Trial reportJMIR mHealth and uHealth2026
Caregiver App Use and Child Behavioral Adherence in Relation to Obesity-Related Outcomes in an mHealth App-Assisted Childhood Obesity Intervention: Secondary Analysis of a Cluster Randomized Trial.
Trial report in JMIR mHealth and uHealth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
6 authors.
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Abstract
Background: Childhood obesity remains a major public health challenge. Mobile health (mHealth) interventions offer a scalable approach to support behavior change, but their effectiveness may depend on participant adherence. While both caregiver and child adherence are important, few studies have jointly examined caregiver app-use adherence and child behavioral adherence within digital obesity interventions. Objective: This study aimed to evaluate the independent and joint associations of caregiver app-use adherence and child behavioral adherence with obesity-related outcomes in a school-based mHealth intervention. Methods: We conducted a secondary analysis of 684 child-caregiver dyads in the intervention arm of the diet, exercise, and cardiovascular health-children cluster-randomized trial, implemented across 3 socioeconomically diverse regions in China. Caregiver app-use adherence was measured using app-recorded app-use frequency and total usage duration. Child behavioral adherence was assessed through weekly behavior monitoring scores covering diet, screen time, and physical activity. Linear mixed models estimated associations between adherence levels and changes in anthropometric and physical fitness outcomes over 9 months. Results: Higher caregiver app-use frequency and duration were both significantly associated with reductions in children's obesity-related indicators, such as BMI (β=-0.19; Conclusions: In this secondary analysis of an mHealth app-assisted childhood obesity intervention, higher caregiver app-use adherence and child behavioral adherence were associated with more favorable changes in weight status and physical fitness. These findings underscore the importance of coengagement in digital health programs and highlight the potential of app-supported, family-engaged strategies for childhood obesity prevention.
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