Obesity Prevention in Children in Latin America Through Interventions Using Technology

Examples of Use of Technology for Obesity Prevention in Latin America

Though there is a low number of intervention studies focused on obesity prevention in Latin America, several studies using technology have been conducted. A description of 3 such studies is provided in the following paragraphs.

One such study assessed the effect of a comprehensive intervention on weight in schoolchildren in Mexico City. ¹² The intervention consisted of 3 educational in-person sessions with parents and children to promote healthy eating habits and exercise. To reinforce this information, a website presented detailed information on various topics every 2 weeks, such as school snack menus and calculation of BMI in children and adults. In addition, parents received text messages on their mobile phones to further reinforce the information provided. Results of the study were favorable, with BMI Z-scores (BMIZ) in the intervention group decreasing and BMIZ in the control group increasing compared to BMIZ at baseline.

A second study focused on examining the effectiveness of Exergames, a tool involving use of digital games to combat childhood obesity in the school environment in Brazil. ¹³ Schoolchildren from an elementary school were divided into 2 groups, traditional physical education and physical education with use of active virtual games. Results indicated that there were no significant differences in the level of physical activity and motivation between the 2 groups. However, the researchers noted that Exergames have the potential to deliver physical education in a playful, fun, and motivating way, offering children the opportunity to experience unusual sports and activities. ¹⁴

A third study assessed the impact of a web-based intervention supplemented with text messages to reduce cancer risk associated with unhealthy diet, obesity, and sedentary lifestyle, among other factors, in adolescents in Spain and Mexico. ¹⁵ Participants were assigned to receive either exclusively the online intervention, which was based on psychosocial models and the school curriculum, or the intervention supplemented with encouraging text messages. Results indicated that the web-based intervention supplemented with text messages had some impact on risky behaviors and appeared to be useful in controlling overweight adolescents. At follow-up, there was a reduction in overweight in the group receiving the intervention supplemented with text messages. The researchers noted that almost all adolescents, both in Spain and Mexico, had Internet access either at school or at home. ¹⁶

Opportunities for Use of Technology for Obesity Prevention in Latin America

In terms of different types of technology that may be used for obesity prevention among youth in Latin America, mobile phones may be a useful vehicle for delivery of interventions, as there is widespread use in this region. ¹⁷ Text message may be an effective way to reach children and adolescents with educational information related to obesity prevention. Mobile phones have been cited as useful tools for interventions focused on health promotion because of widespread use, tendency to carry phones at all times, and attachment to these devices. ¹⁸ According to the Pew Research Center, a median of 76% of people in emerging and developing markets say they have used their cell phones to send text messages in the past 12 months. ¹⁹ A number of interventions using cell phones to promote healthy behavior have been conducted in diverse populations in the United States,^{20 -23} and the same strategy may be further tested in Latin American youth. There have been studies specifically focused on Latinos in the United States as well, such as research seeking to build a short messaging service for use with Latina adolescents. ²⁴ Of note, a 2013 systematic review of mobile phone–based interventions for health did not identify any studies conducted in Latin America. ²⁵ Additional research is needed in this area, and researchers have noted that the widespread availability of smartphones, tablets, and portable activity devices such as accelerometers presents the opportunity to encourage physical activity and healthful eating, particularly in adolescents. ²⁶

In addition, computer ownership is relatively high in a number of Latin American nations. Majorities in Chile (72%), Venezuela (61%), Argentina (58%), and Brazil (55%) have computers in their homes. ¹⁹ Previous studies conducted in youth in Latin America have indicated frequent use of the Internet and suggest that it is a useful vehicle for delivery of health education. For example, results of a qualitative study on influences on eating habits of adolescents in Lima, Peru, conducted by Banna et al revealed that participants frequently mentioned the television and/or the Internet as part of their daily routine. ²⁷ Nearly all participants stated that computers interested them and that they used the Internet frequently for both schoolwork and social activities. The majority had used the Internet to search for nutrition information and viewed Internet sources as credible. The researchers note that the frequent use of technology in this group is important to consider when designing nutrition education interventions, with computers and mobile phones as potential vehicles for information delivery. ²⁷ Of note, a 2016 systematic review of the effectiveness of e- and mHealth interventions to promote physical activity and healthy diets in developing countries only identified 3 studies in Latin America. ²⁸

Implementation of interventions using technology in conjunction with strategies at the physical environmental and macrosystem levels may prove to be an effective means of combating obesity in youth in Latin America. A recent article highlights some of the challenges present in this region, such as the double burden of overweight and malnutrition, and describes some of the recent policies put in place to combat the obesity epidemic. ²⁹ In designing and implementing educational programs, the complexity of addressing both malnutrition and obesity should be considered, as well as the insights gained from the strategies that have been put into place already.