The Effects of E-Health Management for Weight Control and Metabolic Syndrome Abnormalities in Adolescent Girls

Friday, 25 July 2014

Mei-Chen Su, PhD
Department of Nursing, Department of Nursing, Chang Gung University of Sciences and Technology, Taoyuan, Taiwan
Lee-Ing Tsao, DNSc
School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan

Purpose:

Obesity is increasing at an alarming rate among adolescents. Previous studies have shown that lifestyle modification and weight control can improve all of the metabolic risk factors associated with obesity. Adolescent girls are more likely than boys to have sedentary lifestyles, low levels of physical activity, unhealthy weight-control behaviours, and disordered eating behaviours. The purpose of this study investigated the effects of a 6-month health management platform with Internet-based intervention in overweight adolescent girls in Taiwan.

Methods:

After IRB approval, a longitudinal approach and repeated testing using a quasi-experimental design to evaluate the follow-up outcomes of the e-heath management platform intervention for 137 overweight adolescent girls at two nursing colleges with 5 years associated program. The intervention group (n=62) which were completed 6-month health management platform with Internet-based intervention, consisting of 150+ minutes of regular exercise per week; increasing fruit and vegetable intake to 5+ servings per day; decreasing total fat to <30% of total calorie consumption, tailored graphical feedback was provided; one-on-one psychobehavioral counseling based on constructs from the Transtheoretical Model, and peer-group support, reminder system also included. Participants in the control group (n=75) received the typical health education provided in schools. All participants completed anthropometric and metabolic measures including BMI, waist circumference, BP, HDL, triglyceride and fasting glucose at both the baseline, 3-month and 6-month stages. SPSS version 18.0 software was used to compile and analyze the research data. Descriptive statistics, the chi-squared test, Student t test, and generalized estimating equations were used during analysis.

Results:

The results showed that 3 months after the intervention began, the experimental group demonstrated significant improvements (β = -0.436, p = .004) compared with the results of the control group. Improvements were exhibited in the following risk factors for metabolic syndrome: the body mass index (BMI), waist circumference measurements, HDL levels, and systolic and diastolic blood pressure results. In addition, these outcomes remained statically significant 6 months after the intervention began. Six months after the intervention began, the following intervention outcomes were observed: a decline in fasting blood glucose levels (β = -7.174, p < .001). On average, the body weight of the experimental group than the control group in the 3-month decreased 2.146 Kilogram, in the 6-month decreased 2.460 Kilogram, the results were statistically significant (p <.05). The frequency of using the food and exercise diaries was negatively correlated to changes in the risk factors for metabolic syndrome (i.e., BMI and waist circumference measurements and triglyceride levels), but was positively correlated to changes in HDL levels. The frequency of using the website was negatively correlated to changes in the risk factors for metabolic syndrome (i.e., waist circumference measurements and systolic blood pressure and triglyceride levels).

Conclusion:

The 6-month health management platform with Internet-based intervention had positive effects on reserve the markers of metabolic syndrome in overweight adolescent girls. By using the Internet, which is not bound by time and space, this model is the most effective self-health management method for young people. Continued follow up may be required for long-term maintenance in lifestyle behavior change.