Conclusions
Obesity, overweight, Stroke, Diabetes
OBESITY, OBESE, STROKE, SECONDARY, CROSS, DIABETES, HEART, CHILDHOOD OBESITY
In summary, the Aim2Be trial was not effective in improving zBMI, PA, diet, or screen time over a 3-month period among overweight and obese Canadian children compared with those of a waitlist control group. However, secondary analyses revealed some beneficial effects of the intervention among waitlisted control participants who experienced a decline in zBMI and discretionary calories after receiving app access compared with those from before receiving app access. Future studies should explore the mediators of changes in lifestyle behaviors and identify strategies to increase app user engagement with the “active ingredients” of interventions.The authors would also like to thank the parents, caregivers, and children who participated in the study and the individuals and organizations who disseminated information about the study to their families. The authors also acknowledge Ayogo Health Inc, who contributed financial and technical resources to this project. Aim2Be was developed and powered by Ayogo’s Empower platform. The Childhood Obesity Foundation received funding, in part, from the Public Health Agency of Canada with matched financial and in-kind funds from Ayogo Health Inc (Aim2Be developer), Merck Canada Inc, Heart and Stroke, Obesity Canada, Diabetes Canada, Dietitians of Canada, Canadian Society for Exercise Physiology, Craving Change, David Suzuki Foundation, and the Pacific Blue Cross Foundation. Supplemental funding was obtained from a Team Grant in Bariatric Care (Team to Address Bariatric Care in Canadian Children—Team ABC3) from the Canadian Institutes of Health Research (Institute of Nutrition, Metabolism, and Diabetes), Alberta Health Services, Alberta Innovates, Obesity Canada, the Ontario Ministry of Health and Long-Term Care, and the Women and Children’s Health Research Institute. LM received salary support to conduct this research from the British Columbia (BC) Children’s Hospital Research Institute. OD-JG received a postdoctoral salary from the University of British Columbia and PhD scholarships from the National Council of Science and Technology (Conacyt) of Mexico and from Universidad Iberoamericana of Mexico City. CNT-L received a postdoctoral fellowship from the Canadian Institute of Health Research. EJB received a postdoctoral fellowship from BC Children’s Hospital Research Institute. GDCB received funding from the Alberta Health Services Chair in Obesity Research.Authors' Contributions: LM, J Hamilton, J Ho, AB, KM, and GDCB designed the Aim2Be RCT with LM as the lead. LM oversaw the data collection. CNT-L cleaned and processed the collected data. LM conceptualized this study. CNT-L and OD-JG performed analyses. All authors provided input for the interpretation of the data. CNT-L drafted the manuscript with the help of OD-JG and LM. All the authors critically reviewed the drafts of the manuscript. All authors have read and approved the final manuscript.Conflicts of Interest: None declared.CONSORT-eHEALTH checklist (V 1.6.1).Sensitivity analyses exploring 3-month changes in health behaviors between the control and intervention participants who used the app for at least 30 minutes over 3 months.Preteen, teen, and parent app use by time over 3 months.Preteen, teen, and parent engagement with each app feature over 3 months.