Smartphone Technology to Decrease BMI in Overweight and Obese Adolescents

描述（由申请人提供）：超重和肥胖正在以惊人的速度发生在美国和世界各地的儿童和青少年中。在12-19岁的青少年中，估计有34%超重，18%肥胖。在巴尔的摩市，高中生的超重率比全国平均水平高出26%，令人震惊。许多健康问题与年轻人的超重和肥胖有关，包括糖尿病、中风、冠心病、高血压和成年后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育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渐降低体重指数（BMI）的有效干预工具。行为咨询技术旨在成为咨询师和参与者或患者之间的伙伴关系，因为它们允许参与者确定目标，障碍，并创建解决方案，以选择更健康的生活方式。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，在医疗保健访问期间缺乏时间来评估这些。拟议的项目是一项随机临床试验，旨在研究使用基于行为的减肥智能手机应用程序降低一组超重的高中年龄青少年的BMI，这些青少年参加了约翰霍普金斯医院的哈里特巷诊所。智能手机应用程序用于饮食习惯和身体活动的自我监测，并将与申请人实施的一次性行为咨询会议相结合。本研究以社会认知理论为基础，着重于提高健康行为自我效能的策略，以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与。随机分组后，一半受试者将接受智能手机应用程序干预，另一半受试者将通过哈里特莱恩诊所的医疗保健提供者接受常规护理，为期4个月。将分析BMI、健康饮食和体力活动自我效能、健康饮食习惯和体力活动行为的变化，以确定两组之间的差异，同时控制其他可能的协变量。将评估对干预和智能手机技术的满意度。测试这种类型的技术是必要的，因为它可以让忙碌繁忙的医疗保健提供者提供新的方法来提供有效的干预措施，旨在减少超重和肥胖。

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.