title: Short message service reduces dropout in childhood obesity treatment: a randomized controlled trial.
abstract: OBJECTIVE
  Lifestyle programs can reduce the level of overweight in children; however, maintenance results and adherence to treatment are difficult to achieve. New technologies, such as the Short Message Service (SMS), might be a promising tool for enhancing interventions. The effect of an SMS approach aimed at improving treatment results and reducing dropout rates in a pediatric lifestyle intervention, is explored.
  
  
  METHODS
  Overweight and obese children (N = 141; age 7-12 years) participating in a lifestyle program were randomly assigned to an intervention group receiving an SMS Maintenance Treatment (SMSMT) for 38 weeks (n = 73) or to a control group receiving no SMSMT (n = 68). Children were asked to send weekly self-monitoring data on exercise, eating behavior, and emotional well-being. In return, they received tailored feedback messages. A differential decrease in BMI was analyzed with repeated measures ANOVA and dropout with logistic regression analysis.
  
  
  RESULTS
  We found no significant difference in BMI decrease between the two groups after 12 months; however, we showed that the SMSMT group had 3.25 times less probability of dropping out after 1 year (p = .01) than controls. In the first 3 months of SMSMT, the SMSMT completers sent 0.80 SMSs per week, which reduced to 0.50 SMSs in the final 3 months. Younger children sent more SMSs (p = .03).
  
  
  CONCLUSIONS
  These results indicate that SMSMT is effective in reducing dropout rates from a pediatric lifestyle intervention. Future research should examine the effectiveness of SMSMT on weight management and related psychosocial variables.
authors.affiliation: Department of Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre, Rotterdam, the Netherlands. judithdeniet@live.com
authors.forename: Judith
authors.initials: J
authors.lastname: de Niet
authors.forename: Reinier
authors.initials: R
authors.lastname: Timman
authors.forename: Stephanie
authors.initials: S
authors.lastname: Bauer
authors.forename: Erica
authors.initials: E
authors.lastname: van den Akker
authors.forename: Cora
authors.initials: C
authors.lastname: de Klerk
authors.forename: Hans
authors.initials: H
authors.lastname: Kordy
authors.forename: Jan
authors.initials: J
authors.lastname: Passchier
mesh_terms: D015992:Body Mass Index; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009765:Obesity / Q000517:prevention & control*; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D060145:Text Messaging; D016896:Treatment Outcome