Obesity Prevention and Control: Digital Health Interventions for Adolescents with Overweight or Obesity

The CPSTF recommendation is based on evidence from a systematic review published in 2018 (Ho et al., 8 studies [10 study arms], search period through December 2017) combined with more recent evidence (3 studies, search period December 2017 March 2019).

The systematic review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to obesity prevention and control.

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement.

The systematic review included 11 studies (13 study arms).

• Body Mass Index (BMI) z-score decreased by a median of 0.10 (6 studies, 8 study arms)
• Percent body fat decreased by 0.49 percentage points (3 studies)
• BMI decreased by 0.39 kg/m² and 0.27 kg/m² (2 studies)

A systematic review of economic evidence has not been conducted.

The CPSTF finding should be applicable to adolescents recruited from healthcare settings, schools, or other community organizations, regardless of gender, income level, race, or ethnicity.

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

• What are the long-term effects of self-monitoring digital health interventions among adolescents?
• What is the ideal intervention duration or level of intensity? Is a short, intense intervention more or less effective than a longer and less intense intervention?
• What are the effects of adding access to healthier foods or safe and accessible opportunities for physical activity to the intervention?
• What are the effects of adding social media to the intervention?
• How effective are these interventions across different populations and settings (e.g., low income populations, students with disabilities, rural communities, isolated populations)?

• Included studies were conducted in urban and suburban areas of the United States (6 studies), other high-income countries (4 studies), and one upper middle income country (1 study).
• Adolescents in the included studies were 12-16 years of age, and represented African American, Hispanic, Asian American, and white populations.

Effectiveness Review

• Logic Model
• Text Description

When starting an effectiveness review, the systematic review team develops an analytic framework. The analytic framework illustrates how the intervention approach is thought to affect public health. It guides the search for evidence and may be used to summarize the evidence collected. The analytic framework often includes intermediate outcomes, potential effect modifiers, potential harms, and potential additional benefits.

Effectiveness Review

Summary Evidence Table – Effectiveness Review

The number of studies and publications do not always correspond (e.g., a publication may include several studies or one study may be explained in several publications).

Effectiveness Review

Chen JL, Guedes CM, Lung AE. Smartphone-based healthy weight management intervention for Chinese American adolescents: short-term efficacy and factors associated with decreased weight. J Adolesc Health 2019;64(4):443-9.

Doyle AC, Goldschmidt A, Huang C, Winzelberg AJ, Taylor CB, Wilfley DE. Reduction of overweight and eating disorder symptoms via the Internet in adolescents: a randomized controlled trial. J Adolesc Health 2008;43(2):172-9.

Fonseca H, Prioste A, Sousa P, Gaspar P, Machado Mdo C. Effectiveness analysis of an internet-based intervention for overweight adolescents: next steps for researchers and clinicians. BMC Obes 2016;3:15.

Jones M, Luce KH, Osborne MI, Taylor K, Cunning D, et al. Randomized, controlled trial of an internet-facilitated intervention for reducing binge eating and overweight in adolescents. Pediatrics 2008;121(3):453-62.

Mameli C, Brunetti D, Colombo V, Bedogni G, Schneider L, et al. Combined use of a wristband and a smartphone to reduce body weight in obese children: randomized controlled trial. Pediatr Obes 2018;13(2):81-7.

Nawi AM, Che Jamaludin FI. Effect of internet-based intervention on obesity among adolescents in Kuala Lumpur: a school-based cluster randomised trial. Malays J Med Sci 2015;22(4):47-56.

Patrick K, Norman GJ, Davila EP, Calfas KJ, Raab F, et al. Outcomes of a 12-month technology-based intervention to promote weight loss in adolescents at risk for type 2 diabetes. J Diabetes Sci Technol 2013;7(3):759-70.

Pittman AF. Effect of a school-based activity tracker, companion social website, and text messaging intervention on exercise, fitness, and physical activity self-efficacy of middle school students. J Sch Nurs 2018:1059840518791223.

Riiser K, Londal K, Ommundsen Y, Smastuen MC, Misvaer N, Helseth S. The outcomes of a 12-week Internet intervention aimed at improving fitness and health-related quality of life in overweight adolescents: the Young & Active controlled trial. PLoS One 2014;9(12):e114732.

Sousa P, Fonseca H, Gaspar P, Gaspar F. Controlled trial of an Internet-based intervention for overweight teens (Next.Step): effectiveness analysis. Eur J Pediatr 2015;174(9):1143-57.

White MA, Martin PD, Newton RL, Walden HM, York-Crowe EE, et al. Mediators of weight loss in a family-based intervention presented over the internet. Obes Res 2004;12(7):1050-9.

Williamson DA, Martin PD, White MA, Newton R, Walden H, et al. Efficacy of an internet-based behavioral weight loss program for overweight adolescent African-American girls. Eat Weight Disord 2005;10(3):193-203.

Williamson DA, Walden H, White MA, York-Crowe E, Newton RL, et al. Two-year internet-based randomized controlled trial for weight loss in African-American girls. Obesity 2006;14(7):1231-43.

Effectiveness Review

The search for evidence included two steps.

Studies searched and screened for inclusion were published in English and were limited to countries with high income economies as defined by the World Bank.

Database: PubMed 1800-

Date searched: 3/27/2019
Results: 487

Search Strategy:

(“Adolescent”[Mesh] OR “Young Adult”[Mesh]) OR adolescen*[Title/Abstract] OR teenage*[Title/Abstract] OR young[Title/Abstract] OR student*[Title/Abstract] OR juvenile[Title/Abstract] OR school*[Title/Abstract] OR kid[Title/Abstract] OR kids[Title/Abstract] OR youth[Title/Abstract] OR underage[Title/Abstract]

AND

“Therapy, Computer-Assisted”[Mesh] OR “Internet”[Mesh] OR “Computers”[Mesh] OR “text messaging”[MeSH] OR “Feedback”[Mesh] OR phone*[Title/Abstract] OR computer-assisted[Title/Abstract] OR computer-based[Title/Abstract] OR web-based[Title/Abstract] OR Telemedicine[Title/Abstract] OR “communication network”[Title/Abstract] OR “remote consultation”[Title/Abstract] OR “electronic health”[Title/Abstract] OR “mobile health”[Title/Abstract] OR telehealth[Title/Abstract] OR e-health[Title/Abstract] OR ehealth[Title/Abstract] OR mhealth[Title/Abstract] OR m-health[Title/Abstract] OR hypermedia[Title/Abstract] OR multimedia[Title/Abstract] OR computer*[Title/Abstract] OR internet[Title/Abstract] OR online[Title/Abstract] OR on-line[Title/Abstract] OR “world wide web”[Title/Abstract] OR website*[Title/Abstract] OR telecare[Title/Abstract] OR telemonitoring[Title/Abstract] OR interactive[Title/Abstract] OR wireless[Title/Abstract] OR mobile[Title/Abstract] OR “personal digital assistant”[Title/Abstract] OR pda[Title/Abstract] OR “interactive voice response”[Title/Abstract] OR ivr[Title/Abstract] OR “text message”[Title/Abstract] OR “text messaging”[Title/Abstract] OR “text message”[Title/Abstract] OR SMS[Title/Abstract] OR IOTA[Title/Abstract] OR bluetooth[Title/Abstract] OR chat [Title/Abstract] OR “chat room”[Title/Abstract] OR “instant message”[Title/Abstract] OR IM[Title/Abstract] OR twitter [Title/Abstract] OR tweet[Title/Abstract] OR blog[Title/Abstract] OR “social network”[Title/Abstract] OR tailored[Title/Abstract] OR automated[Title/Abstract] OR individualized[Title/Abstract] OR programmed[Title/Abstract] OR remote[Title/Abstract] OR self-monitoring[Title/Abstract] OR feedback[Title/Abstract] OR prompt[Title/Abstract] OR reminder[Title/Abstract] OR facebook[Title/Abstract] OR FB[Title/Abstract]

AND

(“Obesity”[Mesh] OR “Weight Gain”[Mesh] OR “Body Mass Index”[Mesh] OR “Waist Circumference”[Mesh] OR “Waist-Hip Ratio”[Mesh] OR “Abdominal Fat”[Mesh] OR “Body Fat Distribution”[Mesh] OR “Skinfold Thickness”[Mesh] OR “Overweight”[Mesh] OR “Adiposity”[Mesh] OR “Weight Loss”[Mesh]) OR (overweight[Title/Abstract] OR adipos*[Title/Abstract] OR overeat*[Title/Abstract] OR overfeed*[Title/Abstract] OR obese*[Title/Abstract] OR obesity[Title/Abstract] OR BMI[Title/Abstract] OR “abdominal fat”[Title/Abstract] OR “skinfold thickness”[Title/Abstract] OR “body mass”[Title/Abstract] OR weight[Title/Abstract] OR “body fat”[Title/Abstract] OR waist-hip[Title/Abstract] OR circumference*[Title/Abstract] OR Exercise[Title/Abstract] OR sport*[Title/Abstract] OR exercise[Title/Abstract] OR “physical exertion”[Title/Abstract] OR physical exercise*[Title/Abstract] OR “motor activity”[Title/Abstract] OR kinesiotherapy[Title/Abstract] OR pilates[Title/Abstract] OR yoga[Title/Abstract] OR “physical activity”[Title/Abstract] OR diet[Title/Abstract] OR diets[Title/Abstract])

AND

controlled clinical trial[Publication Type] OR randomized controlled trial[Publication Type] OR randomized[Title/Abstract] OR placebo[Title/Abstract] OR drug therapy[MeSH Subheading] OR randomly[Title/Abstract] OR trial[Title/Abstract] OR groups[Title/Abstract]) NOT (Animals[Mesh] NOT humans[Mesh]

AND

(“2017/12/01″[CRDT] : “2019/03/22″[CRDT])

Database: EMBASE (OVID) 1947

Results: 384/289 after duplicates removed
Date searched: 04/01/2019
Search terms remain the same as the Ho,T. article but simplified search string.

Search strategy:

exp adolescent/ OR exp young adult/ OR (adolescen* or teenage* or young or student* or juvenile or school* or kid or kids or youth or underage).ti,ab.

AND

exp computer assisted therapy/ OR exp Internet/ OR exp computer/ OR exp text messaging/ OR exp feedback system/ OR (phone* OR ‘computer-assisted’ OR computer-based OR web-based OR telemedicine OR communication network OR remote consultation OR electronic health OR mobile health OR telehealth OR e-health OR ehealth OR mhealth OR m-health OR hypermedia OR multimedia OR computer* OR internet OR online OR on-line OR world wide web OR website* OR telecare OR telemonitoring OR interactive OR wireless OR mobile OR personal digital assistant OR pda OR interactive voice response OR ivr OR text messaging OR text message* OR sms OR iota OR Bluetooth OR chat OR chat room OR instant message* OR im OR twitter OR tweet* OR blog* OR social network* OR tailored OR automated OR individualized OR programmed OR remote OR self-monitoring OR feedback OR prompt OR reminder OR facebook OR fb).ti,ab.

AND

obesity’exp OR weight gain/exp OR body mass/exp OR waist circumference/exp OR waist hip ratio/exp OR abdominal fat/exp OR body fat distribution’exp OR skinfold thickness/exp OR weight reduction/exp OR (overweight OR adipos* OR overeat* OR overfeed* OR obese* OR obesity OR bmi OR ‘abdominal fat’ OR ‘skinfold thickness’ OR ‘body mass’ OR weight OR body fat OR ‘waist-hip’ OR circumference* OR sport* OR exercise OR ‘physical exertion’ OR ‘physical exercise’ OR ‘motor activity’ OR kinesiotherapy OR pilates OR yoga OR ‘physical activity’ OR diet OR diets).ti,ab.

AND

Activated study types: ‘clinical trial’; ‘controlled clinical trial’;’randomized controlled trial’; ‘randomized controlled trial (topic)’/

(201712* or 2018* or 2019*).dc.

Database: PsycINFO (OVID) 1806-

*The following search string did not work in PsycINFO(OVID)
double-blind method/ or clinical trials as topic/ or clinical trials, phase i as topic/ or clinical trials, phase ii as topic/ or clinical trials, phase iii as topic/ or clinical trials, phase iv as topic/ or controlled clinical trials as topic/ or randomized controlled trials as topic/ or early termination of clinical trials as topic/ or multicenter studies as topic/

32/21 after duplicates removed
Date Searched: 04/01/2019

Search Strategy:

1 STUDENTS/

2 High School Students/

3 Elementary School Students/

4 Junior High School Students/

5 1 or 2 or 3 or 4

6 (adolescen* or teenage* or young or student* or juvenile or school* or kid or kids or youth or underage).ti,ab.

7 5 or 6

8 exp Computer Assisted Therapy/

9 exp COMPUTERS/

10 exp INTERNET/

11 exp Text Messaging/

12 exp FEEDBACK/

13 (phone* or ‘computer-assisted’ or ‘computer-based’ or ‘web-based’ or telemedicine or ‘communication network’ or ‘remote consultation’ or ‘electronic health’ or ‘mobile health’ or telehealth or ‘e-health’ or ehealth or mhealth or ‘m-health’ or hypermedia or multimedia or computer* or internet or online or ‘on-line’ or ‘world wide web’ or website* or telecare or telemonitoring or interactive or wireless or mobile or ‘personal digital assistant’ or pda or ‘interactive voice response’ or ivr or ‘text messaging’ or ‘text message’ or sms or iota or bluetooth or chat or ‘chat room’ or ‘instant message’ or im or twitter or tweet* or blog* or social network* or tailored or automated or individualized or programmed or remote or ‘self-monitoring’ or feedback or prompt or reminder or facebook or fb).ti,ab.

14 exp OBESITY/

15 exp Weight Gain/

16 exp Body Mass Index/

17 exp Body Fat/

18 exp OVERWEIGHT/

19 exp Weight Loss/

20 or/14-19

21 (overweight or adipos* or overeat* or overfeed* or obese* or obesity or bmi or ‘abdominal fat’ or ‘skinfold thickness’ or ‘body mass’ or weight or body fat or ‘waist-hip’ or circumference* or sport* or exercise or ‘physical exertion’ or ‘physical exercise’ or ‘motor activity’ or kinesiotherapy or pilates or yoga or ‘physical activity’ or diet or diets).ti,ab.

22 8 or 9 or 10 or 11 or 12 or 13

23 20 or 21

24 ((randomi?ed adj7 trial*) or (controlled adj3 trial*) or (clinical adj2 trial*) or ((single or doubl* or tripl* or treb*) and (blind* or mask*))).ti,ab.

25 (‘clinical trial’ or ‘clinical trial, phase I’ or ‘clinical trial, phase ii’ or ‘clinical trial, phase iii’ or ‘clinical trial, phase iv’ or ‘controlled clinical trial’ or ‘multicenter study’ or ‘randomized controlled trial’).md.

26 exp clinical trials/

27 24 or 25 or 26

28 7 and 22 and 23 and 27

29 (201712* or 2018* or 2019*).dp.

30 28 and 29

Database: ProQuest (Pro Quest Central) 1970-

Results 1,018 /873 after duplicates removed
Date searched: 04/01/2019

Search Strategy:

(((MESH.EXACT(“Adolescent”) OR MESH.EXACT(“Young Adult”)) OR ti,ab(adolescen* OR teenage* OR young OR student* OR juvenile OR school* OR kid OR kids OR youth OR underage))

AND

((MESH.EXACT(“Therapy, Computer-Assisted”) OR MESH.EXACT(“Internet”) OR MESH.EXACT (“Computers”) OR MESH.EXACT(“text messaging”) OR MESH.EXACT(“Feedback”)) OR ti,ab(phone* OR computer-assisted OR computer-based OR web-based OR Telemedicine OR “communication network” OR “remote consultation” OR “electronic health” OR “mobile health” OR telehealth OR e-health OR m-health OR hypermedia OR multimedia OR computer* OR internet OR online OR “world wide web” OR website* OR telecare OR telemonitoring OR interactive OR wireless OR mobile OR “personal digital assistant” OR pda OR “interactive voice response” OR ivr OR “text message” OR “text messaging” OR “text message” OR SMS OR iOTA OR bluetooth OR chat OR “chat room” OR “instant message” OR im OR twitter OR tweet OR blog OR “social network” OR tailored OR automated OR individualized OR programmed OR remote OR self-monitoring OR feedback OR prompt OR reminder OR Facebook OR FB))

AND

((MESH.EXACT(“Obesity”) OR MESH.EXACT(“Weight Gain”) OR MESH.EXACT(“Body Mass Index”) OR MESH.EXACT(“Waist Circumference”) OR MESH.EXACT(“Waist-Hip Ratio”) OR MESH.EXACT(“Abdominal Fat”) OR MESH.EXACT(“Body Fat Distribution”) OR MESH.EXACT(“Skinfold Thickness”) OR MESH.EXACT(“Overweight”) OR MESH.EXACT(“Adiposity”) OR MESH.EXACT(“Weight Loss”)) OR ti,ab(overweight OR adipose* OR overeat* OR overfeed* OR obese* OR obesity OR BMI OR “abdominal fat” OR “skinfold thickness” OR “body mass” OR weight OR “body fat” OR waist-hip OR circumference* OR exercise OR sport* OR exercise OR “physical exertion” OR physical exercise* OR “motor activity” OR kinesiotherapy OR plates OR yoga OR “physical activity” OR diet OR diets))

AND

ti,ab(randomized OR placebo OR randomly OR trial OR groups))

AND

pd(20171201-20190401)

Database: CINAHL (EBSCO) 1981-

Results 22/11 after duplicates removed
Date searched: 04/02/2019

Search Strategy:

((MH “Adolescence+”) OR (MH “Young Adult”)) OR TI ( adolescen* or teenage* or young or student* or juvenile or school* or kid or kids or youth or underage) OR AB ( adolescen* or teenage* or young or student* or juvenile or school* or kid or kids or youth or underage)

AND

( (MH “Therapy, Computer Assisted+”) OR (MH “Internet+”) OR (MH “User-Computer Interface+”) OR (MH “Text Messaging”) OR (MH “Feedback”) ) OR TI ( phone* OR computer-assisted OR computer-based OR web-based OR Telemedicine OR “communication network” OR “remote consultation” OR “electronic health” OR “mobile health” OR telehealth OR e-health OR ehealth OR mhealth OR m-health OR hypermedia OR multimedia OR computer* OR internet OR online OR on-line OR “world wide web” OR website* OR telecare OR telemonitoring OR interactive OR wireless OR mobile OR “personal digital assistant” OR pda OR “interactive voice response” OR ivr OR “text message” OR “text messaging” OR “text message” OR SMS OR iOTA OR bluetooth OR chat OR “chat room” OR “instant message” OR im OR twitter OR tweet OR blog OR “social network” OR tailored OR automated OR individualized OR programmed OR remote OR self-monitoring OR feedback OR prompt OR reminder OR facebook OR FB ) OR AB ( phone* OR computer-assisted OR computer-based OR web-based OR Telemedicine OR “communication network” OR “remote consultation” OR “electronic health” OR “mobile health” OR telehealth OR e-health OR ehealth OR mhealth OR m-health OR hypermedia OR multimedia OR computer* OR internet OR online OR on-line OR “world wide web” OR website* OR telecare OR telemonitoring OR interactive OR wireless OR mobile OR “personal digital assistant” OR pda OR “interactive voice response” OR ivr OR “text message” OR “text messaging” OR “text message” OR SMS OR iOTA OR bluetooth OR chat OR “chat room” OR “instant message” OR im OR twitter OR tweet OR blog OR “social network” OR tailored OR automated OR individualized OR programmed OR remote OR self-monitoring OR feedback OR prompt OR reminder OR facebook OR FB )

AND

( (MH “Obesity”) OR (MH “Weight Gain+”) OR (MH “Body Mass Index”) OR (MH “Waist Circumference”) OR (MH “Waist-Hip Ratio”) OR (MH “Abdominal Fat”) OR (MH “Adipose Tissue Distribution”) OR (MH “Skinfold Thickness”) OR (MH “Weight Loss”) ) OR TI ( overweight OR adipos* OR overeat* OR overfeed* OR obese* OR obesity OR BMI OR “abdominal fat” OR “skinfold thickness” OR “body mass” OR weight OR “body fat” OR waist-hip OR circumference* ) OR AB ( overweight OR adipos* OR overeat* OR overfeed* OR obese* OR obesity OR BMI OR “abdominal fat” OR “skinfold thickness” OR “body mass” OR weight OR “body fat” OR waist-hip OR circumference* ) OR TI ( Exercise OR sport* OR exercise OR “physical exertion” OR physical exercise* OR “motor activity” OR kinesiotherapy OR pilates OR yoga OR “physical activity” OR diet OR diets ) OR AB ( Exercise OR sport* OR exercise OR “physical exertion” OR physical exercise* OR “motor activity” OR kinesiotherapy OR pilates OR yoga OR “physical activity” OR diet OR diets )

*Activated study types:’randomized controlled trial’

Published Date: 20171201-20190430

Languages: English only

Database: Cochrane (Wiley) 2003

Results 1626/1380 after duplicates removed
Date searched: 04/02/19

Search Strategy:

#1 MeSH descriptor: [Adolescent] explode all trees

#2 MeSH descriptor: [Young Adult] explode all trees

#3 (adolescen* or teenage* or young or student* or juvenile or school* or kid or kids or youth or underage):ti,ab

#4 #1 OR #2 OR #3

#5 MeSH descriptor: [Therapy, Computer-Assisted] explode all trees

#6 MeSH descriptor: [Internet] explode all trees

#7 MeSH descriptor: [Computers] explode all trees

#8 (phone* or computer-assisted or computer-based or web-based or Telemedicine or “communication network” or “remote consultation” or “electronic health” or “mobile health” or telehealth or e-health or ehealth or mhealth or m-health or hypermedia or multimedia or computer* or internet or online or on-line or “world wide web” or website* or telecare or telemonitoring):ti,ab

#9 MeSH descriptor: [Text Messaging] explode all trees

#10 MeSH descriptor: [Feedback] explode all trees

#11 (interactive or wireless or mobile or “personal digital assistant” or pda or “interactive voice response” or ivr or “text message” or “text messaging” or “text message” or SMS or iOTA or bluetooth or chat or “chat room” or “instant message” or IM or twitter or tweet or blog or “social network” or tailored or automated or individualized or programmed or remote or self-monitoring or feedback or prompt or reminder or facebook or FB):ti,ab

#12 #5 or #6 or #7 or #8 or #9 or #10 or #11

#13 MeSH descriptor: [Obesity] explode all trees

#14 MeSH descriptor: [Weight Gain] explode all trees

#15 MeSH descriptor: [Body Mass Index] explode all trees

#16 MeSH descriptor: [Waist Circumference] explode all trees

#17 MeSH descriptor: [Waist-Hip Ratio] explode all trees

#18 MeSH descriptor: [Abdominal Fat] explode all trees

#19 MeSH descriptor: [Body Fat Distribution] explode all trees

#20 MeSH descriptor: [Skinfold Thickness] explode all trees

#21 MeSH descriptor: [Overweight] explode all trees

#22 MeSH descriptor: [Adiposity] explode all trees

#23 MeSH descriptor: [Weight Loss] explode all trees

#24 (overweight or adipos* or overeat* or overfeed* or obese* or obesity or BMI or “abdominal fat” or “skinfold thickness” or “body mass” or weight or “body fat” or waist-hip or circumference*):ti,ab

#25 #13 or #14 or #15 or #16 or #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24

#26 (Exercise or sport* or exercise or “physical exertion” or physical exercise* or “motor activity” or kinesiotherapy or pilates or yoga or “physical activity” or diet or diets):ti,ab

#27 #25 or #26

#28 #4 AND #12 AND #27 with Cochrane Library publication date Between Dec 2017 and Apr 2019, in Cochrane Reviews, Trials

1. Researchers included studies from the following systematic review (search period through December 13, 2017):
   Ho TJH, Lee CCS, Wong SN, Lau Y. Internet-based self-monitoring interventions for overweight and obese adolescents: a systematic review and meta-analysis. International Journal of Medical Informatics 2018;120:2030.
2. A research librarian searched for published studies in the following databases (Search period December 2017 through March 27, 2019): PubMed, Embase, PsychINFO, ProQuest, CINAHL, Cochrane. Search strategies were adjusted to each database, based on controlled and uncontrolled vocabulary and search software.

Ho TJH, Lee CCS, Wong SN, Lau Y. Internet-based self-monitoring interventions for overweight and obese adolescents: a systematic review and meta-analysis. International Journal of Medical Informatics 2018;120:2030.

The following considerations for implementation are drawn from studies included in the evidence review, the broader literature, and expert opinion.

• Interventions incorporating technology are a convenient and relatively new way to reach people, especially younger generations.
• Digital health is rapidly evolving and the impact of newer digital health interventions, such as interventions incorporating social media, were not represented in this body of evidence.
• Storage of confidential personal information is critical; at a minimum, personal information should be encrypted and password-protected.
• Implementers need to ensure information administered to adolescents is age-appropriate and accurate. Involving trained professionals can help. Interventions in the included studies were supported by physicians, dietitians, exercise physiologists, and mental health providers.
  • Digital health interventions that include self-monitoring may increase access for adolescents who are living in rural areas without access to a nearby intervention facility or have transportation challenges that make it difficult to participate in obesity treatment interventions.

Healthy People 2030

Healthy People 2030 includes the following objectives related to this CPSTF recommendation.

• Reduce the proportion of children and adolescents with obesity — NWS‑04