Table 2.
Summary of parent-focused childhood or adolescent obesity eHealth interventions.
| Author, Year, Country | Participants | Intervention description | Parental involvement | Behaviors targeted | Variables measured | Key findings |
| Baranowski et al 2003, USA [19] | n=35, 8 years of age, girls | 4-week camp with specially designed activities, followed by 8-week behavior change Internet intervention. Control girls attended camp with usual activities and a monthly Internet program with general health information and homework. | No parent involvement in camp. Intervention, and control parents had access to a website, which covered similar topics to girls’ website. | Diet (dietary fat intake, dietary fiber, water and satiety, SSBa), moderate to vigorous PAb | Demographics, body mass index (BMI), WCc, physical maturation, body fat (DEXA), diet (2 ×24-hour recall), PA (accelerometer and qne), preferences for PA, and SSB. | For the Internet component, no significant changes to BMI were observed. No other variables were measured at the end of the camp, so the effect of the Internet intervention on variables other than BMI could be determined. |
| Chen et al 2011, USA [21] | n=54, 12-15 years of age Chinese American | Behavior change Internet program with goal setting tailored to stage of change. 8 ×weekly sessions for children. Control participants accessed a general health information Internet site. |
Parents received 3 Internet sessions over 8 weeks to increase knowledge and skills. | Diet (food pyramid, meal planning, portion size), PA | Parent height and weight, child BMI, waist-to-hip ratio, blood pressure, PA (accelerometer), diet (3-day food diary), PA and nutrition knowledge (qne), dietary and PA self-efficacy. | Significantly more participants in the intervention reduced their waist-to-hip ratio than the control group (effect size= −0.01, P=.02). There were also significant increases in PA (effect size=12.46, P=.01), increases to F&Vd intake (effect size=0.14, P=.001) and increased PA knowledge (effect size=0.16, P=.008), and nutrition knowledge (effect size=0.18, P=.001). |
| Davis et al 2013, USA [23] | n=58, 5-11 years of age, rural setting | 8 × weekly telemedicine delivered psychoeducational sessions covering goal setting, diet and PA, plus 6 ×monthly sessions. Control participants visited their primary care physician to discuss set topics. | Parents met in a group separately, but at the same time as the children and covered similar content. | Nutrition (stoplight diet, portion sizes, food labels, vitamins and minerals, nutrient density), energy balance, PA, screen time, and SBe. | Demographics, BMI z-score, diet (24-hour recall), PA (accelerometer), child behavior checklist, behavioral pediatrics feeding assessment scale. | No statistical difference in BMI z-score between groups. There was also no significant difference between groups for kilocalories or PA. |
| Estabrooks et al 2009, USA [20] | n=220, 8-12 years of age | Group A: 2 × 2-hour weekly group sessions on nutrition, PA, problem-solving, and action planning delivered by dietitian. Group B: attended group sessions plus 10 interactive voice response (IVR) follow-up sessions, involving goal-setting at end of call. Both the groups received a workbook with homework on nutrition and PA topics. Control group received workbook only. | Parent was main agent of change (children participated in data collection only) | Weight, nutrition, PA, and parenting skills. | BMI z-score, PA and SB (questionnaire—qne), F&V and SSBa consumption (qne), eating disorder symptoms (qne). | No significant difference in BMI z-score between groups. Significant increase in moderate-intensity physical activity in IVR group but no difference between groups. Participants completing 6-10 IVR calls significantly reduced BMI z-score compared with other groups [F(3,148)= −2.89, P<.01]. |
| Paineau et al 2008, France [22] | n=1013, 7-9 years of age | All intervention families accessed a website containing information, interactive components, and other functionality. They received 30-minute dietary counseling telephone calls from a dietitian monthly for 8 months after Web-based completion of questionnaires. Children received 3 nutrition lessons at school. Children and parents received monthly newsletters. Group A: advised to reduce fat and increase complex cholesterol (CHO), Group B: advised to reduce fat and sugars and increase complex CHO. Control group received only general nutrition information at the same intervals. | Families accessed website and received mobile phone calls. Parents received monthly newsletter. | Nutrition (portions, frequency of eating, meal modification, and healthier alternatives) | Demographics, BMI, BMI z-score, body fat, WC, chest circumference, knee circumference, dietary intake (total energy, fats, sugars, complex CHO, protein) (Web-based qne and dietary records), PA (qne) | No significant difference between groups in regard to BMI or other anthropometric measures. Group A: Significantly increased complex CHO intake (mean change +10.1 (6.0-14.2) 95% CI, P<.05). Group B: Significantly reduced sugar intake (mean change −10.0 (−13.4 to −6.6) 95% CI, P<.01). Both groups A and B reduced total energy (mean change A −60 (−104 to −15) 95% CI, P<.05, B −96 (−146 to −45) 95% CI, P<.01) and fat intake (mean change A −8.2 (−10.6 to −5.8) 95% CI, P<.01, B −8.3 (−10.8 to −5.7), 95% CI, P<.01) compared with control group. No difference in PA between groups. |
| Williamson et al 2005, USA [17] | n=57, 11-15 years of age, African-American girls | Behavioral website providing nutrition information and behavior modification for 6 months. Counseling provided via email. Control group had access to general noninteractive health website. 4 face-to-face sessions over 12 weeks, focused on goal setting, behavioral contracting, monitoring of progress, and problem-solving. Control group sessions were conducted by a dietitian and included general nutrition information. | Parent and adolescent participated in the face-to-face and Internet components together | Nutrition (low energy diet, F&V, PA, food monitoring) | Demographics, BMI, BMI percentile, body fat (DEXA), eating disorders, pubertal status, dietary intake (24-hour recall and FFQ), weight loss behavior scale, child dietary self-efficacy scale, PA social support, children’s eating attitudes test, satisfaction with life scale, child depression inventory, Rosenberg self-esteem scale, Kansas family life satisfaction scale, symptom checklist-90 | Participants in the intervention group lost significantly more body fat (−1.12± 0.47 standard error—SE) than the control group 0.43±0.47 SE, P<.05) There was a significant difference in BMI change between groups (intervention −0.19 ± 0.24 SE, <0.05, control +0.65 ± 0.23 SE, P<.05). Participants in the intervention group significantly reduced fat intake compared with control group (FFQ) (−145.67 ± 37.67 SE, P<.05) |
| Williamson et al 2006, USA [18] | n=57, 11-15 years of age, African-American girls | Behavioral website providing nutrition information and behavior modification over 2 years. Counseling provided via email. Control group had access to general noninteractive health website. 4 face-to-face sessions over 12 weeks, focused on goal setting, behavioral contracting, monitoring of progress, and problem-solving. Control group sessions were conducted by a dietitian and included general nutrition information. | Parent and adolescent participated in the face-to-face and Internet components together | Nutrition (low energy diet, F&V, PA, food monitoring). | Demographics, BMI, BMI percentile, body fat (DEXA), eating disorders, pubertal status, weight loss behavior scale, website use, computer opinion survey. | At 2 years, there was no significant difference in BMI, weight, or body fat. Higher BMI percentile at baseline was associated with greater reduction in BMI percentile. Higher weight loss behavior scale score at baseline was associated with greater improvement. In regard to reported consumption of fattening foods, there was a significant difference between groups (F (1,48) =2.08, P<.05). |
| Wright et al 2013, USA [24] | n=50, 9-12 years of age | Parents and children individually received 12× weekly interactive voice response (IVR) telephone counseling calls, which provided education, monitoring, and counseling on managing weight and reducing screen time. Information sent via electronic health record to the child’s pediatrician and used at visit 1 month after the intervention. Control participants attended the same pediatrician visit. | Received IVR calls independently to children. | Nutrition (energy, spotlight diet, healthy alternatives, cooking and shopping, eating out), and screen time | BMI, dietary intake (energy, fat, fruits, vegetables) (qne), TV viewing time (qne) | There was no significant difference between groups for BMI, BMI z-score, dietary intake or screen time. There was a significant difference in weight (−4.0 change, P=.001), BMI (−1.2 change, P=.01), and BMI z-score (−0.1 change, P=.04) between high users and low users. |
aSSB: sugar-sweetened beverages.
bPA: physical activity.
cWC: waist circumference.
dF&V=fruit and vegetables.
eSB: sedentary behavior.