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Early Life Intervention in Paediatrics Supported by E-Health (ELIPSE)-a coaching app for parents to reduce obesity
Alexander Koch1,2, Andrea Wyssen3, Clemens Haupt4,3
1Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. alexander.koch@insel.ch.
Insights
The ELIPSE app uses guided e-health interventions to improve family lifestyle behaviors, aiming to reduce childhood obesity and risks from second-hand smoke exposure. This novel approach offers personalized support to enhance long-term child health outcomes.
Area of Science:
- Pediatric Health
- Digital Health Interventions
- Behavioral Science
Background:
- Family lifestyle factors significantly influence child health, with physical inactivity and poor diet contributing to obesity and non-communicable diseases (NCDs).
- Second-hand smoke (SHS) exposure is a major risk factor for childhood respiratory illnesses like asthma.
- Cognitive behavioral therapy (CBT) is effective for behavior modification, but its application via mobile apps for families is under-explored.
Purpose of the Study:
- To evaluate the effectiveness of the ELIPSE mobile app, delivering personalized, family-centered, e-health interventions guided by coaches.
- To assess the impact of app-based CBT on family lifestyle behaviors and child health outcomes.
- To determine if the ELIPSE app can reduce childhood obesity and SHS exposure.
Main Methods:
- Two randomized controlled trials (ELIPSE I and II) involving parent-child dyads.
- ELIPSE I: 148 dyads (children aged 6-12 with BMI >97th percentile) randomized to treatment as usual (TAU) or TAU plus ELIPSE app access. Primary endpoint: change in children's total energy intake to expenditure ratio (TEI/TEE).
- ELIPSE II: 160 dyads (smoking parent, child <6 years) randomized to a leaflet or ELIPSE app access. Primary endpoint: change in children's urinary cotinine levels.
Main Results:
- Primary and secondary outcomes are assessed at baseline, 20-week intervention completion, and 48-week follow-up.
- ELIPSE I focuses on changes in children's energy balance and obesity severity.
- ELIPSE II focuses on reducing children's exposure to SHS, measured by cotinine levels.
Conclusions:
- The ELIPSE project introduces a novel, accessible method for addressing NCD risk factors within families.
- The app-based intervention aims to improve long-term child health, reduce illness, and lower healthcare costs.
- The ELIPSE app provides continuous, personalized support, overcoming traditional healthcare limitations of time and space.
Background:
Family lifestyle factors-such as physical activity, diet and parental smoking-are key modifiable determinants for child health. Physical inactivity and calorie-dense diets contribute to obesity, which is linked to 75% of all non-communicable diseases (NCDs). Second-hand smoke (SHS) exposure significantly increases the risk of respiratory NCDs in children, including asthma. Cognitive behavioural therapy (CBT) has proven effective in modifying harmful parental behaviours, but it remains unclear whether app-based CBT for parents can improve family behaviours and child health outcomes. The Early Life Intervention in Paediatrics Supported by E-Health (ELIPSE) project aims to implement and evaluate personalised, family-centred, guided e-health interventions delivered via the ELIPSE mobile app.
Methods:
In two randomized controlled trials (ELIPSE I and II), the ELIPSE app will deliver CBT elements, tailored thematic content, and personalised feedback, all remotely guided by a coach. In ELIPSE I, 148 parent-child dyads (child age 6-12 years, BMI > 97th percentile) are randomly assigned 1:1 to treatment as usual (TAU; control group) versus TAU plus full access to the activated ELIPSE app (intervention group). The primary endpoint is the change in children's ratio of total energy intake to total energy expenditure (TEI/TEE). Secondary endpoints include obesity severity and cardiometabolic risk factors. In ELIPSE II, 160 dyads of a smoking parent and child (< 6 years) are randomly assigned 1:1 to receive either a leaflet on protecting children from SHS exposure (control group) or access to the activated ELIPSE app (intervention group). The primary endpoint is the change in children's urinary cotinine levels. Secondary endpoints include parental measures to reduce SHS exposure. The intervention period for both trials is 20 weeks, with outcomes assessed at baseline, post-intervention, and 48-week follow-up.
Discussion:
The ELIPSE project offers a novel approach to addressing key modifiable NCD risk factors within the family environment, with the goal to improve long-term child health outcomes and reducing morbidity and healthcare costs. Unlike traditional care, the ELIPSE app overcomes time and space constraints, allowing continuous support and personalised guidance.
Trial Registration:
Both trials prospectively registered at ClinicalTrials.gov: ELIPSE I as NCT06208345 (15 January 2024); ELIPSE II as NCT06311162 (7 March 2024).
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