549 - Health Chat: Underserved Adolescent Patients Communicating with their Providers via Mobile Health for Weight Management

Poster Number: 549
Publication Number: 549.245

Christine SanGiovanni, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Eneli U. Ihuoma, Nationwide Childrens Hospital/Ohio State University, Columbus, OH, United States; Michelle Nichols, Medical University of South Carolina, Charleston, SC, United States; Annie N. Simpson, Medical University of South Carolina, Charleston, SC, United States; Jada M. Johnson, Medical University of South Carolina, Charleston, SC, United States; Erin Dawley, Medical University of South Carolina College of Medicine, Charleston, SC, United States; James R. Roberts, Medical University of South Carolina College of Medicine, CHARLESTON, SC, United States

Background: Adolescent obesity in the US is 20%. Smartphone applications (apps) offer self-monitoring and social support tools to facilitate adolescent engagement in reaching healthy goals.

Objective: The objective was to investigate the feasibility and acceptability of an integrated model where Primary Care Providers (PCPs) monitor and support adolescents’ progress in reaching healthy goals between office visits via MyFitnessPal™ app.

Design/Methods: Inclusion criteria were adolescents aged 13-17 years, Medicaid recipient, age and sex-specific body mass index (BMI) ≥the 85th percentile and daily access to a smartphone. Eight PCPs agreed to monitor adolescents’ posts regarding reaching goals. At baseline clinic visit, (virtually or in-person), adolescents set dietary/physical activity goals with PCPs and were encouraged to post their progress in MyFitnessPal™ app frequently. Adolescents received weekly text/email reminders from study team to post progress and completed 3-month follow-up visits and post-intervention surveys regarding their physical activity/dietary intake. Continuous variables were analyzed with paired t-tests, and Bowker’s test analyzed categorical pre and post intervention variable differences. Key informant interviews with participants sought intervention feasibility and acceptability.

Results: Of the 22 adolescents enrolled in the study, mean age was 14 (13-17), 58% (n= 14) female, 66% (n=16) African American/black and 17% (n= 4) white. Mean BMI was 35.2 (23.6- 49.0) or 98th percentile (89.4-99.8). Self-reported desire for dietary change (0-10 Likert scale) was 5.8 (±-2.6) and 5.2 (+/-2.6) for physical activity change. Over 3 months, the average number of posts made by adolescents was 5.8 (+/-5.5), with 9% (n=2) adolescents who made ≥ 10 posts, 27% (n=6) made 5-9 posts, 36% (n=8) made 1-4 posts, and 32% (n=7) made 0 posts. Most of the adolescents (73%) had at least one post that indicated progress with their goals. There were no significant pre and post intervention difference in weight/BMI. Interviews revealed COVID had a negative impact on meeting healthy goals with loss of regular routine and social support. Other key themes included access to care, tools for motivation (e.g., reminder text messages), and challenges with app use.Conclusion(s): Use of a smartphone app as part of a lifestyle intervention has advantages, but engagement by adolescents was limited. Adolescents identified stressors related to the pandemic that adversely affected goal engagement. Further investigation is needed for appropriate components of provider/adolescent-patient communication via mobile health.