ESPE Abstracts (2018) 89 P-P1-119

Telemedicine Therapy for Overweight Adolescents: First Results of a Novel Smartphone App Intervention Using a Behavioural Health Platform

Katrin Heldta, Dirk Büchtera, Björn Broglea, Iris Shih Chen-Hsuanb, Dominik Rüeggerb, Andreas Fillerc, Pauline Gindratd, Dominique Durrere, Nathalie Farpour-Lambertf, Tobias Kowatschc & Dagmar l’Allemanda


aChildren’s Hospital of Eastern Switzerland, St Gallen, Switzerland; bDepartment of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland; cInstitute of Technology Management, University of St Gallen, St Gallen, Switzerland; dFondation SportSmile, Sion & Geneva, Geneva, Switzerland; eFondation SportSmile, Sion & Geneva, Sion, Switzerland; fDepartment of Community Medicine, Primary Care and Emergency, University Hospital, Geneva, Switzerland


Introduction: Despite improved therapy measures since 2014 the prevalence of overweight and obesity in Swiss adolescence stabilized on 19%. Particular challenges are lack of adherence to therapy in youth who are in difficult life situations or live further from specified centres. Therefore it is essential to find simple and novel therapeutic approaches. But although the number of digital based health information systems increases steadily, the effectiveness in reaching long term health goals or life style change mostly remain unproven. The aim is to test a novel design of a health app for overweight adolescents, whether it supports their motivation to participate in a lifestyle intervention including relaxation and activity exercises.

Methods: Based on an open source platform with a text-based healthcare chatbot (THCB), a mobile chat app with a serious game character was designed for Android smartphones. Patients were able to chat with the THCBs Anna or Lukas with the help of pre-defined answer options. Direct communication between patients and health professionals (HP) was also enabled via a second chat channel. Sensor integration provided measurement of physical activity. In a 12-month randomized controlled study, the THCBs encourage patients to achieve daily challenges during 24 weeks (steps per day, breathing exercises, photos of nutrition and home environment, questions on well-being and eating habits) to earn virtual rewards. Effects on therapy adhesion during the 5.5-month intensive phase of intervention with 4 on-site visits will be compared to a treatment-as-usual group with monthly visits.

Results: At start, in 22 patients (39% girls) age and BMI-SDS were not significantly different: 14.2 years (11.9–17) and 2.56 SD (1.7–3.5). At 5.5 months (13 THCB; 7 controls), almost 67% of the patients had >4 THCB conversational turns per day and 43% fulfilled daily challenges completely and successfully. Only during the first month, open chat questions, mainly on technical issues, took place in 3.4% of roughly 18.064 conversational turns.

Conclusion: Interim analysis of the THCB intervention group of an ongoing RCT shows a high compliance with the app services over half a year. This may be explained by the rewarding game system, the peer character of the THCBs and the perceived usefulness of the THCBs on the smartphone, a familiar medium for adolescents.