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Nov. 3, 2024 — San Antonio, Texas
A recent study has shown that integrating digital feedback, like text messaging, with traditional health counseling for parents can significantly reduce obesity rates in very young children. Led by Dr. Eliana Perrin, a Bloomberg Distinguished Professor at Johns Hopkins University, this research suggests that using digital interventions alongside in-person counseling offers parents essential support for nurturing healthy habits in their infants. Published in JAMA and presented at Obesity Week in San Antonio, this innovative approach holds promise in mitigating childhood obesity, especially in underserved communities.
The study’s origins lie in decades of research establishing that early childhood obesity often leads to lifelong health complications, such as diabetes and cardiovascular disease. In the United States, childhood obesity has reached critical levels, affecting approximately one in five school-aged children as of 2018, a rate that has worsened since the COVID-19 pandemic. Existing approaches, largely dependent on in-person interactions with pediatric providers, have seen limited long-term success.
Dr. Perrin and her colleagues built on the Greenlight Program, a health literacy-informed initiative created to help parents guide their children’s nutrition, exercise, sleep, and screen time. The Greenlight Program’s initial success was evident in promoting healthy growth among infants, though its effects waned by age two. To address this, researchers added digital elements—text message reminders and a user-friendly web dashboard—to reinforce goals between well-child visits.
In a collaborative study with Vanderbilt University and five other academic centers, researchers recruited nearly 900 parent-infant pairs from clinics across the U.S., including at Duke, Stanford, and the University of Miami. The study participants reflected diverse demographics: 45% were Hispanic, 20% white, and 16% Black, with over half facing health literacy challenges. Importantly, nearly 16% of households reported food insecurity, indicating restricted access to nutritious food.
Participants were divided into two groups: one received only traditional Greenlight counseling, while the other received additional text messages supporting healthy behaviors tailored to each child’s developmental stage. Parents in the digital group received biweekly text messages, available in English or Spanish, with check-ins to assess their progress toward goals, such as reducing sugary drink intake or limiting screen time. Based on the parents’ feedback, the system offered personalized tips and encouragement.
Results showed that children in the digital intervention group had healthier growth trajectories over two years, with a significant reduction in obesity rates: only 7% of children in the digital group developed obesity by age two, compared to nearly 13% in the traditional counseling group—a 45% relative reduction. Although a weight reduction of 0.33 kg/m may seem modest, it aligns with targets set by the U.S. Preventive Services Task Force, indicating meaningful progress in childhood obesity prevention.
The intervention proved especially effective among children from food-insecure households and those with limited health literacy. Children from Hispanic and Black families, groups historically facing higher obesity risks, showed notable benefits from the digital support. According to Dr. Perrin, this study could pave the way for more equitable health outcomes by addressing disparities that contribute to obesity.
“This study’s impact could be substantial if scaled broadly,” Perrin said, noting the unique value of reaching parents through accessible technologies like smartphones. “Preventing obesity in early childhood provides a crucial foundation for better health throughout life.”
Looking ahead, the researchers plan to follow the children involved in the study to assess the long-term impact of the intervention. If these benefits hold, this approach may represent a significant step forward in combating childhood obesity and promoting health equity.
For more information, refer to the study in JAMA (2024). DOI: 10.1001/jama.2024.22362
