How good are apps for preventing paediatric obesity?

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We all know that obesity is a serious problem for the paediatric population (Ogden et al, 2014). And we also know that kids love using iPhones (Chiong et al, 2014). So it’s not surprising that there are lots of apps on the app store aiming to help children tackle their obesity.

In fact, there are lots of apps for pretty much any medical problem you can think of. But how useful are these apps? Do they follow accepted medical practice or public health strategies?

A study published in Childhood Obesity this month looked at this question.

The authors scoured the App store for iPhone apps aimed at reducing paediatric obesity which were for children to use. They found 62 apps.  And they compared them against the American Academy of Paediatrics’ Strategy for the Prevention of Childhood Obesity

Strategies from the American Academy of Paediatrics.

Recommended behaviors

  1. Eat five fruits and vegetables per day
  2. Get 1 hour of physical activity per day
  3. Limit screen time to less than 2 hours per day
  4. Limit consumption of sugar-sweetened beverages
  5. Eat breakfast daily
  6. Switch to low-fat dairy products as part of a diet rich in calcium
  7. Regularly eat family meals together
  8. Limit fast food, take-out, and eating out
  9. Prepare foods at home as a family
  10. Eat a high-fiber diet

Recommended strategies

  1. Goal setting: Children should set clear goals that reflect progress toward target behavior(s).
  2. Positive reinforcement: Children should be encouraged for effort and achievements related to target behavior(s).
  3. Self-monitoring: Children should be encouraged to record their relevant behaviors, efforts, and progress.
  4. Cognitive restructuring: Negative cognitive patterns should be discouraged and successes, including partial successes, should be highlighted.

They found that apps poorly adhered to the whole guideline, but did tend to focus on specific behaviours. For example, most apps targeted exercise or a particular element of food intake but didn’t focus on the others. In general while the apps were quite good in dealing with the recommended behaviours, they were poor at implementing or suggesting the correct strategies. The most common strategy used was self-monitoring.

As an interesting side note there was no correlation between the cost of the apps and how medically appropriate it was – the most expensive app was in fact one of the poorest performing. And strangely, the reviews left on the app store did seem to tally with AAP guidelines adherance.  Perhaps user reviews on the App Store aren’t as irrelevant as we might think….

So whilst there is a future for encouraging your patients to use apps to tackle chronic medical issues, we have no good regulation yet of apps like this on the app store. Check out any apps yourself before recommending them to your patients as there’s a lot of dross out there.

References

Chiong C, Shuler C, Learning: is there an app for that? The Joan Ganz Cooney Center at Sesame Workshop, New York, 2012.

Davis MM, Gance-Cleveland B, Hassink S, Johnson R, Paradis G, Resnicow K, Recommendations for prevention of childhood obesity. Pediatrics. 2007 Dec;120 Suppl 4:S229-53.

Ogden CL, Carroll MD, Kit BK, Flegal KM, Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014 Feb 26;311(8):806-14.

Wearing JR, Nollen N, Befort C, Davis AM, Agemy CK, iPhone App Adherence to Expert-Recommended Guidelines for Pediatric Obesity Prevention. Childhood Obesity, 2014, 10(2):1-13.

 

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Tessa Davis is a paediatric emergency registrar from Glasgow and Sydney, but currently living in London. Tessa tries to spend time with her 3 kids in between shifts. @tessardavis | + Tessa Davis | Tessa’s DFTB posts

Author: Tessa Davis

Tessa Davis is a paediatric emergency registrar from Glasgow and Sydney, but currently living in London. Tessa tries to spend time with her 3 kids in between shifts. @tessardavis | + Tessa Davis | Tessa’s DFTB posts