Diana Zhu, Aimee L Dordevic, Simone Gibson, Zoe E Davidson
Journal: BMC public health 2025;25(1):59
PMID: 39773158
Unprecedented high childhood obesity rates relate in part to children living in environments that encourage the learning and adaptation of unhealthy lifestyle behaviours, including consuming a diet comprised predominantly of energy-dense/non-core foods and replacing activity with sedentary behaviours. This study aimed to evaluate the effectiveness of an e-Health intervention, the online Better Health Program (BHPO) – a web-based healthy lifestyle programme with health coaching sessions for families, adapted from the in-person group-based version. This research was a randomised control trial which enrolled children aged 7–13 years with overweight or obesity. Participants were randomly assigned to one of the two groups: intervention or control. Results showed that the family-focused web-based programme effectively improved health-related outcome measures in children with overweight and obesity. In fact, a significant, moderate effect on the change in children’s body mass index (BMI) was observed between groups, noting a wide variation in responses. Likewise, following programme completion, a clinically significant mean reduction of 0.13 (0.23) BMI z-score units (weight maintenance and height growth) was observed in participating children. Authors concluded that a 10-week web-based healthy lifestyle programme was effective in influencing clinically meaningful health outcomes in primary school-aged children with overweight/obesity in the short-term, supporting the use of e-Health approaches in the clinical management of childhood obesity.
BACKGROUND
Electronic health (e-Health) interventions may increase effectiveness and address limitations of conventional in-person childhood obesity treatment programs. This study evaluates the effectiveness of a 10-week e-Health (web-based) healthy lifestyle program for school-aged children with overweight/obesity.
METHODS
In this randomised control trial (RCT), families with children aged 7-13 years with overweight/obesity (body mass index, BMI ≥ 85th percentile), living in Victoria, Australia, were recruited. Families were randomised to intervention or waitlist control and received the 10-week web-based program. The primary outcome was the change in children's BMI z-score over 10 weeks. Other outcomes included change in children's waist circumference, dietary intake, physical activity, and quality of life over 10 weeks.
RESULTS
Of 148 children (125 families) recruited, 102 children (85 families) completed the RCT. A significant decrease in children's BMI z-scores was observed in the intervention compared to the control group over 10 weeks (mean difference 0.11; 95% CI, 0.02-0.20). The web-based program was also effective in improving children's quality of life and lifestyle behaviour changes over 10 weeks. In the intervention group, there was a significant increase in children's quality of life scores (intervention versus control: median change (IQR) = 11 (3, 17) versus 1 (-3, 7); p = 0.034), overall diet quality scores (6 (2, 10) versus 2 (-3, 5); p < 0.001), and daily physical activity levels (5.2 (-2.6, 12.8) versus - 0.2 (-8.2, 4.5); p = 0.022) compared to the control group.
CONCLUSIONS
A web-based healthy lifestyle program effectively improved short-term health-related outcomes in children with overweight/obesity. Further research is needed to identify determinants of program effectiveness, evaluate sustained effects, and equitably tailor childhood obesity e-Health interventions to diverse populations.
TRIAL REGISTRATION
This study was registered with the Australian New Zealand Clinical Trial Registry (ACTRN12621001762842) on November 11, 2021, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=383053 .
© 2025. The Author(s).
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