@文章{信息:doi/10.2196/14458，作者="Cueto, Victor and Wang, C Jason and Sanders, Lee Michael"，标题="基于移动应用程序的健康指导和行为改变计划对超重和肥胖儿童参与者参与度和体重状况的影响:回顾性队列研究"，期刊="JMIR Mhealth Uhealth"，年="2019"，月="11"，日="15"，卷="7"，数="11"，页数="e14458"，关键词="儿童肥胖;移动健康;移动应用;健康指导;健康行为;自我监控;背景:传统上，儿童和青少年肥胖的有效治疗需要频繁的面对面接触，而且通常受到参与者参与度低的限制。移动医疗工具可以提供可替代的模式，提高参与者的参与度。目的:本研究的目的是通过基于移动应用程序的健康指导和体重管理行为改变计划，评估儿童随时间的参与程度，并研究参与程度和体重状态变化之间的关系。方法:这是一项对Kurbo用户数据的回顾性队列研究，Kurbo是一个商业项目，通过视频聊天提供每周个人指导，并支持通过移动应用程序自我监测健康行为。研究参与者包括2015年3月至2017年3月期间Kurbo的用户，他们年龄在5至18岁之间，超重或肥胖(体重指数; BMI ≥ 85th percentile or ≥ 95th percentile) at baseline. The primary outcome, engagement, was defined as the total number of health coaching sessions received. The secondary outcome was change in weight status, defined as the change in BMI as a percentage of the 95th percentile ({\%}BMIp95). Analyses of outcome measures were compared across three initial commitment period groups: 4 weeks, 12 to 16 weeks, or 24 weeks. Multivariable linear regression models were constructed to adjust outcomes for the independent variables of sex, age group (5-11 years, 12-14 years, and 15-18 years), and commitment period. A sensitivity analysis was conducted, excluding a subset of participants involuntarily assigned to the 12- to 16-week commitment period by an employer or health plan. Results: A total of 1120 participants were included in analyses. At baseline, participants had a mean age of 12 years (SD 2.5), mean BMI percentile of 96.6 (SD 3.1), mean {\%}BMIp95 of 114.5 (SD 16.5), and they were predominantly female 68.04{\%} (762/1120). Participant distribution across commitment periods was 26.07{\%} (292/1120) for 4 weeks, 61.61{\%} (690/1120) for 12-16 weeks, and 12.32{\%} (138/1120) for 24 weeks. The median coaching sessions (interquartile range) received were 8 (3-16) for the 4-week group, 9 (5-12) for the 12- to 16-week group, and 19 (11-25) for the 24-week group (P<.001). Adjusted for sex and age group, participants in the 4- and 12-week groups participated in --8.03 (95{\%} CI --10.19 to --5.87) and --9.34 (95{\%} CI --11.31 to --7.39) fewer coaching sessions, compared with those in the 24-week group (P<.001). Adjusted for commitment period, sex, and age group, the overall mean change in {\%}BMIp95 was --0.21 (95{\%} CI --0.25 to --0.17) per additional coaching session (P<.001). Conclusions: Among overweight and obese children using a mobile app--based health coaching and behavior change program, increased engagement was associated with longer voluntary commitment periods, and increased number of coaching sessions was associated with decreased weight status. ", issn="2291-5222", doi="10.2196/14458", url="http://mhealth.www.mybigtv.com/2019/11/e14458/", url="https://doi.org/10.2196/14458", url="http://www.ncbi.nlm.nih.gov/pubmed/31730041" }