Twelve-month effectiveness of telephone and SMS support to mothers with children aged 2 years in reducing children's BMI: a randomized controlled trial

Li Ming Wen; Huilan Xu; Philayrath Phongsavan; Chris Rissel; Alison Hayes; Sarah Taki; Limin Buchanan; Lisa Simone; Renee Moreton; Louise A Baur

doi:10.1038/s41366-023-01311-7

Twelve-month effectiveness of telephone and SMS support to mothers with children aged 2 years in reducing children's BMI: a randomized controlled trial

Int J Obes (Lond). 2023 Sep;47(9):791-798. doi: 10.1038/s41366-023-01311-7. Epub 2023 Apr 22.

Authors

Li Ming Wen^{1

2

3

4}, Huilan Xu^{5

6}, Philayrath Phongsavan⁷, Chris Rissel^{7

8}, Alison Hayes^{7

9}, Sarah Taki^{5

7

9

6}, Limin Buchanan^{5

6}, Lisa Simone⁵, Renee Moreton¹⁰, Louise A Baur^{7

9

11}

Affiliations

¹ Health Promotion Unit, Population Health Research & Evaluation Hub, Sydney Local Health District, Sydney, NSW, Australia. LiMing.Wen@health.nsw.gov.au.
² Sydney School of Public Health, Faculty of Medicine and Health, and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia. LiMing.Wen@health.nsw.gov.au.
³ NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH), Sydney, NSW, Australia. LiMing.Wen@health.nsw.gov.au.
⁴ Sydney Institute for Women, Children and Their Families, Sydney Local Health District, Sydney, NSW, Australia. LiMing.Wen@health.nsw.gov.au.
⁵ Health Promotion Unit, Population Health Research & Evaluation Hub, Sydney Local Health District, Sydney, NSW, Australia.
⁶ Sydney Institute for Women, Children and Their Families, Sydney Local Health District, Sydney, NSW, Australia.
⁷ Sydney School of Public Health, Faculty of Medicine and Health, and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
⁸ College of Medicine and Public Health, Rural and Remote Health, South Australia and Northern Territory, Flinders University, Bedford Park, SA, Australia.
⁹ NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH), Sydney, NSW, Australia.
¹⁰ Population Health, Sydney Local Health District, Sydney, NSW, Australia.
¹¹ Specialty of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.

Abstract

Background/objectives: Few quality intervention studies have assessed whether a combined telephone and short message service (SMS) intervention to mothers is effective in reducing BMI and obesity risk behaviors of children at 3 years of age. This study aimed to assess effectiveness of telephone and SMS support in reducing children's body mass index (BMI) and obesity risk behaviors.

Subjects/methods: A randomized controlled trial (RCT) with 662 women of 2-year-old children (with the proportion of overweight and obesity being similar to the general population) was conducted in Sydney, Australia, March 2019-October 2020. The mothers in the intervention group received three telephone support sessions plus SMS messages and mailed-intervention-booklets over a 12 months period i.e., 24-26, 28-30, and 32-34 months of the child's age. Mothers in the control group received usual care and two mailed booklets on information not related to the intervention. The primary outcome was child's BMI at 3 years of age. Secondary outcomes were children's dietary and activity behaviors. All outcome measures were based on mothers' self-report using standardized tools due to COVID-19 pandemic restrictions.

Results: 537 (81%) mothers completed the post-intervention assessment at 3 years with only 470 (71%) children having weight and height measures. Multiple imputation analysis showed no statistically significant difference in mean BMI between the groups. Children in the intervention group were more likely not to eat in front of the TV [AOR 1.79 (95% CI 1.17-2.73), P = 0.008], more likely to meet the dietary recommendations [AOR 1.73 (95% CI 0.99-3.02), P = 0.054] and meet the activity recommendations [AOR 1.72 (95% CI 1.11-2.67), P = 0.015] than those in the control group respectively. Among those with an annual household income (<AUD$80,000), the intervention was significantly associated with a lower mean BMI [16.26 (SD 2.22) kg.m^-2] in the intervention group than [16.84 (SD 2.37)] in the control, a difference of -0.59 kg/m² (95% CI: -1.15 to -0.03, P = 0.040).

Conclusions: A staged telephone and SMS support intervention to mothers with children aged 2 years was associated with improved dietary and activity behaviors. The intervention was also associated with reduced children's BMI at age 3 years only for those from lower income households.

Trial registration: The trial is registered with the Australian Clinical Trial Registry (ACTRN12618001571268).

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Australia / epidemiology
Body Mass Index
COVID-19*
Child, Preschool
Female
Humans
Mothers*
Obesity / epidemiology
Telephone
Weight Loss

Associated data

ANZCTR/ACTRN12618001571268