Views of adolescent patients and their families on the use of digital technology to support health behaviour change in young people under the care of a Complications of Excess Weight service (Preprint)

Abstract

The increasing prevalence of paediatric obesity presents a major challenge for healthcare services. In England, Complications of Excess Weight (CEW) clinics provide specialist multidisciplinary care for children presenting with co-morbidities of severe obesity. Positive treatment outcomes require the young person and their family to make behavioural changes to improve the child’s health. However, there are many barriers to health behaviour change, particularly for adolescents. Digital technology could be used to enhance the support offered by CEW clinics to adolescent patients to increase the likelihood of successful behavioural change, but little is known about their and their families’ views of this.

We aimed to explore the views of adolescent patients and their families on how digital technology could be utilised by CEW clinics to support health behaviour change.

The study took a participatory design approach. Four focus groups and co-design workshops were facilitated by a cross-disciplinary team of clinicians, academics and technology innovators. Participants were adolescent CEW clinic patients (aged 10-16 years) and their adult family members. Focus groups and workshops explored young people’s health priorities, the barriers and facilitators of health behaviour change, and co-designed ways in which technology could be used to support young people in overcoming these barriers to achieve their health goals. Focus group data were analysed using inductive content analysis, with findings integrated with key co-design workshop outputs.

37 individuals (19 adolescents, 18 family members) participated across the focus groups and workshops. Participants were in favour of the increased use of digital technology by CEW clinics as an adjunct to in-person support. Weight was not mentioned by participants as an important aspect of their health. Instead, mental health, sleep and peer support were identified as the domains in which adolescent CEW patients felt they would most benefit from additional support and participants reported that technology could be helpful in providing this support. Participants expressed a preference for technology able to individually tailor content to the young person’s needs, including relatable peer-produced content. The need for support for both the young person themselves and their family members was highlighted, as well as the need to integrate strategies to maintain engagement with any technological offering.

There is clear potential for digital technology to be used to support the holistic health priorities of young people receiving specialist care for co-morbidities related to excess weight. We plan to use the findings of this study as the basis to begin developing innovative approaches to the use of technology to support this high-need group.