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Randomized Controlled Trial
. 2023 Apr 25:25:e38545.
doi: 10.2196/38545.

Efficacy of the Aim2Be Intervention in Changing Lifestyle Behaviors Among Adolescents With Overweight and Obesity: Randomized Controlled Trial

Claire N Tugault-Lafleur  1 , Olivia De-Jongh González  2 , Janice Macdonald  3 , Jennifer Bradbury  3 , Tom Warshawski  3 , Geoff D C Ball  4 , Katherine Morrison  5 , Josephine Ho  6 , Jill Hamilton  7 , Annick Buchholz  8 , Louise Mâsse  2
Affiliations
Randomized Controlled Trial

Efficacy of the Aim2Be Intervention in Changing Lifestyle Behaviors Among Adolescents With Overweight and Obesity: Randomized Controlled Trial

Claire N Tugault-Lafleur et al. J Med Internet Res. .

Abstract

Background: Aim2Be is a gamified lifestyle app designed to promote lifestyle behavior changes among Canadian adolescents and their families.

Objective: The primary aim was to test the efficacy of the Aim2Be app with support from a live coach to reduce weight outcomes (BMI Z score [zBMI]) and improve lifestyle behaviors among adolescents with overweight and obesity and their parents versus a waitlist control group over 3 months. The secondary aim was to compare health trajectories among waitlist control participants over 6 months (before and after receiving access to the app), assess whether support from a live coach enhanced intervention impact, and evaluate whether the app use influenced changes among intervention participants.

Methods: A 2-arm parallel randomized controlled trial was conducted from November 2018 to June 2020. Adolescents aged 10 to 17 years with overweight or obesity and their parents were randomized into an intervention group (Aim2Be with a live coach for 6 months) or a waitlist control group (Aim2Be with no live coach; accessed after 3 months). Adolescents' assessments at baseline and at 3 and 6 months included measured height and weight, 24-hour dietary recalls, and daily step counts measured with a Fitbit. Data on self-reported physical activity, screen time, fruit and vegetable intake, and sugary beverage intake of adolescents and parents were also collected.

Results: A total of 214 parent-child participants were randomized. In our primary analyses, there were no significant differences in zBMI or any of the health behaviors between the intervention and control groups at 3 months. In our secondary analyses, among waitlist control participants, zBMI (P=.02), discretionary calories (P=.03), and physical activity outside of school (P=.001) declined, whereas daily screen time increased (P<.001) after receiving access to the app compared with before receiving app access. Adolescents randomized to Aim2Be with live coaching reported more time being active outside of school compared with adolescents who used Aim2Be with no coaching over 3 months (P=.001). App use did not modify any changes in outcomes among adolescents in the intervention group.

Conclusions: The Aim2Be intervention did not improve zBMI and lifestyle behaviors in adolescents with overweight and obesity compared with the waitlist control group over 3 months. Future studies should explore the potential mediators of changes in zBMI and lifestyle behaviors as well as predictors of engagement.

Trial registration: ClinicalTrials.gov NCT03651284; https://clinicaltrials.gov/ct2/show/study/NCT03651284.

International registered report identifier (irrid): RR2-10.1186/s13063-020-4080-2.

Keywords: RCT; adolescents; childhood obesity; lifestyle management; mHealth; mobile health; mobile phone; randomized controlled trial.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
CONSORT (Consolidated Standards of Reporting Trials) flow diagram for participants enrolled in the Aim2Be randomized controlled trial (RCT). WEB-Q: Waterloo Eating Behavior Questionnaires; zBMI: BMI Z score.
See this image and copyright information in PMC

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