Sung-Hyo Seo, Yujin Kim, Yoolwon Jeong
The effectiveness of digital health interventions cannot be explained by modality alone but is shaped by how interventions are structured and integrated. Interventions embedded within interconnected digital, social, and care delivery systems appear more effective, highlighting the importance of system-level design in obesity prevention and management. Future digital health interventions should be designed as adaptive, integrated systems that leverage data and coordinated support across family, school, and healthcare contexts to enhance real-world effectiveness.
BACKGROUND: Digital health interventions for childhood and adolescent obesity have shown mixed effectiveness, with prior studies largely focusing on stand-alone mobile-based approaches. Limited attention has been given to how the structural characteristics of interventions influence outcomes. This study aimed to examine the structural characteristics of contemporary digital health interventions, including wearable devices, artificial intelligence, web-based platforms, exergames, and virtual or augmented reality, and to assess how these factors relate to intervention effectiveness.
METHODS: We conducted a scoping review of digital health interventions beyond stand-alone mobile-based approaches for obesity prevention and management among children and adolescents, following PRISMA-ScR guidelines. Interventions were analyzed using a structured framework across three dimensions: modality, behavioral mechanisms, and integration, along with family engagement and digital role.
RESULTS: Of the twenty-three studies included in the review, ten (43.4%) showed significant or partially significant effects. Interventions incorporating exergame-based modalities, behavioral activation, social support, and family engagement showed higher effectiveness. Hybrid-integrated interventions demonstrated greater effectiveness compared to fully digital or parallel approaches. In contrast, interventions using digital components primarily as adjunct tools showed lower effectiveness.
CONCLUSION: The effectiveness of digital health interventions cannot be explained by modality alone but is shaped by how interventions are structured and integrated. Interventions embedded within interconnected digital, social, and care delivery systems appear more effective, highlighting the importance of system-level design in obesity prevention and management. Future digital health interventions should be designed as adaptive, integrated systems that leverage data and coordinated support across family, school, and healthcare contexts to enhance real-world effectiveness.