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PreprintCited by 39Mobile Health and mHealth ApplicationsObesity, Physical Activity, DietNutrition, Health and Food Behavior

eHealth Intervention to Improve Health Habits in the Adolescent Population: Mixed Methods Study (Preprint)

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Benavides, Carmen, Benítez-Andrades, José Alberto, Marqués-Sánchez, Pilar, Arias, Natalia·2020·JMIR mhealth and uhealth
DOI 10.2196/preprints.20217PMC PMC7932840

Preprint — published as 10.2196/20217

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Abstract

BACKGROUND: Technology has provided a new way of life for the adolescent population. Indeed, strategies aimed at improving health-related behaviors through digital platforms can offer promising results. However, since it has been shown that peers are capable of modifying behaviors related to food and physical exercise, it is important to study whether digital interventions based on peer influence are capable of improving the weight status of adolescents. OBJECTIVE: The purpose of this study was to assess the effectiveness of an eHealth app in an adolescent population in terms of improvements in their age- and sex-adjusted BMI percentiles. Other goals of the study were to examine the social relationships of adolescents pre- and postintervention, and to identify the group leaders and study their profiles, eating and physical activity habits, and use of the web app. METHODS: The BMI percentiles were calculated in accordance with the reference guidelines of the World Health Organization. Participants' diets and levels of physical activity were assessed using the Mediterranean Diet Quality Index (KIDMED) questionnaire and the Physical Activity Questionnaire for Adolescents (PAQ-A), respectively. The variables related to social networks were analyzed using the social network analysis (SNA) methodology. In this respect, peer relationships that were considered reciprocal friendships were used to compute the "degree" measure, which was used as an indicative parameter of centrality. RESULTS: The sample population comprised 210 individuals in the intervention group (IG) and 91 individuals in the control group (CG). A participation rate of 60.1% (301/501) was obtained. After checking for homogeneity between the IG and the CG, it was found that adolescents in the IG at BMI percentiles both below and above the 50th percentile (P50) modified their BMI to approach this reference value (with a significance of P<.001 among individuals with an initial BMI below the P50 and P=.04 for those with an initial BMI above the P50). The diet was also improved in the IG compared with the CG (P<.001). After verifying that the social network had increased postintervention, it was seen that the group leaders (according to the degree SNA measure) were also leaders in physical activity performed (P=.002) and use of the app. CONCLUSIONS: The eHealth app was able to modify behaviors related to P50 compliance and exert a positive influence in relation to diet and physical exercise. Digital interventions in the adolescent population, based on the improvement in behaviors related to healthy habits and optimizing the social network, can offer promising results that help in the fight against obesity.

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  • Recent studies have identified several challenges that undermine the feasibility of technology-driven interventions, including teachers' lack of understanding of the operating systems of the technology, limited internet access, and poor technology infrastructure.

    “Although a few reviews suggest that technology-driven interventions may be feasible [29, 41], recent studies have identified several challenges that undermine their feasibility. These challenges include teachers’ lack of understanding of the operating systems of the technology, limited internet access, and poor technology infrastructure [51, 52].”

    From School-based healthy eating interventions for adolescents aged 10–19 years: an umbrella review (2024) · cites this paper as [51]

  • Curricula driven by technology effectively encouraged healthy eating behaviours at the individual level.

    “Our review found that curricula driven by technology effectively encouraged healthy eating behaviours at the individual level, a finding further reinforced by recent studies [50–52].”

    From School-based healthy eating interventions for adolescents aged 10–19 years: an umbrella review (2024) · cites this paper as [51]

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Authors
Benavides, C., Benítez-Andrades, J. A., Marqués-Sánchez, P., & Arias, N.
Affiliations
Universidad de León (ES)
ORCID
Venue
JMIR mhealth and uhealth
Publisher
JMIR Publications Inc.
Published
2020-05-13
Volume
9
Issue
2
Pages
e20217-e20217
ISSN
2291-5222 (ISSN-L)
DOI
10.2196/preprints.20217
PMC
PMC7932840
OpenAlex
W3127429709
Cited by
39
References
43
Citations by year
2026: 8 · 2025: 10 · 2024: 7 · 2023: 6 · 2022: 5 · 2021: 3
FWCI
5.90
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR mhealth and uhealth (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • arXiv (Cornell University) (submittedVersion, cc-by-nc-nd)
  • Buleria (Universidad de León) (submittedVersion, cc-by-nc-nd)
  • arXiv (Cornell University)
Funders
  • Junta de Castilla y León (LE014G18)
  • Universidad de León
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
adolescent obesity, eHealth apps, peer influence, peer relationships, social networks, body mass index percentiles, dietary habits, physical activity, Mediterranean diet, group leaders, digital health interventions, healthy lifestyle habits, social network analysis, reciprocal friendship, Mediterranean diet quality, physical activity level, screen time, sedentary behavior
MeSH terms
Adolescent, Habits, Humans, Obesity, Health Behavior, Exercise, Telemedicine

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