NEW YORK (Reuters Health) ? A series of interactive computer exercises designed to encourage healthy eating and physical activity didn't keep middle schoolers in the Netherlands from gaining extra weight, according to a new study.
The web-based program did lead to short-term improvements in the number of sugary drinks and snacks the kids consumed, but researchers said it was probably too brief to change their habits over the long run.
This type of approach "is based on the assumption that one size doesn't fit all" when it comes to health messages, said Mia Lustria, who studies web interventions at Florida State University in Tallahassee but wasn't involved in the new research.
"You use specific information about the person and you craft the message so that they can relate to this more, to speak to their attitudes and their beliefs more directly," she said.
While computer programs can surely be beneficial in terms of supporting healthy lifestyle changes, Lustria added, "We shouldn't look at this as the end-all and be-all."
The new study involved close to 900 students at 20 schools in the Netherlands. Half of the 12- and 13-year olds acted as a comparison group, while the rest completed eight computer sessions over a few months.
Each session was on a different health topic -- including sugary drinks, fruits and vegetables and sports participation. They taught kids about the benefits of eating better and exercising more, and included a survey on their own health habits and whether or not they wanted to improve them. The program then helped them create a plan on how they would make positive changes and who would support them.
After four months, kids who had gone through the program, called FATaintPHAT, reported drinking fewer sugary drinks and eating fewer snacks and slightly more veggies than kids who didn't. In general, there was little difference in how much exercise students got after completing the web exercises, researchers reported Monday in the Archives of Pediatrics & Adolescent Medicine.
Two years later, a similar number of kids in both groups -- between 16 and 18 percent -- were overweight or obese, and there was no difference in their average body mass index (a measure of weight in relation to height) or the size of their waists.
Study author Nicole Ezendam, then with the Erasmus University Medical Center in Rotterdam, pointed out that the students didn't have any additional reminders of the information they learned in each session. And they might not have had a supportive environment to make changes in their daily lives either.
Schools could improve that by adding more gym classes and improving food in the cafeteria, for example, she said.
To create long-term changes in adolescents' health, schools need to focus on "building a society which supports healthy behavior," Ezendam, who has since moved to Tilburg University, told Reuters Health. "The intervention that we developed and tested can be one element within such as society. We need a whole society which is supportive."
"The tailored intervention itself is a tool and it's a supplement to a more holistic approach to changing these behaviors," Lustria agreed.
And, she said, the program may simply need to last longer. "I think to increase the efficacy of these types of interventions it's important to continue to be engaged in it beyond eight (sessions), so you learn the skills and techniques and stay motivated that way," she told Reuters Health.
Still, "The results are quite encouraging," she concluded. "Health behaviors to begin with are very hard to change."
"We're still really early on in the field of electronic health interventions," said Gary Bennett, who studies obesity prevention at Duke University in Durham and wasn't involved in the new study.
"We've got a lot of kids who are overweight who are at risk for obesity who really need treatment and for whom approaches like this may work," he told Reuters Health.
One way to improve long-term health outcomes with technology, he said, may be adding mobile apps that give kids up-to-the-minute feedback on what they're eating and how much they're exercising.
"Engagement is really the name of the game," Bennett said.
SOURCE: http://bit.ly/voFuwg Archives of Pediatrics & Adolescent Medicine, online November 7, 2011.
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