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Imagine turning the tech era's most annoying invention voice-response telephone systems into something good.
Researchers say they did exactly that in a study on the use of interactive-voice response counseling to offer nutrition tips to families with obese children.
Although children started out with roughly similar body mass index (BMI) scores, those whose parents completed at least six interactive voice-response counseling calls ended the study with slightly lower BMIs than children in the two other intervention groups did.
"I don't think anyone loves automated phone calls," said lead author Paul Estabrooks, an associate professor in human nutrition, food, and exercise at Virginia Polytechnic Institute and State University. "The difference is we're calling with information they want and information that is tailored toward them. It's a smart system."
After parents used the voice-activated system, children "did not gain weight at the same rate," he said. "It's tough to put that into pounds. The idea is that this group has a trajectory. What we managed to do is stop that and decrease it slightly."
Three approaches studied
The study, in the January issue of the American Journal of Preventive Medicine, involved 220 parent-child pairs receiving care from Kaiser Permanente Colorado. The children were all obese or overweight. The researchers assigned families randomly to three groups. One group received a workbook designed to help children increase physical activity and consumption of fruits and vegetables. Another group received the workbook plus two small-group sessions with a dietitian. The third group received all of the above, and 10 counseling sessions using interactive voice response technology.
The no-counseling groups reduced consumption of sugared drinks by 26-28 ounces per week after a year. In comparison, the group that also had phone counseling showed a decrease of 36 ounces per week.
Children in all groups slightly increased their daily servings per day of fruit. Changes in physical activity were hard to gauge, because many children refused to wear an accelerometer to measure how much they moved.
Alice Ammerman, DrPH, director of the Center for Health Promotion and Disease Prevention at the University of North Carolina at Chapel Hill, says, "We have to attack obesity in many different ways." The phone intervention "is one piece of that."
With the price of gas and the economic downturn, "it's harder and harder to get people to come out to clinics," Ammerman says.
Ellyn Satter, a family therapist and registered dietician, says, "This is a creative approach that might turn out to have some utility." However, Satter added, "I just wish it hadn't been applied to such a negative intervention." Her objection: "If you identify a child as overweight and teach parents food restrictions, both parents and children become food preoccupied," Satter said. "It's surprising the children didn't gain weight."