Obesity, Adolescent Clinical Trial
Official title:
PathMate2: The Impact of Health Information System Services on the Effects of Therapy in Overweight Teenagers
Randomised controlled trial in overweight adolescents using a health App.
Problem In Switzerland, 20% of children are overweight and novel methods are urgently needed
to control the epidemic. Foundations of chronic diseases develop during childhood and track
into adulthood obesity in more than 75% of patients, contributing to a significant increase
in public health costs.
Multi-professional programs combining physical activity, nutritional and behavioral
components have positive effects on therapy outcomes and co-morbidities, but these
interventions induce high costs and are time-consuming for health providers, patients and
families, in particular those living in rural regions. In fact, less than 0.2% of overweight
children can participate in these programs. Thus, health information systems (HIS) have not
only the potential to improve outcomes of obesity therapy but also to reduce health costs and
increase access to health care in remote regions. Most HIS have indeed not been evaluated in
this regard.
Preparation work In the PathMate project (SNF grant #135552), a mobile HIS has been developed
for teenagers to support therapy and to prevent obesity in accordance with state-of-the-art
multiprofessional programs and, in contrast to commercially available IT applications, with a
high standard of data protection and safety. The IS effects of this HIS have been
successfully evaluated in first longitudinal studies. In parallel, the impact of
multi-professional therapies in Swiss children as well as potential confounders have been
established in several longitudinal cohort studies with up to two-years follow-up.
Objectives
The overall goal of PathMate2 is to assess the impact of HIS services on the degree of
obesity measured by the body mass index (BMI) incl. other health outcomes. Individual and
shared understanding between patients and therapists are assessed as mediating factors.
Specific goals are:
1. to assess the effects of a child-friendly IT-mediated low-threshold intervention under
the supervision of primary care providers and obesity experts, compared to expensive
on-site consultations in highly specialized pediatric obesity centers
2. to automatically capture and process obesity-related biosignals by smart sensors and use
results for immediate feedback for the patients and medical providers based on
permissions and communication patterns and
3. to design evidence-based selfregulation interventions for teenager in their everyday
life by coupling Neuro Information Systems (NeuroIS) services with Smart Health Sensors
(SHS).
Methods HIS services are collaboratively developed by design-science research and evaluated
by medical experts, patients, IS researcher and computer scientists. First, HIS services from
PathMate are enhanced with SHS enabling real-time data analytics on mobile devices and
results can be seen by both therapists and patients. Second, a randomized controlled trial
(RCT) is conducted by a physician in a specialized pediatric obesity center in St. Gall with
the goal to evaluate the effects of the re-designed and improved HIS services on adherence to
therapy of the patient and his parents as well as on BMI and other health outcomes; a second
RCT is conducted in parallel to assess the effects of these services in a community setting
in the French-speaking part of Switzerland.
Importance and impact Building on the preliminary results of the PathMate project it is
expected that the improved HIS services that are going to be designed and evaluated in
PathMate2 have the potential for a significant impact on individual health and the quality of
healthcare systems in general.
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