Smartphone Technology to Decrease BMI in Overweight and Obese Adolescents

描述(申请人提供)：超重和肥胖在美国和全世界的儿童和青少年中以惊人的速度发生。在12-19岁的青少年中，估计有34%超重，18%肥胖。巴尔的摩市高中生超重的比例比全国平均水平高出26%，令人担忧。许多健康问题都与年轻人的超重和肥胖有关，包括成年后糖尿病、中风、冠心病、高血压和过早死亡的风险增加。减少这一人群超重和肥胖的干预措施侧重于增加体力活动和改变饮食习惯。行为咨询技术和自我监测已被证明是逐步降低体重指数(BMI)的有效干预工具。行为咨询技术被设计为咨询师和参与者或患者之间的合作伙伴关系，因为它们允许参与者识别目标、障碍，并创建解决方案，以导致更健康的生活方式选择。需要新的和创新的解决方案来监测身体活动和饮食习惯，因为许多医疗保健提供者报告说，在医疗保健就诊期间缺乏时间来评估这些。这项拟议的项目是一项随机临床试验，旨在研究在约翰·霍普金斯医院哈里特·莱恩诊所就诊的一组超重高中年龄青少年中，使用基于行为的减肥智能手机应用程序降低BMI的情况。这款智能手机应用程序用于自我监控饮食习惯和体力活动，并将与申请者实施的一次性行为咨询课程相结合。本研究以社会认知理论为基础，研究如何提高健康行为的自我效能感，从而提高健康行为的效果。为了实现这些目标，将招募60名超重和肥胖青少年参加。随机化后，一半的参与者将接受智能手机应用程序干预，另一半将通过他们在哈里特·莱恩诊所的医疗保健提供者接受为期四个月的常规护理。BMI、健康饮食和身体活动的自我效能、健康饮食习惯和身体活动行为的变化将分析两组之间的差异，同时控制其他可能的协变量。对干预和智能手机技术的满意度将进行评估。测试这类技术势在必行，因为它可以让忙碌的医疗保健提供者以新的方式提供旨在减少超重和肥胖的高效和有效的干预措施。

DESCRIPTION (provided by applicant): Overweight and obesity are occurring at an alarming rate in children and adolescents in the United States and throughout the world. Among adolescents, aged 12-19 years, it is estimated that 34% are overweight and 18% are obese. The prevalence of being overweight as a high school student in Baltimore City is an alarming 26% higher than the national average. Many health problems are associated with overweight and obesity in the young, including increased risk of diabetes, stroke, coronary heart disease, hypertension, and premature mortality as an adult. Interventions to decrease overweight and obesity in this population have focused on increasing physical activity and modifying dietary habits. Behavioral counseling techniques and self-monitoring have been shown to be effective intervention tools to gradually decrease body mass index (BMI). The behavioral counseling techniques are designed to be a partnership between the counselor and participant or patient in that they allow the participant to identify goals, barriers, and create solutions to lead to healther lifestyle choices. New and innovative solutions to monitoring physical activity and dietary habits are needed, as many healthcare providers have reported a lack of time to assess these during healthcare visits. The proposed project is a randomized clinical trial that examines the use of a behaviorally-based weight loss Smartphone application on decreasing BMI in a group of overweight high school aged adolescents who attend the Harriet Lane Clinic at the Johns Hopkins Hospital. The Smartphone application is used for self-monitoring of dietary habits and physical activity and will be combined with a one time behavioral counseling session implemented by the applicant. This study is informed by Social Cognitive Theory, which focuses on strategies to increase self-efficacy for healthy behaviors to enhance health behavior outcomes. To achieve these aims, 60 overweight and obese adolescents will be recruited for participation. Following randomization, half of the participants will receive the Smartphone application intervention and half will receive usual care through their healthcare provider at the Harriet Lane Clinic for four months. Changes in BMI, self-efficacy for healthy eating and physical activity, healthy eating habits, and physical activity behaviors will be analyzed for differences between the two groups while controlling for other possible covariates. Satisfaction with the intervention and Smartphone technology will be assessed. Testing this type of technology is imperative as it could allow busy healthcare providers new ways to deliver efficient and effective interventions aimed at reducing overweight and obesity.