicity.
Evidence Gaps
- What are the long-term effects of self-monitoring digital health interventions among adolescents?
- What is the ideal intervention duration or level of intensity? Is a short, intense intervention more or less effective than a longer and less intense intervention?
- What are the effects of adding access to healthier foods or safe and accessible opportunities for physical activity to the intervention?
- What are the effects of adding social media to the intervention?
- How effective are these interventions across different populations and settings (e.g., low income populations, students with disabilities, rural communities, isolated populations)?
Implementation Considerations and Resources
- Interventions incorporating technology are a convenient and relatively new way to reach people, especially younger generations.
- Digital health is rapidly evolving and the impact of newer digital health interventions, such as interventions incorporating social media, were not represented in this body of evidence.
- Storage of confidential personal information is critical; at a minimum, personal information should be encrypted and password-protected.
- Implementers need to ensure information administered to adolescents is age-appropriate and accurate. Involving trained professionals can help. Interventions in the included studies were supported by physicians, dietitians, exercise physiologists, and mental health providers.
- Digital health interventions that include self-monitoring may increase access for adolescents who are living in rural areas without access to a nearby intervention facility or have transportation challenges that make it difficult to participate in obesity treatment interventions.
Crosswalks
Healthy People 2030 includes the following objectives related to this CPSTF recommendation.