ESPE Abstracts

Introduction: The Royal College of Paediatrics and Child Health state that adolescents with significant obesity require access to evidence-based weight management services (WMS). Due to the known benefits of exercise and physical activity (PA) on physiological and psychological outcomes increasing exercise and PA should form a cornerstone of any WMS for adolescents living with obesity. However, supervised exercise interventions face challenges within a clinical setting, due to the need for dedicated space and qualified staff. Additionally, supervised exercise programs have high attrition rates and low adherence among adolescents with obesity. A promising method to encourage engagement in exercise and PA is the use of mobile health (mHealth) technologies. However, the feasibility of incorporating an mHealth supported exercise and PA intervention into a paediatric WMS has not been investigated. The aim of this trial was to assess the feasibility of a 12-week mHealth exercise and PA intervention in adolescents with severe obesity receiving treatment from a tertiary WMS.

Methods: Eleven adolescents with severe obesity (16±1yrs, BMI 41±7) supported by a tertiary WMS were randomised to receive routine care (n=4) or the MOTIVATE-WMA intervention (n=7). Routine care involved individualised management plans developed by a multidisciplinary team of healthcare professionals. The MOTIVATE-WMA intervention was a 12-week structured exercise and PA program which used mHealth biometrics to support a counselling intervention delivered by an exercise specialist. The program was supported by a smart watch and phone app, providing real-time feedback during exercise, and enabling improved communication between the exercise specialist and participant. The design of the MOTIVATE-WMA program was informed by social cognitive theory and used delivery of established behaviour change techniques and motivational interviewing to promote long-term adherence.

Results: We observed preliminary evidence of a large effect (d = 0.85, 95% CI = -2 to 7) in favour of the MOTIVATE-WMA (3±4 exercise sessions per week) intervention on exercise behaviour compared to routine care (0±1 exercise sessions per week). 57% (n=4) of MOTIVATE-WMA participants completed exercise sessions during the 12-week intervention compared to 25% (n=1) of participants receiving routine care.

Conclusion: This preliminary data from the MOTIVATE-WMA trial suggests incorporating an mHealth supported exercise and PA intervention to a multidisciplinary WMS increased exercise behaviour with participants completing more exercise than those receiving routine care. Future work needs to investigate the MOTIVATE-WMA intervention in a larger cohort, including clinical outcomes to evaluate how greater exercise adherence influences clinical outcomes.