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Health apps targeting children with overweight-a protocol for a systematic review with meta-analysis and Trial
Rajeeb Rashid1, Paolo Perego2, Laura Condon3
1Paediatric Unit, Department of Child Health, University of Edinburgh, St John's Hospital, Livingston, EH54 6PP, UK.
Insights
This systematic review examines smartphone apps for overweight children. It aims to determine the clinical effects of these mHealth apps on body mass index (BMI) and overall health outcomes.
Area of Science:
- Pediatrics
- Public Health
- Digital Health
Background:
- Childhood overweight is a growing global health concern.
- Multi-component interventions (diet, physical activity, behavior change) can reduce body mass index (BMI).
- The clinical impact of smartphone applications (apps) for managing childhood overweight remains largely unknown.
Purpose of the Study:
- To systematically review the effects of mHealth apps on children with overweight.
- To evaluate the efficacy and safety of smartphone applications as an intervention tool for pediatric overweight.
- To identify evidence gaps for future mHealth interventions in children.
Main Methods:
- Systematic review of randomized clinical trials (RCTs) involving children aged 0-18 years with overweight.
- Comparison of mHealth apps against sham apps, no app, or usual care.
- Comprehensive database searches (Cochrane Library, Embase, PsycINFO, PubMed, IEEE, Web of Science, CINAHL, LILACS).
- Assessment of primary outcomes (body weight, quality of life, serious adverse events) and secondary outcomes (self-efficacy, anxiety, depression).
- Independent data extraction and bias risk assessment by at least two authors.
- Risk of bias evaluation using eight domains and Trial Sequential Analysis for random errors.
- Quality of evidence assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool.
Main Results:
- This section will present the synthesized evidence on the beneficial and harmful effects of mHealth apps for children with overweight, based on the included RCTs.
- The review will highlight the impact on primary outcomes such as body weight and quality of life, as well as secondary outcomes like self-efficacy and mental health indicators.
- Potential biases towards benefits due to the inclusion of only RCTs will be acknowledged.
Conclusions:
- The systematic review will provide evidence regarding the effectiveness and safety of smartphone applications for pediatric overweight management.
- Findings will inform the development of future mHealth interventions by identifying successful strategies and areas needing further research.
- The study aims to contribute to the understanding of digital health tools in addressing the rising prevalence of childhood overweight.
Background:
The prevalence of overweight is increasing worldwide in children. Multi-component interventions incorporating diet, physical activity, and behavioural change have been shown to reduce body mass index (BMI). Whilst many children have their own smartphone, the clinical effects of using smartphone applications (apps) for overweight are unknown. This systematic review aims to ascertain the effects of mHealth apps in children with overweight.
Methods:
We will include randomised clinical trials irrespective of publication type, year, status, or language. Children between 0 and 18 years with overweight will be included. We will compare apps targeting overweight versus sham app, no app, or usual intervention. No distinction about operative system will be considered (i.e. Android, iOS, and Window Mobile will be included). The following databases will be searched: The Cochrane Library, Excerpta Medica database (Embase), PsycINFO, PubMed, IEEE Explore, Web of Science, CINAHL, and LILACS. Primary outcomes will be body weight, quality of life, and serious adverse event. Secondary outcomes will be self-efficacy, anxiety, depression, and adverse event not considered serious. Trial inclusion, data extraction, and bias risk assessment will be conducted independently by at least two authors. We will assess risk of bias through eight domains and control risks of random errors with Trial Sequential Analysis. The quality of the evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation Tool (GRADE).
Discussion:
We will provide evidence of the beneficial and harmful effects of smartphone apps for children with overweight and highlight any gaps in the evidence in order to shape future potential interventions. By only including randomised clinical trials, we know that we bias our review towards benefits.
Systematic Review Registration:
PROSPERO CRD42019120210.
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