Efficacy of the Aim2Be Intervention in Changing Lifestyle Behaviors Among Adolescents With Overweight and Obesity: Randomized Controlled Trial

BackgroundAim2Be is a gamified lifestyle app designed to promote lifestyle behavior changes among Canadian adolescents and their families. ObjectiveThe primary aim was to test the efficacy of the Aim2Be app with support from a live coach to reduce weight outcomes...

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Main Authors: Claire N Tugault-Lafleur, Olivia De-Jongh González, Janice Macdonald, Jennifer Bradbury, Tom Warshawski, Geoff D C Ball, Katherine Morrison, Josephine Ho, Jill Hamilton, Annick Buchholz, Louise Mâsse
Format: Article
Language:English
Published: JMIR Publications 2023-04-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2023/1/e38545
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author Claire N Tugault-Lafleur
Olivia De-Jongh González
Janice Macdonald
Jennifer Bradbury
Tom Warshawski
Geoff D C Ball
Katherine Morrison
Josephine Ho
Jill Hamilton
Annick Buchholz
Louise Mâsse
author_facet Claire N Tugault-Lafleur
Olivia De-Jongh González
Janice Macdonald
Jennifer Bradbury
Tom Warshawski
Geoff D C Ball
Katherine Morrison
Josephine Ho
Jill Hamilton
Annick Buchholz
Louise Mâsse
author_sort Claire N Tugault-Lafleur
collection DOAJ
description BackgroundAim2Be is a gamified lifestyle app designed to promote lifestyle behavior changes among Canadian adolescents and their families. ObjectiveThe primary aim was to test the efficacy of the Aim2Be app with support from a live coach to reduce weight outcomes (BMI Z score [zBMI]) and improve lifestyle behaviors among adolescents with overweight and obesity and their parents versus a waitlist control group over 3 months. The secondary aim was to compare health trajectories among waitlist control participants over 6 months (before and after receiving access to the app), assess whether support from a live coach enhanced intervention impact, and evaluate whether the app use influenced changes among intervention participants. MethodsA 2-arm parallel randomized controlled trial was conducted from November 2018 to June 2020. Adolescents aged 10 to 17 years with overweight or obesity and their parents were randomized into an intervention group (Aim2Be with a live coach for 6 months) or a waitlist control group (Aim2Be with no live coach; accessed after 3 months). Adolescents’ assessments at baseline and at 3 and 6 months included measured height and weight, 24-hour dietary recalls, and daily step counts measured with a Fitbit. Data on self-reported physical activity, screen time, fruit and vegetable intake, and sugary beverage intake of adolescents and parents were also collected. ResultsA total of 214 parent-child participants were randomized. In our primary analyses, there were no significant differences in zBMI or any of the health behaviors between the intervention and control groups at 3 months. In our secondary analyses, among waitlist control participants, zBMI (P=.02), discretionary calories (P=.03), and physical activity outside of school (P=.001) declined, whereas daily screen time increased (P<.001) after receiving access to the app compared with before receiving app access. Adolescents randomized to Aim2Be with live coaching reported more time being active outside of school compared with adolescents who used Aim2Be with no coaching over 3 months (P=.001). App use did not modify any changes in outcomes among adolescents in the intervention group. ConclusionsThe Aim2Be intervention did not improve zBMI and lifestyle behaviors in adolescents with overweight and obesity compared with the waitlist control group over 3 months. Future studies should explore the potential mediators of changes in zBMI and lifestyle behaviors as well as predictors of engagement. Trial RegistrationClinicalTrials.gov NCT03651284; https://clinicaltrials.gov/ct2/show/study/NCT03651284 International Registered Report Identifier (IRRID)RR2-10.1186/s13063-020-4080-2
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spelling doaj.art-8c946cd566be48f5a205df32db3040782023-08-28T23:57:26ZengJMIR PublicationsJournal of Medical Internet Research1438-88712023-04-0125e3854510.2196/38545Efficacy of the Aim2Be Intervention in Changing Lifestyle Behaviors Among Adolescents With Overweight and Obesity: Randomized Controlled TrialClaire N Tugault-Lafleurhttps://orcid.org/0000-0002-4598-9372Olivia De-Jongh Gonzálezhttps://orcid.org/0000-0003-4782-9513Janice Macdonaldhttps://orcid.org/0009-0002-7481-9505Jennifer Bradburyhttps://orcid.org/0009-0001-6309-9816Tom Warshawskihttps://orcid.org/0000-0001-6424-5291Geoff D C Ballhttps://orcid.org/0000-0002-9432-3120Katherine Morrisonhttps://orcid.org/0000-0002-1737-256XJosephine Hohttps://orcid.org/0000-0003-0379-4427Jill Hamiltonhttps://orcid.org/0000-0002-1958-2800Annick Buchholzhttps://orcid.org/0000-0003-2598-3368Louise Mâssehttps://orcid.org/0000-0003-2483-8791 BackgroundAim2Be is a gamified lifestyle app designed to promote lifestyle behavior changes among Canadian adolescents and their families. ObjectiveThe primary aim was to test the efficacy of the Aim2Be app with support from a live coach to reduce weight outcomes (BMI Z score [zBMI]) and improve lifestyle behaviors among adolescents with overweight and obesity and their parents versus a waitlist control group over 3 months. The secondary aim was to compare health trajectories among waitlist control participants over 6 months (before and after receiving access to the app), assess whether support from a live coach enhanced intervention impact, and evaluate whether the app use influenced changes among intervention participants. MethodsA 2-arm parallel randomized controlled trial was conducted from November 2018 to June 2020. Adolescents aged 10 to 17 years with overweight or obesity and their parents were randomized into an intervention group (Aim2Be with a live coach for 6 months) or a waitlist control group (Aim2Be with no live coach; accessed after 3 months). Adolescents’ assessments at baseline and at 3 and 6 months included measured height and weight, 24-hour dietary recalls, and daily step counts measured with a Fitbit. Data on self-reported physical activity, screen time, fruit and vegetable intake, and sugary beverage intake of adolescents and parents were also collected. ResultsA total of 214 parent-child participants were randomized. In our primary analyses, there were no significant differences in zBMI or any of the health behaviors between the intervention and control groups at 3 months. In our secondary analyses, among waitlist control participants, zBMI (P=.02), discretionary calories (P=.03), and physical activity outside of school (P=.001) declined, whereas daily screen time increased (P<.001) after receiving access to the app compared with before receiving app access. Adolescents randomized to Aim2Be with live coaching reported more time being active outside of school compared with adolescents who used Aim2Be with no coaching over 3 months (P=.001). App use did not modify any changes in outcomes among adolescents in the intervention group. ConclusionsThe Aim2Be intervention did not improve zBMI and lifestyle behaviors in adolescents with overweight and obesity compared with the waitlist control group over 3 months. Future studies should explore the potential mediators of changes in zBMI and lifestyle behaviors as well as predictors of engagement. Trial RegistrationClinicalTrials.gov NCT03651284; https://clinicaltrials.gov/ct2/show/study/NCT03651284 International Registered Report Identifier (IRRID)RR2-10.1186/s13063-020-4080-2https://www.jmir.org/2023/1/e38545
spellingShingle Claire N Tugault-Lafleur
Olivia De-Jongh González
Janice Macdonald
Jennifer Bradbury
Tom Warshawski
Geoff D C Ball
Katherine Morrison
Josephine Ho
Jill Hamilton
Annick Buchholz
Louise Mâsse
Efficacy of the Aim2Be Intervention in Changing Lifestyle Behaviors Among Adolescents With Overweight and Obesity: Randomized Controlled Trial
Journal of Medical Internet Research
title Efficacy of the Aim2Be Intervention in Changing Lifestyle Behaviors Among Adolescents With Overweight and Obesity: Randomized Controlled Trial
title_full Efficacy of the Aim2Be Intervention in Changing Lifestyle Behaviors Among Adolescents With Overweight and Obesity: Randomized Controlled Trial
title_fullStr Efficacy of the Aim2Be Intervention in Changing Lifestyle Behaviors Among Adolescents With Overweight and Obesity: Randomized Controlled Trial
title_full_unstemmed Efficacy of the Aim2Be Intervention in Changing Lifestyle Behaviors Among Adolescents With Overweight and Obesity: Randomized Controlled Trial
title_short Efficacy of the Aim2Be Intervention in Changing Lifestyle Behaviors Among Adolescents With Overweight and Obesity: Randomized Controlled Trial
title_sort efficacy of the aim2be intervention in changing lifestyle behaviors among adolescents with overweight and obesity randomized controlled trial
url https://www.jmir.org/2023/1/e38545
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