Healthcare Text Messaging to Improve Diet, Physical Activity and Weight Loss in a Pediatric Lipid Clinic
Condition: Pediatric Obesity
MeSH terms: Pediatric Obesity
Study type: Interventional

Summary: 
      The purpose of this study is to determine if health-related text messages sent from
      healthcare providers to overweight and obese adolescents enrolled at a pediatric lipid clinic
      will result in increased adherence to their nutrition and physical activity goals and improve
      their weight loss. The study will also assess if the volume of texts per week impacts
      outcomes.
    

Detailed description: 
      Phase 1: We will recruit 5 participants the from the UF Pediatric Lipid and Obesity clinic
      for pre-intervention cognitive interviewing to assess acceptability of the intervention and
      request their input on a representative sample of text messages. Then, 20 participants will
      be recruited from the same clinic for the intervention (10 controls, 10 intervention
      participants). Controls will receive current standard care - clinic visits every three months
      anthropometric assessments and counseling on physical activity and nutrition goals by a
      healthcare provider, typically with no patient-provider communication between visits. The
      intervention group will receive the typical clinic visits plus daily text messages in between
      visits with fitness and nutrition messages to support their health goals. All participants
      will have anthropometric measurements at baseline, 3 and 6 months. Each participant will
      complete a Schwartz Diet and Activity History at 0, 3 and 6 month visits, and a post
      intervention survey will be completed at the 3 month time point.

      Phase 2: The second phase will be a larger scale study to assess for statistically
      significant effects of the text messaging intervention. One hundred participants will be
      recruited from the UF Pediatric Lipid and Obesity Clinic, one hundred from the UF Pediatric
      Headache Clinic and one hundred from the Congenital Heart Center for a total of three hundred
      (n=300) participants at three clinic locations. Participants will be randomized at each
      clinic location to one of two groups, Group A (immediate intervention, n=50) or Group B
      (control group, delayed intervention, n=50).

      Participants randomized to Group A will receive the typical clinic visits (which includes
      anthropometric measures every three months, counselling on physical activity and nutrition
      goals by a healthcare provider and for those prescribed medication for a chronic condition,
      medication counseling by a healthcare provide) plus daily text messages in between visits for
      3 months to support their health goals. Group B will initially act as the control and will
      receive the typical clinic visits (which includes anthropometric measures every three months,
      counseling on physical activity and nutrition goals by a healthcare provider, and for those
      prescribed medication for a chronic condition, medication counseling by a healthcare
      provider) with typically with no patient-provider communication between visits. After a
      6-month delay, Group B will then receive the intervention which includes the typical clinic
      visits as stated previously plus daily text messages in between visits for 3 months to
      support their health goals. Participants will be seen in clinic at standard intervals for
      routine follow up (typically every 3 months). Three months after participants finish
      receiving the text messages, the same anthropometric and medication measures (for those
      prescribed chronic medication) that were collected at baseline as part of routine care will
      be repeated. Each participant will complete a Block Food Screener and Block Physical Activity
      Screener at 0, 3, and 6 months. A post-intervention survey will be completed after the
      participants have stopped receiving text messages.
    

Intervention name(s): Group A; Group B
Intervention type(s): Behavioral; Other
Intervention description(s): Phase 1: Group A will receive the typical clinic visits plus daily text messages for 12 weeks.
Phase 2: Group A will receive the typical clinic visits (which includes anthropometric measures every three months, counseling on physical activity and nutrition goals by a healthcare provider and for those prescribed medication for a chronic condition, medication counseling by a healthcare provide) plus daily text messages in between visits for 3 months to support their health goals.; Phase 1: Group B will receive current standard care - clinic visits every three months anthropometric assessments and counseling on physical activity and nutrition goals by a healthcare provider, typically with no patient-provider communication between visits.
Phase 2: Group B will initially act as the control and will receive the typical clinic visits (which includes anthropometric measures every three months, counseling on physical activity and nutrition goals by a healthcare provider, and for those prescribed medication for a chronic condition, medication counseling by a healthcare provider) with typically with no patient-provider communication between visits. After a 6-month delay, Group B will then receive the intervention which includes the typical clinic visits as stated previously plus daily text messages in between visits for 3 months to support their health goals.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Pediatric; Obesity; Overweight; Texting; Text message; SMS; Diet; Weight Loss; Nutrition; Physical activity; BMI z-score; BMI