Endocrine Abstracts

NHS England has established several Complications from Excess Weight (CEW) services. Despite physical activity (PA) being an integral part of successful weight management programmes, the capacity to offer an effective PA program within CEW services could be limited by resources. The aim of the study was to assess the feasibility of embedding an exercise specialist led, mobile health (mHealth) technology supported, PA and exercise intervention (MOTIVATE-CEW) to a CEW service. A 12-week feasibility, parallel group, randomised control trial was conducted in 23 adolescents with obesity (m/f n=10/13, age 15±1y, SDS BMI 3.54±0.54) receiving care from Alder Hey Children’s Hospital (AHCH) CEW service. Participants were randomised to usual care (UC, n=11) or UC plus MOTIVATE-CEW (n=12). Participants receiving MOTIVATE-CEW co-designed a personalised progressive exercise and PA programme alongside an exercise specialist. The intervention was facilitated by mHealth technologies (smart watch, mobile app and coach’s platform), which enabled remote exercise sessions and feedback guided by biometrics. A mixed method process evaluation assessed reach, dose and fidelity, and preliminary effectiveness was measured (health-related quality of life (HRQOL), body composition and cardiovascular disease risk factors). 45% of eligible participants were recruited and 87% completed post-intervention assessments. Recruited participants shared similar demographics to the AHCH CEW cohort for age, sex, and deprivation. A large effect size favouring MOTIVATE-CEW was observed for time spent completing moderate-to-vigorous intensity exercise per week (MOTIVATE-CEW 97±127mins, UC 5±12mins; d= 1.01), captured through optical heart rate monitoring. Qualitative perceptions of MOTIVATE-CEW were positive, key facilitators included regular personalised advice from an exercise specialist and the creation of graded action plans with specific behavioural goals. Data availability for in-clinic outcomes was good (≥85%). Preliminary evidence of moderate-to-large effects in favour of MOTIVATE-CEW were observed for HRQOL (EQ-5D-Y visual analogue scale; d=0.80), HDL cholesterol (d=0.67) and triglycerides (d=0.62). MOTIVATE-CEW demonstrated positive effects on exercise behaviour, suggesting that the addition of exercise specialists supported by mHealth technologies to CEW services would be an effective strategy to improve engagement in exercise and PA. Good reach and data availability suggests this study design is feasible for future trials.