Many studies show that preventive interventions to correct excessive body mass (BM) based on self-monitoring of BM parameters, physical exercises and eating habits using mHealth technology lead to effective and long-term reduction of BM. No such studies have been conducted in Russia.
OBJECTIVE
To evaluate the effectiveness of a preventive intervention to reduce excessive BM using mHealth technology compared to conventional medical practice in primary health care facilities.
MATERIAL AND METHODS
We examined 195 patients who were randomly assigned into the following groups: group I (73 patients) — intensive intervention; group II (73 patients) — moderate intervention; group III (49 patients) — control group. Primary preventive consultation was given to patients in all groups. Group I and II patients were provided with scales, tonometer, pedometer, and self-monitoring instructions; group III patients were provided only with self-monitoring instructions. Group I patients measured their BM, blood pressure, and number of steps and completed a weekly food diary. The patients received feedback by means of reminders or supportive messages based on the results of parameter analysis. On-site visits were carried out 2 weeks, 1, 2, 3, and 6 months after the start of the study. Group II patients received feedback on the analysis results during on-site visits at 3 and 6 months. Group III patients measured their BM and kept a food diary on their own; they received feedback on the results of the analysis only during the on-site visit at 6 months. Validity of intergroup differences was assessed by the χ2, Kruskal-Wallis, Mann-Whitney, and Friedman tests.
RESULTS
Anthropometric parameters reduced in patients of all groups by the end of observation. In group I, the reduction in mean BM was 1.5 times greater than in group II, and 2 times greater than in the control group. Similar patterns were observed in the change of the waist circumference (WC). However, there were significant differences between the groups in the rate of change of anthropometric parameters: in all three groups, the greatest reduction rate of BM, BM index, and WC was recorded in the first three months of observation and slowed down in the following three months. The differences between the groups in the rate of achievement of the BM reduction target level by 5% evaluated using the χ2 criterion were significant (p=0.030). The percentage of patients with BM reduction by 5% vs. baseline was also different in the intensive intervention group. The value of the χ2 criterion (χ2=7.066) in the three-group comparisons exceeded the critical value with a significance level of p=0.030.
CONCLUSION
The effectiveness of mHealth technology based on preventive consultation and self-monitoring was demonstrated. More pronounced improvements of anthropometric parameters were observed in patients in the intensive intervention group.
