Application of Innovative Technologies in the Prevention and Treatment of Overweight in Children and Adolescents

  • Deborah F. Tate
Part of the Issues in Clinical Child Psychology book series (ICCP)

Internet and other technology-based interventions have increasingly been developed and evaluated for behavior change. Recently, two review papers have been published evaluating Web- or computer-based interventions for chronic disease compared with non-Web-based or no-treatment controls (Wantland, Portillo, Holzemer, Slaughter, & McGhee, 2004; Murray, Burns, See, Lai, & Nazareth, 2005). One review of 24 randomized controlled trials (RCTs) pooled across 3,000 child and adult participants, found that interactive health communication applications (e.g., computer or Internet-based packages that combine health information with social, decision, or behavior change support) had significantly positive effects on changing patient knowledge, perceived social support, and key behavioral and clinical outcomes when compared with non-Web-based control programs (Murray et al.). Effect sizes in the meta-analytic review ranged from −.01 to.75, but results were more favorable for patients assigned to the Web-based interventions compared with control groups. The reviews included several interventions developed for pediatric chronic illnesses, such as asthma self-management and type-I diabetes. Because these reviews compared Web-based programs to non-Web-based interventions or controls, they do not enable much delineation of the components of such programs that lead to greater efficacy. In fact, few hypotheses about the way in which these technologies are best developed or applied have been explicitly tested, but to date, most of the research on using technology for child or adolescent overweight suggests initial feasibility with some limited outcome evaluations.

Children and adolescents are increasingly exposed to a wide variety of technologies at younger ages than in prior decades. Technologies that are commonly used by this age group include computers, mobile phones, portable music players, video and portable electronic games, TV, and others. This chapter will review and discuss promising directions for using technology with children and adolescents with a particular focus on application of prevention or treatment of overweight.


Video Game Sedentary Behavior Screen Time Physical Activity Promotion Internet Intervention 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Bandura, A. (1986). Social foundations of thought and action. Englewood Cliffs, NJ: Prentice-HallGoogle Scholar
  2. Baranowski, T., Baranowski, J., Cullen, K. W., Marsh, T., Islam, N., Zakeri, I., et al. (2003). Squire's quest! Dietary outcome evaluation of a multimedia game. American Journal of Preventative Medicine, 24, 52–61CrossRefGoogle Scholar
  3. Dunton, G. F., Whalen, C. K., Jamner, L. D., Henker, B., & Floro, J. N. (2005). Using ecologic momentary assessment to measure physical activity during adolescence. American Journal of Preventative Medicine, 29, 281–287CrossRefGoogle Scholar
  4. Epstein, L. H., Roemmich, J. N., & Raynor, H. A. (2001). Behavioral therapy in the treatment of pediatric obesity. Pediatric Clinics of North America, 48, 981–993PubMedCrossRefGoogle Scholar
  5. Faith, M. S., Berman, N., Heo, M., Pietrobelli, A., Gallagher, D., Epstein, L. H., et al. (2001). Effects of Contingent-TV on physical activity and TV-Viewing in obese. Children. Pediatrics, 107, 1043–1048PubMedCrossRefGoogle Scholar
  6. Francis, L. A., & Birch, L. L. (2006). Does eating during television viewing affect preschool children's intake? Journal of the American Dietetic Association, 106, 598–600PubMedCrossRefGoogle Scholar
  7. Frenn, M., Malin, S., Brown, R. L., Greer, Y., Fox, J., Greer, J., et al. (2005). Changing the tide: An internet/video exercise and low-fat diet intervention with middle-school students. Applied Nursing Research, 18, 13–21PubMedCrossRefGoogle Scholar
  8. Gammon, D., Årsand, E., Walseth, O. A., Andersson, N., Jenssen, M., & Taylor, T. (2005). Parent-child interaction using a mobile and wireless system for blood glucose monitoring. Journal of Medical Internet Research, 7, e57PubMedCrossRefGoogle Scholar
  9. Goran, M. I., & Reynolds, K. (2005). Interactive multimedia for promoting physical activity (IMPACT) in children. Obesity Research, 13, 762–771PubMedCrossRefGoogle Scholar
  10. Haller, D., Sanci, L., Sawyer, S., Coffey, C., & Patton, G. (2006). R u ok 2 txt 4 research? Feasibility of text message communication in primary care research. Australian Family Physician, 35, 175–176PubMedGoogle Scholar
  11. Hurling, R., Fairley, B. W., & Dias, M. B. (2006). Internet-based exercise interventions: Are more interactive designs better? Psychology & Health, 21, 757–772CrossRefGoogle Scholar
  12. Kautiainen, S., Koivusilta, L., Lintonen, T., Virtanen, S. M., & Rimpela, A. (2005). Use of information and communication technology and prevalence of overweight and obesity among adolescents. International Journal of Obesity (London), 29, 925–933CrossRefGoogle Scholar
  13. Krishna, S., Francisco, B. D., Balas, E. A., König, P., Graff, G. R., & Madsen, R. W. (2003). Internet-enabled interactive multimedia asthma education program: A randomized trial. Pediatrics, 111, 503–510PubMedCrossRefGoogle Scholar
  14. Lane, S. J., Heddle, N. M., Arnold, E., & Walker, I. (2006). A review of randomized controlled trials comparing the effectiveness of hand held computers with paper methods for data collection. BMC Medical Informatics and Decision Making, 31, 23CrossRefGoogle Scholar
  15. Lanningham-Foster, L., Jensen, T. B., Foster, R. C., Redmond, A. B., Walker, B. A., Heinz, D., et al. (2006). Energy expenditure of sedentary screen time compared with active screen time for children. Pediatrics, 118, e1831–e1835CrossRefGoogle Scholar
  16. Lenhart, A., Madden, M., & Hitlin, P. (2005). Teens and technology: Youth are leading the transition to a fully wired and mobile nation. Pew Internet and American Life Project.
  17. Long, J. D., & Stevens, K. R. (2004). Using technology to promote self-efficacy for healthy eating in adolescents. Journal of Nursing Scholarship, 36, 134–139PubMedCrossRefGoogle Scholar
  18. Marks, J. T., Campbell, M. K., Ward, D. S., Ribisl, K. M., Wildemuth, B. M., & Symons, M. J. (2006). A comparison of web and print media for physical activity promotion among adolescent girls. Journal of Adolescent Health, 39, 96–104PubMedCrossRefGoogle Scholar
  19. Marshall, S. J., Biddle, S. J., Gorely, T., Cameron, N., & Murdey, I. (2004). Relationships between media use, body fatness and physical activity in children and youth: A meta-analysis. International Journal of Obesity and Related Metabolic Disorders, 28, 1238–1246PubMedCrossRefGoogle Scholar
  20. McPherson, A. C., Glazebrook, C., Forster, D., James, C., & Smyth, A. (2006). A randomized, controlled trial of an interactive educational computer package for children with asthma. Pediatrics, 117, 1046–1054PubMedCrossRefGoogle Scholar
  21. Murray, E., Burns, J., See, T. S., Lai, R., & Nazareth, I. (2005). Interactive health communication applications for people with chronic disease. Cochrane Database of Systematic Reviews, 19, CD004274Google Scholar
  22. Palermo, T. M., Valenzuela, D., & Stork, P. P. (2004). A randomized trial of electronic versus paper pain diaries in children: Impact on compliance, accuracy, and acceptability. Pain, 107, 213–219PubMedCrossRefGoogle Scholar
  23. Patrick, K., Sallis, J. F., Prochaska, J. J., Lydston, D. D., Calfas, K. J., Zabinski, M. F., et al. (2001). A multicomponent program for nutrition and physical activity change in primary care: PACE+ for adolescents. Archives of Pediatric and Adolescent Medicine, 155, 940–946Google Scholar
  24. Perri, M. G., Nezu, A. M., Patti, E. T., & McCann, K. L. (1989). Effect of length of treatment on weight loss. Journal of Consulting and Clinical Psychology, 57, 450–452PubMedCrossRefGoogle Scholar
  25. Petty, R. E., & Cacioppo, J. T. (1986). The elaboration likelihood model of persuasion. Advances in Experimental Social Psychology, 19, 123–205CrossRefGoogle Scholar
  26. Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to additive behaviors. American Psychologist, 47, 1102–1114PubMedCrossRefGoogle Scholar
  27. Ritterband, L. M., Borowitz, S., Cox, D. J., Kovatchev, B., Walker, L. S., Lucas, V., et al. (2005). Using the internet to provide information prescriptions. Pediatrics, 116, e643–e647PubMedCrossRefGoogle Scholar
  28. Ritterband, L. M., Cox, D. J., Walker, L. S., Kovatchev, B., McKnight, L., Patel, K., et al. (2003). An internet intervention as adjunctive therapy for pediatric encopresis. Journal of Consulting and Clinical Psychology, 71, 910–917PubMedCrossRefGoogle Scholar
  29. Robinson, S., Perkins, S., Bauer, S., Hammond, N., Treasure, J., & Schmidt, U. (2006). Aftercare intervention through text messaging in the treatment of bulimia nervosa-Feasibility pilot. International Journal of Eating Disorders, 39, 633–638PubMedCrossRefGoogle Scholar
  30. Russ, C. R., Tate, D. F., Whitely, J. A., Winett, R. A., Winett, S. G., & Pfleger, J. (1998). The effects of an innovative www-based health behavior program on the nutritional practices of tenth grade girls: Preliminary report on the eat4 life program. Journal of Gender, Culture, & Health, 3, 121–128CrossRefGoogle Scholar
  31. Saelens, B. E., & Epstein, L. H. (1998). Behavioural engineering of activity choice in obese children. International Journal of Obesity, 22, 275–277PubMedCrossRefGoogle Scholar
  32. Segal, K. R., & Dietz, W. H. (1991). Physiologic responses to playing a video game. American Journal of Diseases of Children, 145, 1034–1036PubMedGoogle Scholar
  33. Stone, A. A., & Shiffman, S. (2002). Capturing momentary, self-report data: A proposal for reporting guidelines. Annals of Behavioral Medicine, 24, 236–243PubMedCrossRefGoogle Scholar
  34. Tate, D. F., Jackvony, E. H., & Wing, R. R. (2003). Effects of internet behavioral counseling on weight loss in adults at risk for Type 2 diabetes: A randomized trial. Journal of the American Medical Association, 289, 1833–1836PubMedCrossRefGoogle Scholar
  35. Tate, D. F., Jackvony, E. H., & Wing, R. R. (2006). A Randomized trial comparing human e-mail counseling, computer automated tailored counseling, and no counseling in an internet weight loss program. Archives of Internal Medicine, 166, 1620–1625PubMedCrossRefGoogle Scholar
  36. Tate, D. F., Jelalian, E., Ferguson, E., & Wing, R. R. (2005). Combining face-to-face and internet channels in the treatment of overweight adolescent girls. Obesity, 13, A3Google Scholar
  37. Tate, D. F., Wing, R. R., & Winett, R. A. (2001). Using internet technology to deliver a behavioral weight loss program. Journal of the American Medical Association, 285, 1172–1177PubMedCrossRefGoogle Scholar
  38. Turnin, M. C., Tauber, M. T., Couvaras, O., Jouret, B., Bolzonella, C., Bourgeois, O., et al. (2001). Evaluation of microcomputer nutritional teaching games in 1,876 children at school. Diabetes and Metabolism, 27, 459–464PubMedGoogle Scholar
  39. U.S. Census Bureau. (2005). Computer and internet use in the United States: 2003, current population reports. October 2005Google Scholar
  40. Utter, J., Scragg, R., & Schaaf, D. (2006). Associations between television viewing and consumption of commonly advertised foods among New Zealand children and young adolescents. Public Health Nutrition, 9, 606–612PubMedCrossRefGoogle Scholar
  41. Wang, X., & Perry, A. C. (2006). Metabolic and physiologic responses to video game play in 7- to 10-year-old boys. Archives of Pediatric and Adolescent Medicine, 160, 411–415CrossRefGoogle Scholar
  42. Wantland, D. J., Portillo, C. J., Holzemer, W. L., Slaughter, R., & McGhee, E. M. (2004). The effectiveness of web-based vs. non-web-based interventions: A meta-analysis of behavioral change outcomes. Journal of Medical Internet Research, 6, e40PubMedCrossRefGoogle Scholar
  43. Wiecha, J. L., Peterson, K. E., Ludwig, D. S., Kim, J., Sobol, A., & Gortmaker, S. L. (2006). When children eat what they watch: Impact of television viewing on dietary intake in youth. Archives of Pediatric & Adolescent Medicine, 160, 436–442CrossRefGoogle Scholar
  44. Williamson, D. A., Martin, P. D., White, M. A., Newton, R., Walden, H., York-Crowe, E., et al. (2005). Efficacy of an internet-based behavioral weight loss program for overweight adolescent African-American girls. Eating & Weight Disorders, 10, 193–203Google Scholar
  45. Williamson, D. A., Walden, H. M., White, M. A., York-Crowe, E., Newton, R. L., Jr, Alfonso, A., et al. (2006). Two-year internet-based randomized controlled trial for weight loss in African-American girls. Obesity (Silver Spring), 14, 1231–1243CrossRefGoogle Scholar
  46. Winett, R. A., Roodman, A. A., Winett, S. G., Bajzek, W., Roviniak, L. S., & Whiteley, J. A. (1999). The effects of the Eat4Life internet-based health behavior program on the nutrition and activity practices of high school girls. Journal of Gender, Culture & Health, 4, 239–254CrossRefGoogle Scholar
  47. Winett, R. A., Tate, D. F., Anderson, E. S., Wojcik, J. R., & Winett, S. G. (2005). Long-term weight gain prevention: A theoretically based internet approach. Preventive Medicine, 41, 629–641PubMedCrossRefGoogle Scholar
  48. Yon, B. A., Johnson, R. K., Harvey-Berino, J., & Gold, B. C. (2006). The use of a personal digital assistant for dietary self-monitoring does not improve the validity of self-reports of energy intake. Journal of the American Dietetic Association, 106(8), 1256–1259PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Deborah F. Tate
    • 1
  1. 1.University of North CarolinaChapel Hill

Personalised recommendations